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Archived: Heatherbrook Good

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Reports


Inspection carried out on 16 May 2017

During a routine inspection

The inspection took place on 16 May 2017 and was unannounced. At our previous inspections on 11 December 2014 and 13 October 2015, the service met all legal requirements and was rated 'Good'.

Heatherbrook is a 45 bedded care home providing nursing care for people with dementia. Accommodation is provided on two floors and each person has a single

bedroom. The ground floor has 20 bedrooms and there are 25 bedrooms on the first floor. At the time of the visit, there were 34 people using the service.

The service 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 service is run.

We found that the service did not always deploy enough staff to meet people's needs and staff worked long hours. We have made a recommendation about this. Staff were caring and kind to ensure people were not at risk of harm. Care plans and risk assessments were completed for each person using the service. People using the service were treated with respect and dignity and that their privacy was ensured.

There was a robust recruitment system in place to ensure staff were appropriately checked before they started work at the service. The support and training available to staff helped them to deliver care that reflected and met people's needs. Medicine administration was undertaken by staff who had training and experience. People were also encouraged and supported to make their own decisions regarding their care and the service operated in line with the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

There were a range of activities in which people could participate. People's healthcare needs were monitored and appropriate care was provided. The food provided at the service was varied and nutritious.

Staff worked as a team supporting one another. The registered manager sought the views of stakeholders through surveys and meetings to ensure continuous improvement of the service.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.

Inspection carried out on 13 October 2015

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection of this service on 11 December 2014. During that inspection we found that the service met all the legal requirements.

After the inspection we received concerns from relatives about the safety of people. We were advised by the provider that following safeguarding investigations two care staff had been dismissed. Relatives were concerned that people were neglected and there were not enough staff at the home. We conducted this inspection on 13 October 2015 to review these concerns.

Heatherbrook is a 45 bedded care home providing nursing care for people with dementia. There were 42 people living at the home at the time of our inspection. The home's registered manager was not in a day-to-day management of the service at the time of this visit. We were informed that the registered manager was working one day a week at this service as they were also managing another service owned by the provider. 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 and associated Regulations about how the service is run. We will discuss this further with the provider to ensure that the appropriate person is registered to manage the service in line with the Act.

People and most of the relatives we spoke with told us that they felt the home was safe. One relative, however, said the home was not always safe because there were incidents of unexplained bruises. However, the deputy manager and the incident forms confirmed that incidents were recorded and, as required, reported to the placing authorities. We noted that the provider had worked with the local authorities to investigate and address issues relating to incident concerns. People told us and we observed that the home was clean and bright. We noted there were arrangements in place for controlling infections and there was a nominated lead person for infection control.

People were protected from abuse because the provider had good staff recruitment systems in place. Each person employed to work at the home was appropriately checked to ensure they were able to provide suitable care to people. We noted the provider had a safeguarding policy and that staff had attended training in safeguarding and were aware of how to use the whistleblowing process to raise concerns. At the time of the inspection there were enough staff working at the home. However, one person and some staff told us that there were times when the staffing level was not enough. We have made a recommendation that the provider continuously reviews the staffing level to ensure that there were enough experienced staff at all times to meet people’s needs.

Risk assessments had been completed for each person and staff had guidance on managing risks to people. We noted that risk assessments were reviewed regularly and arrangements were put in place to ensure people were protected, for example, from influenza.

Inspection carried out on 11 December 2014

During a routine inspection

This inspection took place on 11 December 2014 and was unannounced.

At our previous inspection in September 2013, we found the provider was meeting the regulations we inspected.

Heatherbrook is a 45 bedded care home providing nursing care for people with dementia. Accommodation is provided on two floors and each person has a single bedroom. The ground floor has 20 bedrooms and there are 25 bedrooms on the first floor.

The service has 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 service is run.

People's needs were assessed and reviewed, and information about their preferences and support arrangements were included in their care plans and risk assessments. Staff were aware of people’s needs and were able to provide appropriate care and support. Staff had support, supervision and different training programmes relevant to their roles. This showed staff had appropriate knowledge and skill to respond to people's needs.

Staff in the service knew how to recognise and report abuse, and what action to take if they were concerned about people's safety. Staff were aware of the service’s whistleblowing police and knew they what to do if they felt concerns were not dealt with appropriately by the registered manager. We noted the service had appropriate arrangements for receiving, storing and administering medicines. We observed all parts of the service were clean during our visit.

The service had a complaints’ process which allowed people to raise concerns. People and their relatives were aware of how to contact if they had a concern. We noted staff listened to people and investigated their concerns.

The service had a quality assurance system, which was used to monitor the quality of the service people received. We also noted relatives' meetings and staff meetings were arranged to enable people to share their views to make improvements. People and their relatives told us they knew how to make a complaint if they had a concern.

Inspection carried out on 31 August and 6 September 2013

During a routine inspection

During this inspection we spoke with five people using the service and their visitors, and the relatives of five other people. We also spoke with the home's manager, deputy manager, an activities co-ordinator and other staff.

Most of the relatives we spoke with said they were very pleased with the quality of the care provided. One relative told us, "I really can't fault it, they are very good with [my relative]. I feel they are safe and looked after". Another relative said, "they are very caring and encourage her to eat. I can go away on holidays and know that she is safe. I have no concerns".

People using the service and their representatives were consulted about the care and treatment they received. The six care plans we looked at showed that the staff understood people's health and physical care needs, as well as their life histories and social interests. This meant staff were able to plan and deliver individualised care.

Effective systems were in place to protect people from the risk of abuse.

Most of the relatives we spoke with told us there were enough staff to safely meet people's needs, although two people said the staff were often busy and their relatives had to wait for support.

Appropriate measures were in place to monitor the quality of the service, including actions to seek the views of people living at Heatherbrook and their representatives.

Inspection carried out on 13 November 2012

During a routine inspection

People told us they felt Heatherbrook provided a good service that had improved and that they felt happy with the care their relatives received. One person said �things have got better, they�re being put right�. Another person told us that the service being provided was �not bad at all. They do their best to do things for people�.

Another person told us �any healthcare needs of dad�s are looked after well. I speak to staff when I have worries and they are great about it�. We found that arrangements were in place to safeguard people from the risk of possible abuse and there had been a programme of environmental improvement making the service more suitable and comfortable for people with dementia. There were checks in place to monitor the quality of services people received and improvements had been made where these checks highlighted such a need.

Inspection carried out on 8 November 2011

During a routine inspection

People said that staff seemed friendly and caring towards people. They said that there were usually enough staff around. Relatives spoken to said that the carers were friendly. We were told by one person that they had seen an improvement in their relative since they had been here while another said that they liked the home. Another said that the home had kept them informed of their relatives� progress and had no complaints.

Reports under our old system of regulation (including those from before CQC was created)