We carried out a review of the data available to us about SeeAbility - Heather House Nursing Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about SeeAbility - Heather House Nursing Home, you can give feedback on this service.
See Ability - Heather House Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The home can accommodate up to 16 people. Accommodation is provided in two bungalows side by side that are joined with use of a communal dining area. Accommodation is all on one level and provides nursing care for young adults with a physical disability, learning disability, sensory impairment and autism. The service specialised in providing care and support to young people with Juvenile Batten Disease. The accommodation is set in a wooded site on the outskirts of Tadley. There were 16 people living at the service at the time of our inspection. Each person had their own room and bathroom. Heather House is on the same site as other services that the provider manages.
Attached to the home via a linked walkway was a purpose built and designed resource centre. This was available for the sole use of people living on the site but mainly used by people living at Heather House. Within this resource centre was a hydrotherapy pool, a large adapted kitchen area, an interactive suite which could be used for sensory activity, a quiet lounge and other large rooms that were used for activity such as art therapy or music therapy.
There was a registered manager in post. 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.
Medicines were managed safely. Nurses were responsible for all administration of medicines at the service and all medicines management. We observed a registered nurse on part of a medicine round and their practice was seen to be safe.
There were sufficient staff on duty to provide care and support to meet people’s needs. There was a registered nurse on duty at all times, two during the day and one at night. Staff worked well as a team to make sure people’s needs were met safely and appropriately.
Risks had been assessed and measures taken to keep people safe. If people had epilepsy there was guidance on how to support people if they had a seizure and there were descriptions of seizures for each person.
Staff were recruited safely with pre-employment checks carried out prior to them starting employment. Staff knew how to recognise different kinds of potential abuse and understood the procedures to follow to report their concerns.
Staff worked closely with healthcare professionals to promote people’s well-being and make sure health needs were monitored.
People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Where people had their liberty restricted, the service had completed the related assessments and decisions had been properly taken. Staff had been trained and understood the general requirements of the Mental Capacity Act (2005).
Meal times were a social occasion with sufficient quantities of food and drinks available. Where people needed support to eat this was provided by staff who maintained people’s dignity throughout the meal time.
Staff were supported and had access to a range of training in a variety of areas. Staff understood and knew the people they were supporting, some had worked together for many years. New staff had an induction and had monthly supervisions throughout their probation period. All staff had regular supervision with their line managers which was an opportunity to discuss any concerns, training needs or any other support required.
Visitors were welcomed at any time and people were supported to maintain relationships with their friends and family. There was accommodation on site for families who had travelled to visit their relatives. People were supported to share photos and videos of themselves doing various activity with their families.
There was a structured activity programme which included therapy such as hydrotherapy, physiotherapy, music, arts and crafts and sessions in an interactive suite using touch screen technology and sensory equipment.
Communication between the management team, staff, people living at the service and families was effective and regular. The service had a complaints policy and procedure. People and their families were supported to raise concern if they wanted to and were confident their issues would be dealt with in a timely way.
We observed a positive person-centred culture at the service, people were treated with respect and their dignity was promoted and maintained. All of the management team role modelled good practice by taking time to work side by side with support workers at times. The registered manager was a specialist in the care and support of people with Juvenile Batten Disease.
The regional head of operations visited regularly and completed quality and safety audits. In addition the service also completed monthly audits in a range of areas. This meant the service was continually monitoring quality and safety to make improvement.
We inspected SeeAbility - Heather House Nursing Home on 15 and 17 July 2015. This was an unannounced inspection.
SeeAbility - Heather House Nursing Home consists of two purpose built ground floor units and is set in a wooded site on the outskirts of Tadley. Facilities include a sensory suite, indoor hydropool, Jacuzzi baths and other specialist activity rooms. The home also provides a guest suite for visiting families to promote family relationships and maintain family links.
SeeAbility - Heather House Nursing Home is a residential nursing home providing specialist care for up to 16 young adults with degenerative conditions. These include Juvenile Batten disease (JBD). They also support individuals who have complex physical and learning disabilities. At the time of the inspection there were 14 people living in the home with varying degrees of visual impairment, moderate to severe learning disabilities and healthcare needs. Some people had very limited verbal communication skills and they required staff support with all aspects of their personal care, nutrition, mobility and to go into the community.
Ten of the 14 people in the home were living with JBD. The provider’s webpage notes ‘Batten disease describes a group of rare inherited neurodegenerative disorders that occur in children and adults. Juvenile Batten disease usually begins at early school age. It often begins with vision problems. Later short-term memory loss, epilepsy, motor problems and declining school progress becomes apparent. Life expectancy is limited to between late teens and mid thirties’.
The registered manager was a trustee of the Batten Disease Family Association. They worked with scientists and healthcare professionals to share expertise in Batten Disease as any advancements have potential benefit for people living at Heather House. Staff had improved their understanding and treatment of epilepsy of people with JBD at the home following this joint working.
The home had a registered manager. 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 home is run.
