Heathlands Care Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment, we rated this key question requires improvement. At this assessment, the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

At our last inspection, the provider was in breach of Regulation 17 (Good Governance), which relates to management oversight rather than the Effective key question. At this inspection, although improvements had been made, the provider remained in breach as increased oversight was still required in how the Mental Capacity Act 2005 was implemented and how people’s goals and aspirations were monitored.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment were effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People’s needs were assessed before moving to Heathlands Care Centre to ensure the service could meet them. Information was gathered in areas such as people’s mobility, health, personal information and risks to their safety and well-being. People and their families confirmed they were involved in the assessment process and felt their views had been listened to. Due to concerns identified during our previous inspection, the manager told us they had also sought agreement from the local authority before anyone moved in. They told us, “As the service is still developing, we want to ensure staff have the skills to support the needs of anyone who comes to us. After an assessment, this is discussed with the nurses, so everyone is in agreement.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The service had implemented a number of best-practice tools with assistance from the Care Home Support Team. These included health monitoring systems to detect changes in people’s health and help staff determine what action to take. Observations taken as part of this process were also shared directly with the GP to enable them to respond to any concerns. People’s weight was monitored regularly, and recognised tools were used to assess if people were at risk of malnutrition. Where concerns were identified, referrals were made to review people’s health and nutritional intake. Assessments were also used to monitor and address risks to people’s skin integrity. Where people were at risk of choking, staff were aware of how to prepare their food to the correct consistency in line with internationally recognised guidance.

The provider worked well across teams and services to support people. They made sure people’s needs were shared with other services where appropriate.

We observed that staff worked together and communicated well to help ensure people’s safe and effective care. Staff told us they appreciated the systems the manager had implemented to support them in their roles. This included regular monitoring of people’s care, such as when people were repositioned, food and fluid and personal care needs. One staff member told us, “The manager has brought lots of changes. We feel we are now giving the proper care, and everything is done on time by working as a team.”

Due to the concerns highlighted during our previous inspections, the local authority had employed a consultant to spend 3 days each week at the service. In addition, a range of professionals also supported the service and provided additional oversight. Staff and the management team reflected that this additional support had been instrumental in bringing about the changes in the service.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. People told us requests for appointments and referrals were made to health care professionals as required. One person told us, “If I need to visit the dentist, the home arranges that for me.” One relative told us, “They have been very good with the medical side of things and arranging appointments.”

Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. People were supported to have a healthy lifestyle in line with their wishes. Regular exercise groups were held, and we observed that these were well attended. The manager told us the menu was continually updated and that they ensured there were healthy options available, including fresh fruit and vegetables. Support was available to lose or gain weight, where this was identified as something people wished to have support with.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met people's expectations.

Outcomes and goals were recorded within people’s care records and improvements were seen since our last inspection. However, we found records of people’s goals and aspirations often lacked personalisation and did not reflect discussion with the person, or their families, that had taken place. The manager told us they were aware this was an area which needed continued development and that they were working with staff to ensure people’s care plans and desired outcomes were person-centred and reflective of the individual. Despite these concerns, we observed staff supported people in a person-centred and respectful way.

The provider did not always tell people about their rights regarding consent and did not always respect their rights when delivering care and treatment.

There were instances in which the principles of the Mental Capacity Act 2005 were not followed, resulting in people’s rights not being respected. We observed that several people had sensor alarms fitted to alert staff if anyone crossed the threshold of their door. Whilst capacity assessments and best interests decisions had been completed for some people, this was not the case for all those with an alarm fitted. There was also a lack of information regarding how support should be provided in the least restrictive way to people who had one to one staff support throughout the day.

In other areas, we found capacity assessments had been completed for specific decisions, and best interest decisions had been made with the involvement of those who knew the person best.

We observed staff sought consent and discussed people’s preferences prior to providing care and support. People confirmed this was always the case and their preferences were respected. One person told us they did not like to be checked on when they were in their room. They told us, “The carers all do their best to look after me. I give them credit, they are not in and out all of the time, which is what I prefer.”