Heaton House Care Home

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 remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulations in relation to record keeping.

This service scored 58 (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 was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider completed assessments prior to people’s admission, to ensure the home was suitable and could meet their needs. Where necessary relatives were also involved in this process. Upon admission, additional information was sought, to ensure assessments reflected people’s current needs and wishes. During the assessment we observed a staff member meeting with the family of a recent admission to discuss this person’s likes, dislikes and gather more details on their life history, to help compile their care records.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

At the last assessment in January 2025, we noted each person had a daily fluid target. However, as fluid charts had not been completed consistently, there was no evidence to show people had been offered this amount each day. At this assessment, we found the completion of fluid charts was much more consistent, however, the provider had removed daily fluid targets from people’s care records. As a result, staff did not have guidance on how much to offer people each day. British Dietetic Association guidance indicates older men should drink up to 2000 millilitres a day, older women 1600 millilitres a day. Fluid charts showed these amounts were not being offered, nor consumed. Where good hydration had been identified as important in people’s care records, there was no guidance for staff on what to do, if this was not achieved.

Staff also documented people’s nutritional intake using food charts. For 1 person requiring a modified diet, food charts indicated a number of meals / foods had been provided, which were contrary to modified dietary guidance, such as curry and rice, jacket potato and pies. This person had been assessed by a Speech and Language Therapist, who had agreed this person could have sandwiches provided the crusts were removed and they contained no meat filling. However, whenever sandwiches had been provided, food logs did not indicate crusts had been removed, nor what the filling had been. We observed this person’s diet during 2 of our 3 site visits and noted food was provided in line with guidance, which suggested record keeping was the issue.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider worked with healthcare professionals to make sure people received appropriate support for all their care and support needs. Care records detailed which professionals had been involved with people and any advice provided.Team working between staff was effective. They shared information and updates about people with each other to ensure a consistent approach with how care and support was provided to people.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People received support to stay well and access medical professionals as and when required. One person stated, “If we are unwell, then they will call a doctor. I have no complaints.”

Staff knew people well, which included understanding things which could affect their wellbeing. One person told us, “I am allergic to a number of things, but they [staff] know me off by heart and make sure they don’t give me these things.” An exercise class was held on a weekly basis, which people enjoyed attending, telling us they benefited from keeping moving, and would enjoy doing this more.

During one of our site visits, a medical emergency occurred in the home. Staff dealt with this calmly and professionally and ensured the person’s privacy and dignity was respected. Medical attention was sought promptly, with management taking a lead whilst waiting for paramedics to arrive.

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

Monitoring of care and completion of certain care tasks and/or clinical recording was inconsistent. One person had not been weighed since May 2025, despite their care plan stating this was to be done monthly. Another person should have been weighed weekly, due to risk of unexplained weight loss, however had only been weighed 7 times since June 2025.

Daily foot checks should have been completed for a person with diabetes; however, we found no evidence of this within their care records.

People’s risk of malnutrition was assessed via the Malnutrition Universal Screening Tool (MUST), which is a widely used system to help identify adults at risk of malnutrition and ensure timely action is take where necessary. The MUST tool allocates people a score which signifies the level of risk, 0 being a low risk of malnutrition, 3 or above being high risk. Within 1 person’s care records, it stated their current MUST score was 0, 1 and 4. The actions required for a person scoring 0 and one scoring 4 are significantly different.

One person was at risk of skin breakdown and due to being unable to move themselves when in bed or sat in a chair, required staff to complete regular repositioning. This person’s care plan stated this should be done every 2 hours. Based on records provided, repositioning was not being done in line with guidance. Between the 29 November 2025 and 4 December 2025, only 11 instances had been documented, rather than the expected 60. This person’s skin was intact, with no redness evident, which suggested this was a record keeping issue.

The provider did not always tell people about their rights around consent and did not always ensure they adhered to the Mental Capacity Act 2005, when people lacked capacity to provide consent.

Each person’s care records included a consent form, which covered the provision of care, use of person’s photograph and for staff to administer medicines. We reviewed these documents for 5 people and found none of them had been signed by the person themselves, just a staff member. As such, there was no evidence to show these people had provided their consent. Where people lack capacity to consent and haven’t legally appointed someone to do so on their behalf, any decisions need to be done via the best interest process. There was no evidence to show this process had been followed for any of these 5 people.

The provider shared examples of when the best interest process had been used to make decisions where people lacked capacity, for example the use of bed rails to maintain a person’s safety. However, we noted only staff members had been involved in the decision making, with no indication others’ opinions had been sought, such as family members, social workers or the GP, which is contrary to the Mental Capacity Act 2005 code of practice.

People told us staff verbally sought consent prior to providing care, and we observed this occurring during our site visits.