Staff knew people well and supported them appropriately to stay safe and well. However, people’s records did not always include all the information staff required to know how to manage risks to people’s health and how decisions relating to people’s care had been made. The provider was employing new staff and had increased the use of agency staff. An accurate, up to date record of people’s care and risks was required to ensure staff, who did not know people well, would know how to support them appropriately without being overly reliant on the support of experienced staff.
Quarterly quality monitoring visits were undertaken by senior management. However, the quality assurance systems implemented by the registered manager between the quarterly provider visits were not sufficiently robust for such a complex, high risk service. Regular health and safety checks were carried out to ensure the physical environment in the home was safe for people to live in.
There was a nurturing atmosphere within the home and staff put people at the heart of the home. People and their relatives were encouraged to be involved in the planning of care. Staff were motivated and flexible to ensure people’s plans were realised, and that they had meaningful and enjoyable lives.
Staff had a positive approach to keeping people safe. Staff showed commitment to managing people’s changing risks. Staff were familiar with the health risks people living with JBD faced and nurses knew how to respond if people experienced health emergencies. People had varying levels of independence in meeting their own nutrition and hydration needs. Several people required the use of a Percutaneous Endoscopic Gastrostomy (PEG) to receive nutrition. When a person was having ongoing and serious trouble swallowing and couldn’t get enough food or liquids by mouth, a feeding tube was put directly into the stomach through the abdominal skin. This procedure is called a percutaneous endoscopic gastrostomy (PEG). Staff were skilled in managing people’s PEG nutrition appropriately in line with professional guidance and checked that people’s PEGs were used safely.
All of the staff received training that provided them with the knowledge and skills to meet people’s needs in an effective and individualised manner.
Relatives we spoke with told us people received excellent health care at SeeAbility - Heather House Nursing Home. People living with JBD had ongoing complex health needs and they received timely support from appropriate health professionals. This included support from the provider’s physiotherapy team and speech and language therapist; and established access to a range of community healthcare resources including; dietician; occupational therapist and wheelchair services. A local GP visited the home weekly to monitor people’s health needs. People’s health was reviewed as needed and staff implemented professional’s guidelines appropriately. Systems were in place to ensure people received their medicines as prescribed.
The registered manager and staff’s response to people’s complex health needs, was outstanding. Staff found creative ways to maintain people’s skills and independence. Staff proactively supported people living with JBD to retain their muscle, communication and social function. The home had a purpose built activity centre where people were supported to engage in a variety of leisure and therapeutic activities. Staff told us that people’s loved ones were an integral part of care for people and care and support was extended to them as well. Accommodation was available to people’s relatives at the home and creative ways were used to support people to stay in touch with their loved ones.
Staff sought people’s consent before they provided care and support. However, some people were unable to make certain decisions about their care. In these circumstances the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were followed. Where people had restrictions placed upon them to keep them safe, the staff ensured people’s rights to receive care that met their needs and preferences were protected. Where people were legally restricted to promote their safety, the staff continued to ensure people’s care preferences were respected and met in the least restrictive way.
People and their relatives were involved in the assessment and review of their care. Staff supported and encouraged people to access the community and participate in activities that were important to them.
Feedback was sought from relatives and people and used to improve the care. People knew how to make a complaint and these were managed in accordance with the provider’s complaints policy.
The culture of the home was nurturing and supportive. People were treated with kindness, compassion and respect, and staff promoted people’s independence and right to privacy. The staff were highly committed and provided people with positive care experiences. They ensured people’s care preferences were met and gave people opportunities to try new experiences.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
We looked at the records for three people at the home and saw a variety of assessments were available for staff so they could care for people. We saw consideration was given for both nursing and medical needs so that staff could understand the individual needs of people. We spoke with the manager who told us how they ensured they were up to date with the latest medical research into Juvenile Battens Disease so they ensured they provided evidenced based care.
We spoke with two relatives who told us it was a "fabulous home" and that they were very happy with the care provided.
We reviewed the care plans of six people who used the service and found them to be person centred. They contained a comprehensive range of information about the care and support required by each individual. On speaking with staff we found them to be knowledgeable regarding the contents of each person's file and their responsibilities around meeting individuals' needs.
We observed staff treating people in a dignified and respectful manner, ensuring at all times the person was aware of what was going to happen next.
The provider had effective monitoring systems in place to identify, assess and manage risks to the health, safety and welfare of people who used the service. We saw that the manager undertook regular checks to ensure the quality of service provision.
People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Staff we spoke with told us that they had access to regular training and supervision. They also told us that they felt comfortable with raising any concerns and that they felt supported and listened to.
We observed that there were a high number of positive interactions between staff and people who lived at Heather House. Staff showed care and concern for the perople that they were supporting. They assisted people in a relaxecd way, allowing them to do things at their own pace, for example, when they were eating. Staff were sensitive to people's needs and feelings. Staff empowered people to use their skills and abilities and celebrated people's achievements.
One person who was able to tell us said that everything was good at Heather House.