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Inspection report

Date of Inspection: 15 April 2014
Date of Publication: 8 May 2014

Overview

Inspection carried out on 15 April 2014

During a routine inspection

We undertook an inspection of Heathside on 15th April 2014. During the inspection we spoke with the registered manager, four staff, three relatives, a health care professional and seventeen people who used the service. We encouraged the people using the service to participate in our visit using their preferred methods of communication.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

� Is the service safe?

� Is the service effective?

� Is the service caring?

� Is the service responsive?

� Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Policies and procedures had been developed by the registered provider (Warrington Community Living) to provide guidance for staff on how to safeguard the care and welfare of the people using the service. This included guidance on the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS).

We were informed that none of the people using the service had been referred for a mental capacity assessment and no applications had therefore been submitted to deprive a person of their liberty.

We noted that the provider had written to the local authority to seek advice on the use of a restricted egress system (coded door) which was fitted to the main entrance of the home. This is good practice as the use of this lock could prevent many of the people living at Heathside from leaving the premises without assistance.

Training records highlighted that a number of staff had not completed Mental Capacity Act or Deprivation of Liberty Safeguards training. This has been brought to the attention of the provider so that action can be taken to increase staff knowledge and understanding.

The provider had developed guidance on recruitment and selection to provide information to staff on the procedures for recruiting new employees. We looked at a sample of recruitment records for three staff which had been stored electronically. Examination of records and / or discussion with staff confirmed staff had undergone a comprehensive recruitment process prior to commencing work with the provider.

A full application could not be located for one employee. We have received assurances from the provider that action was being taken to recover missing records and to audit all personnel files to identify any other gaps.

We noted a number of gaps in one person�s fluid intake / output chart. Likewise, there was an inconsistent approach used by staff to monitor and review care plan records on a monthly basis. Examples were discussed with the manager who confirmed that action would be taken to improve record keeping.

Is the service effective?

We spoke to seventeen people who lived at Heathside during our inspection. Comments received from people using the service included; �The staff are very good and look after you�; �I�m very happy. I can�t fault the way I am cared for� and �It�s a pleasant place to live. I would recommend the home.�

Records highlighted that there had been eight complaints in the last twelve months and that complaints had been listened to and acted upon. No complaints or allegations were received from people using the service or their representatives during our inspection. We have highlighted to the provider the need to ensure the procedure is visible and accessible to people using the service and / or their representatives.

No concerns were raised by the people using the service or their representatives about the meal options, standard of catering or quantity of food provided during our visit. People spoken with informed us they were offered a choice of menu and records of individual choices were available for reference.

Comments received included: �The food is very good. We can choose what we want� and �There are drinks throughout the day and plenty to eat.�

Is the service caring?

We also spoke with the relatives of three people who were supported by the service. All feedback received was positive and confirmed the service was responsive and caring to the needs of the people using the service.

We received comments such as: �This place is brilliant�; �My mother is very well cared for. I have no concerns�; �The staff are brilliant. They are welcoming and friendly. I can�t fault anything� and �I�m very happy with my observations and the feedback I receive from my relative.�

Is the service responsive?

Records viewed highlighted that the provider is committed to the inclusion of people in the development and operation of the service. For example, since our last inspection the provider had involved a consultant to assess the service in accordance with �Progress for Providers� (Care Homes). �Progress for Providers� is a nationally well-regarded self-assessment to enable providers to check how they are doing in delivering personalised services to people living with dementia.

Is the service well- led?

The provider has worked well with the Care Quality Commission and was aware of the need to keep us updated on any significant events via statutory notifications.

The service continued to utilise a comprehensive internal quality assurance system and had developed systems to involve and obtain feedback from people using the service and / or their representatives.