Healthlinc Apartments

Updated 21 May 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This included checking the provider was meeting COVID-19 vaccination requirements. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and an inspection manager.

Service and service type

Healthlinc Apartments is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Healthlinc House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with three people who used the service. People had various ways of communicating including talking with us, using sign language and using body language. We observed the care and support people received as well as how people and staff interacted. We spoke with five care staff, a registered nurse, the service manager and the nurse manager. We reviewed a range of records including three people’s care records, multiple medicines records and staff recruitment and support records.

After the inspection

We continued to seek clarification from the provider to validate evidence we found. We reviewed staff training data and quality assurance records. We also spoke with a further four care staff by telephone.

Updated 21 May 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Healthlinc Apartments is a residential care service providing nursing and personal care for up to seven people who live with a learning disability. Some people may also require support with mental health, sensory or physical needs. There were five people living in the service at the time of the inspection. Healthlinc Apartments is one of three registered services on the same site.

People’s experience of using this service and what we found

The provider’s management systems were not robust enough to demonstrate effective oversight of the quality of the service. There was a lack of distinction between two registered services on site. The provider had not fully acknowledged the impact of the high use of agency staff on people and staff. Staff lacked confidence in the provider. Audits had taken place but needed minor improvements regarding action plans.

People were supported by enough staff. However, regular deployment of agency staff meant there was a lack of meaningful interaction between people and those agency staff. Staff understood their responsibilities to keep people safe. People’s medicines were managed safely and reviewed frequently. Measures were in place to reduce the risk of infection to people.

People were supported to take part in activities which were important to them. However, people’s opportunities were impacted when being supported by agency staff who did not know them well. Information was available to people in different methods depending on their needs and preferences. The provider had a policy to effectively manage complaints.

Staff received training relevant to their role. People’s care records reflected their current needs and assessment tools were used to monitor people’s on-going support. People were supported with eating and drinking and staff supported people with different aspects of their daily living. The service and facilities met people’s needs. People had access to on-going healthcare support. People’s mental capacity had been formally assessed and best interests decisions were in place where required.

People were encouraged to express themselves freely using their preferred communication method. Staff treated people with dignity and respect. Staff and people were involved in the running of the service and their views were sought.

Right Culture

There was a lack of visible leadership from the service manager. Agency staff use was high, and this resulted in people not always receiving consistent care from staff who knew them well. People and those important to them were involved in planning their care. Permanent staff placed people’s wishes, needs and rights at the heart of everything they did.

Right Support

Staff supported people to have maximum possible choice and control over their own lives. The service gave people care and support in a safe, clean and well-maintained environment that met their sensory and physical needs. People had a choice about their living environment and were able to personalise their rooms. Staff supported people to make decisions following best practice in decision-making. Staff supported people with their medicines in a way that and achieved the best possible health outcome.

Right Care

Staff promoted equality and diversity in their support for people. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 21 May 2021).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the Safe, Responsive and Well-led sections of this full report.

Enforcement

We have identified a breach in relation to the provider’s oversight of the quality of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.