Heathlands Care Centre

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met. At our last inspection the provider was in breach of legal regulation in relation to person centred care. At this inspection we found some improvement had been made and the provider was no longer in breach of this regulation. However, there was a breach of legal regulation in relation to ensuring robust management oversight of the service and the failure to ensure the support people received was personalised.

This service scored 46 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. Whilst staff were polite to people they were supporting, the approach appeared transactional rather than personalised. We did not hear staff chatting with people or spending time with them on a more social level. For example, staff made welfare checks for those people who needed or preferred to spend time in their rooms. However, people told us care staff did not stay to chat with them and we observed this to be the case. One person told us, “It would be nice to have some company, but I can’t get out to sit in the lounge so can’t see them.” When staff were supporting people with tasks such as eating or drinking they did not make conversation and appeared bored in their body language. Very few people or relatives knew the names of any staff members working at Heathlands.

Care plans varied in the level of detail and guidance regarding how people preferred their care. Some people had detailed guidance which reflected people’s preferences well. For others there was a lack of information regarding how people wanted their care and what was important to them. Care plans were reviewed monthly or following any changes. The original content of people’s care plans was not always changed which meant some people’s care records appeared contradictory and staff did not have access to the most important and current information first. One person told us that whilst they preferred to stay in their room, they felt they needed to have a short walk each day and their GP had advised this. They told us, “(Relative) came to an agreement with them, that I would be helped out each day, but promises don’t always come to fruition, certainly not today, I didn’t get my walk and I should have some exercise.”

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. We received mixed responses regarding how the service worked alongside health professionals. One relative told us of an incident when their relatives health condition had not been reported to the GP despite staff being aware. They described this had caused their relative to change their routine and caused anxiety for the family. Other people told us they were extremely happy with the way they were looked after. One person said they had been to a hospital appointment that day and told of their gratitude to the staff member who had accompanied them.

Records and observations showed there was a lack of consistency in relation to how health related was support was provided. We found there was little communication with the diabetes support team despite one person’s blood glucose levels regularly being outside the desired levels. When we spoke to nursing staff regarding this, they told us they were professionals and knew what to do. This did not demonstrate an understanding of the additional support available from specialist healthcare teams and the importance of this in managing specific conditions.

In other instances, we found people were supported with their health and social care needs well. Referrals had been made to the intensive support team for a number of people who were experiencing high levels of anxiety. One relative had told us they had seen improvements in how the staff supported their relative as a result of the guidance they had received from this team.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s care records did not contain guidance in relation to how they would prefer information to be presented in line with the Accessible Information Standard (AIS). This is a requirement of publicly funded providers to meet the information and communication needs of people with a disability or sensory loss. Whilst communication plans were in place for people, these did not always contain clear guidance for staff, particularly in relation to the sensory needs of those people living with sight or hearing impairments.

Support was provided to people whose first language was not English to enable them to make choices. This included the use of flash cards; menu’s being translated and staff learning key words that were relevant to the person. We observed some staff having conversations with people in their first language. Signage around the home was very clear and supported people to access all areas of the home. Signs were large and bright and contained both pictorial and written descriptions.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result. Relatives told us they were not always involved in the care planning process. One relative told us, “We weren’t really involved, not in an official way. I think we were phoned up at the start and asked a few questions but that is all”. Other comments made by people such as being able to make choices regarding how they preferred their care reflected people were not fully involved in their care or planning the routines of the home.

The manager told us they had recently held their first residents and relatives meeting since coming into post which they felt had gone well. A board was displayed in the hall which stated what people and relatives had said at previous meetings and what had been done in response. For example, the board stated people had requested more activities and outings and in response the board stated the service provided more outings, activities and summer trips. As the inspection took place in December, this indicated this request, and action was from some time ago. No one we spoke with mentioned the opportunity to go out on trip and the manager told us people having the opportunity to go out was something they needed to work on as this was not currently happening.

The provider had a complaints policy in place which was accessible both in the home and on the service website. A relative told us they had recently raised concerns with service and felt these had been acknowledged and action taken to minimise the risk of the issue happening again.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. People living with sight or hearing impairments did not always receive the support they required in relation to this. One relative told us, “I don’t like to complain but two hearing aids have got lost and one was found in someone else’s room. We have asked for [relative’s] ears to be syringed. [Relative] is deaf, and [they] can’t go to the music sessions because [they] can’t hear. [Relatives’] glasses have been lost too. Last week when we came [they] were wearing someone else’s glasses.”

In other instances, we found people had equity in accessing support in line with their needs. People had access to the equipment they required to keep them safe and comfortable. One relative told us their loved one was able to spend more time in the lounge area which they enjoyed due to having a chair which they could sit in for longer periods. The person could also be transferred between their bedroom and lounge whilst in their chair. This reduced the number of times they needed to be supported using the hoist which they could find distressing. We observed a number of people were supported using similar chairs.

People and their relatives told us there were no restrictions on when people could receive visitors. Relatives confirmed they were made to feel welcome in the home.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. We observed this was particularly the case for people who were living with dementia and were cared for mainly in their rooms. Staff had little time to spend with them outside providing their care and people were left for long periods with no interaction or stimulation. We reviewed care records for one person which gave no information regarding if they preferred to have their television on, if they preferred music, the radio or enjoyed being quiet. There was no evidence consideration had been given to how people in this situation would be protected from the risk of social isolation.

In general people and their relatives felt the experience and outcomes of their care had improved since the new manager had been in post. Although not everyone attended activities, people we spoke with told us they appreciated the efforts of the activity co-ordinator in planning events.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Whilst people did not express any concerns regarding how staff supported them with planning for the care they wished to receive at the end of their life, care plans did not always include information regarding their wishes. Where information was recorded this lacked personalised detail regarding what was important to people.

No one was receiving end of life care at the time of our inspection. However, staff told us they felt they had the skills and understanding to provide people’s care at this time and ensure they were pain free. Training records showed staff had received training in supporting people at this time of their life.

The manager showed us letters of thanks from relatives regarding how staff had supported their relative at the end of their life.