Heyberry House

During our visit, we found the following examples of good practice.

At the time of our visit, the home had just closed to visitors due to an outbreak of Coronavirus. Prior to this, excellent provisions were in place to ensure visitors were safe to enter the home to see their loved ones. For example, there was a designated area for visitors to visit their loved ones; they were required to have a negative Coronavirus test on site and wear a facemask. Social distancing was maintained at all times.

The provider has also assessed and considered the impact on people’s emotional well-being on not being able to have visitors. This was good practice. In response to this, the provider had acted proactively to ensure that visitation was facilitated as much as possible to protect people’s mental health. For example, where people could not meet their loved ones in the designated area, arrangements had been put in place for them to maintain contact by alternative means. For instance, by permitting a visit in the person’s own bedrooms with appropriate safety precautions in place or through the use of social media.

Prior to the outbreak, any new people admitted to the home were required to have negative COVID-19 test and, a 14 day period of isolation following admission. This process adhered to government guidelines on care home admissions.

Due to the outbreak, people living in the home were self-isolating in their bedrooms and staff were taking appropriate precautions to maintain their safety. There were systems in place to maintain good infection control standards and regular checks were undertaken. Staff had sufficient supplies of personal protective equipment (PPE) to protect them and others from risk and clinical waste was disposed of in accordance with government guidelines to prevent cross contamination.

Staff members were tested weekly for COVID-19 and people living in the home monthly in accordance with government guidelines. People living in the home and staff had been offered the COVID-19 vaccination and had received their first of two vaccinations.

Staff who had tested positive were isolating at home. The provider had sufficient staff to support people living in the home without the use of agency staff. Staff returning to work following a period of isolation were risk assessed and supported appropriately.

Heyberry House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

Heyberry House provides personal care and accommodation for up to 41 older people. Nursing care is not provided. At the time of the visit 38 people lived at the home.

The home is a purpose built facility set in its own grounds in the area of Birkenhead, Wirral. The home is decorated to a good standard throughout with accommodation provided across three floors. A passenger lift enables access to the bedrooms located on the upper floors. All bedrooms are single occupancy with en-suite facilities. Specialised bathing facilities are also available on each floor. On the ground floor, there is a communal lounge, dining room and conservatory for people to use.

There was no registered manager in post at this visit. This was because the previous registered manager had achieved a promotion within Anchor Trust and had commenced in a new role. A new manager for the home had been appointed and they were in the process of registering with CQC.

A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

We looked at the care files belonging to five people who lived at the home and saw that in the majority, their needs and risks were assessed. Risks in relation to some people’s health needs required further detail to give staff sufficient guidance on how to meet these needs appropriately. People’s daily care records which recorded people’s food and fluid intake and the personal care they had received had not always been properly reviewed. We spoke with both the regional manager and manager about the above issues. They assured us these issues would be addressed immediately.

Care plans contained person centred information. Where people lived with dementia, information about how this condition impacted on their day to day life was limited. We saw there was some good practice with regards to the implementation of the Mental Capacity Act 2005 but this required further development to ensure it was routinely applied. People’s choices were reflected in their care plans and daily records showed people’s consent was sought before support was provided. People told us they were able to choose how they lived their life at the home and that staff respected this.

We saw that people were able to express their views and suggestions about the running of the service through regular resident meetings. Records showed these meetings were inclusive and that people’s suggestions were acted upon where possible.

People told us they felt safe at the home and that staff were kind, caring and compassionate. They said their needs were responded to promptly and that whenever they asked for help, staff were always on hand to provide it. It was clear that people thought highly of the staff team and no-one had any concerns or complaints about their care. Relatives were as equally complimentary.

Medicines were managed safely and people received the medication they needed. People had access to a range of health and social care professionals in support of their needs including routine health appointments such as GP visits, dentists and opticians. People received enough to eat and drink and we saw that mealtimes were a sociable and enjoyable event.

There were a range of social and recreational activities provided. The activities we observed on the day of our visit were well-attended and people looked like they were having a good time with staff. Activities were promoted positively on a colourful noticeboard and there were lots of different things to choose from each day. Interactions between people and staff were positive and the home had a warm, homely atmosphere. We observed that staff treated people kindly, with respect and supported them at their own pace.

