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 provider was previously in breach of legal regulation in relation to record keeping. Improvements were not found at this assessment, and the provider remained in breach of this regulation.

This service scored 50 (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’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

There was evidence of people’s needs being assessed when they first moved to the home, however, some care plans lacked important information about people’s care, for example regarding eating and drinking and personal hygiene. An electronic system was used to record care interventions carried out by staff, however, there were lots of gaps where these had not always been clearly recorded.

Information in people’s care plans was not always accurate, complete and up to date. Some care plans contained old or conflicting details. The provider completed monthly care plan audits; however, these were not always effective as they failed to identify the issues and shortfalls found during the assessment process.

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

At our last inspection, staff did not have guidance on how much fluid to offer people each day. At this inspection we found people’s nutrition and hydration needs were still not being met in line with current guidance. We reviewed 12 people’s care records and found the provider had not accurately assessed the nutrition and hydration risks to 6 of these people and had not done all reasonably practicable to mitigate the risks associated with meeting nutritional and hydration needs. Other people’s nutrition and hydration records were satisfactory.

Choking risk assessments for 2 people did not contain information about the type of diet they required, as assessed by SaLT; these guidelines are important because they are designed to help people eat and drink safely, particularly if they have swallowing difficulties.

One person required a level 5 mince and moist diet. This was documented in their latest SaLT guidance, which we were told was the latest document. However, food charts consistently showed they had a soft and bite sized diet which is level 6. For another person, their risk assessment stated they are at risk of choking due to having a poor swallowing reflex, however, their nutrition and hydration care plan stated they were not at risk of choking.

The fluid intake chart for another person stated they had a daily fluid intake target of 2000mls per day. On many occasions this had not been achieved, however, staff had either written within the daily notes the person had ‘Good fluid intake’, or staff had not recorded any intake at all.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

Where required, staff worked alongside external professionals such as GP’s and social workers to ensure care and treatment were aligned. Staff shared information and updates about people with each other to ensure a consistent approach with how care and support was provided.

However, as some people’s care records were not up to date, there was a risk partners or other services would not have an accurate understanding of a person’s needs from the information available and care plans were not always updated to reflect new guidance from partners.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

The provider could not demonstrate people were receiving the full level of food and fluid intake expected for those at higher risk, and to sustain a healthy life; there was an increased risk of avoidable harm. A lack of adequate daily fluids can often lead to dehydration, urinary tract infections, constipation, falls due to weakness, low blood pressure, confusion, and kidney injury or electrolyte imbalance.

The provider did not offer enough opportunities to support people’s physical and emotional wellbeing. People were not encouraged to take an active part in local community activities, which would help them maintain a healthier and more active lifestyle. Throughout the inspection, was saw many people were unengaged and appearing to lack any motivation; we observed 1 person sat at the dining table from morning until after lunch. Another person was still eating Weetabix at 3pm in the afternoon; this person said it was their breakfast.

Feedback from people regarding the quality of food on offer was mixed. One person told us, “The food’s no good; it’s cheap. On Sunday we have a roast dinner and the rest of the time it’s rubbish. I requested sausage and chips today as I don’t like quiche.” A second person said, “The food’s not bad, it’s blended, it’s all done together like a blob. My drinks are thickened.”

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 both clinical expectations and the expectations of people themselves.

At our last inspection, the provider did not routinely monitor people’s care and treatment. At this inspection, although the provider had carried out some monitoring of people’s care and treatment this was not always consistent or effective in driving continuous improvement. We found outcomes for people were not routinely reviewed to ensure they were consistently positive, met relevant clinical expectations, and reflected what mattered to people themselves.

Care records did not always clearly evidence how the impact of care and treatment had been evaluated, particularly when people’s needs changed or risks increased. As a result, opportunities to review effectiveness, learn from outcomes, and make timely improvements were not always taken.

Although some outcome information was collected, this was not always used effectively to inform decision making or service improvement, therefore we were not assured care and treatment were consistently achieving the intended outcomes for people. Although staff used clinical monitoring tools, timely action had not always been taken to address any concerns and improve outcomes for people.

The provider had not fully embedded effective quality monitoring arrangements, and some aspects of governance arrangements required improvement. Key risk assessments were not in place for 2 people admitted in May and June 2026; this was in contradiction to the providers’ admissions policy and procedure.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

At our last inspection, we found people were not always routinely told about their rights around consent, including their right to make choices, ask questions, or change their mind about care and treatment. At this inspection consent forms were now in place for all people.

A consents file was in place; however, 5 people’s forms were not available in the file. We informed the registered manager, and these were provided after the site visit dates. A relative told us, “They (staff) let me know if there are any problems.”

Care plans identified people’s capacity, ability to consent or make decisions, and support needed to make decisions. We observed staff asking for consent before supporting people. A person told us, “It’s not bad here, but I’ve never been anywhere else. They (staff) will do anything for you; any help you need they will do it. I feel safe, there’s always someone around and the staff are good when you can get hold of them.”