There were a range of quality assurance systems in place to assess the quality and safety of the service. People’s satisfaction with the service was sought through the use of a satisfaction survey and everybody’s feedback was overwhelmingly positive. The home was well led, open and transparent and the people and relatives we spoke with were more than happy with the care provided.

Is the service safe?

We spoke to three people who lived at the home. They said they felt safe with staff and had no worries or concerns. We spoke to one relative who said 'I feel happy when I come into the home, I don't worry about them at all. It's a happy place'. A safeguarding policy and procedure was in place to advise staff what they should do if they suspect abuse and staff received regular training in safeguarding. We spoke to two staff members who both demonstrated a good understanding of types of abuse and how to protect the welfare of vulnerable people.

Is the service effective?

The people who lived at the home and the relative we spoke with told us they were given a choice as to how they lived life at the home. They told us staff always sought their consent before support was provided. People's comments included 'They always ask if I want some privacy'; 'Staff are great' and 'Very nice'. The relative said 'Brilliant here. Staff are lovely. They don't force them to do anything. They do anything they can do to help'. Care records showed evidence that people and/or their relatives were involved in regular discussions about their care and that they had received the care and support outlined in their support plan.

Is the service caring?

We observed staff supporting people throughout the day. We saw they were kind, attentive and supported people at their own pace. It was clear from our observations and from speaking directly with staff that they had a good understanding of people's care and support needs and knew the people who lived at the home well. When asked if they were well looked after, people's comments included: 'I'm treated very well, no problems whatsoever'; Yes I think so, it's pretty good' and 'They do everything for me'. The relative we spoke to said the care was 'Fantastic'.

Is the service responsive?

Care records were person centred and clearly described people's needs and risks and how these were to be managed. People needs and risks were regularly reviewed and changes made to the support provided as and when required. Care records showed that people who lived at the home were supported to access health and social care services such as GPs, dietetic services, speech and language therapy and mental health support. People we spoke with said staff acted promptly in the event of ill health and checked on their welfare regularly. A range of activities were provided at the home to meet people's social and leisure needs and visitors were made welcome throughout the day.

Is the service well led?

The management team undertook a range of quality audits to ensure risks to people's health, safety and welfare were identified and managed. Quality and safety were also monitored independently from the management team by the provider's regional care and dementia advisor and health and safety officer who undertook regular visits to the home. Regular resident meetings took place and the minutes of the meetings showed people's views and opinions were sought and acted upon by the provider. An external survey was undertaken in 2013 and showed people and/or their relatives were very satisfied with the standard of the service provided.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time of our visit.

'It's a wonderful place"

"Everything here is lovely"

"I think they are very good, very good indeed"

'Never had it so cushy'

We saw that people's needs were assessed and regularly reviewed. Care records were personalised, contained information about a person's individual needs and preferences and promoted the person's independence where possible.

We reviewed the home's staffing arrangements. Staffing was based on the needs of people who lived at the home and adjusted appropriately when needs changed. We found staffing arrangements to be well organised and sufficient to meet the needs of the people living at the home.

We reviewed three staff records and saw evidence that staff were appropriately trained and supported to care for people. We observed people were well cared for and treated kindly. Staff we spoke with talked about the people they cared for with warmth and familiarity.

We reviewed the provider's complaints policy. The complaints policy gave simple concise instructions to people on how to make a complaint. We reviewed a complaint received by the home and saw that it had been logged, thoroughly investigated and responded to appropriately in line with the provider's complaints policy.

We spoke to two visitors who said "I think the care provided is very person centred. People are treated with dignity and respect", "The care staff are excellent", "If I raise a concern then it is dealt with appropriately", "The staff are lovely and the home pristine" and "The food is nicely presented and choices are available."

We spoke to two health care professionals who commented "The staff are very helpful", "The home is clean and odour free", "The staff have been very helpful and caring" and "This home has a nice atmosphere and no unpleasant smells."

We spoke with five staff on duty. They commented "The management team are very supportive", "I enjoy my job", "The staff work well together as a team", "The home is lovely and the residents are very nice", "I like supporting the residents and every day is different" and "It is good to care for people and to treat them with dignity and respect."