We carried out a review of the data available to us about The Heathers 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 The Heathers, you can give feedback on this service.
The Heathers is a residential care home providing accommodation and personal care to up to 25 people with a range of care needs, including dementia, in one adapted building. At the time of our inspection there were 23 people using the service.
People’s experience of using this service and what we found
Some aspects of the home required improvement. These related to the storage and disposal of medicines, and record keeping. The issues found, and written about in the Well Led section of the full report, did not have any direct impact on people or put them at risk of unsafe care.
People felt safe living at The Heathers. One person said, “I’m very well looked after, and the meals are very nice”. They were supported by staff who had received training and understood how to protect people from the risk of abuse or harm. People’s risks had been identified, assessed and were managed by staff according to information contained in care plans. In the main, medicines were managed safely. There were sufficient numbers of staff on duty to ensure people’s care and support needs were met in a timely manner.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were encouraged to be involved in the management of the home. Residents’ meetings enabled people to air their views and provide feedback, which was acted upon. One person told us they knew the home manager well and added, “I see her most days”.
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 30 July 2019).
Why we inspected
This inspection was prompted in part due to concerns received about the management and care people received at the home. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. We discussed the concerns with the home manager and provider, and during the inspection found no evidence that people were at risk of harm.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Heathers on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
¿ The service organised staff shifts so that staff entered the home at staggered times. This allowed them to safely complete the donning and doffing of Personal Protective Equipment (PPE) and take lateral flow devices (LFD) Covid tests before starting work.
¿ Staff were experienced in the infection, prevention and control processes to support new admissions to the service. The provider was contracted to provide care to people with short stay reablement support.
¿ The service had provided easy read information to people which gave them information on the Covid-19 virus, social distancing and other infection control procedures.
¿ Risk assessments had been completed to support specific people living with dementia, and others, to remain safe when there were high risks identified in maintaining isolation and social distancing. This included providing one to one support so that the person could avoid high traffic areas and guiding them on safe walks in external areas of the service.
The Heathers is a residential care home providing personal care for up to 25 people with a range of care needs, including frailty of old age. The home also provides respite care for up to six people who have been discharged from hospital and who require a period of assessment. At the time of the inspection, 23 people were living at the home. The home accommodates people in one adapted building.
People’s experience of using this service and what we found
People and their relatives felt the home provided a safe environment. One person said, “Oh yes, I feel pretty safe here. It’s because the safety standards are very good”. People’s risks were identified and assessed, with guidance for staff on mitigating risks, which was followed. Staffing levels were enough to meet people’s needs. Medicines were managed safely.
People were positive about the skills and experience of staff who supported them. People and their relatives were encouraged to be involved in decisions about their care. A relative said, “I think they look after her well and communication from the home is good; I always get information on Mum”. Staff completed a range of training to meet people’s care and support needs.
People were supported to have a healthy diet and with their nutrition and hydration needs. The lunchtime meal was a sociable occasion. Special diets were catered for. One person said, “I like the food here and I have put on weight since coming here”. Another person told us, “The meals are nicely cooked and they always make sure I have fluids”. People had access to a range of healthcare professionals and support. Premises were suitable and comfortable and met people’s needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were looked after by kind and caring staff who knew them well. People were treated with dignity and respect. One person said, “Staff are nice and helpful. I’m quite happy with all my things around me”.
People received personalised care that was responsive to their needs. Activities were organised and people were encouraged to go out if they wished. External entertainers visited the home.
People could spend the rest of their lives at the home, if their needs could be met and this was their wish.
People felt that the provider and management team were approachable and friendly. People were encouraged in involving and developing the service provided and their feedback was valued. One person said, “I’m happy living here and the staff are pretty good. I’d recommend the place”.
Staff felt supported by the management team in their roles. Staff meetings provided opportunities for staff to reflect on their working practice and to discuss any issues or concerns.
A system of audits monitored and measured all aspects of the home and were used to drive improvement. The home worked proactively with health and social care professionals.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
The rating at the last inspection was Requires Improvement (published 28 September 2018) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Heathers on our website at www.cqc.org.uk.
Follow-up
We will continue to monitor information we receive about the service until we return as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We inspected The Heathers on 27 and 28 June 2018. The first day was unannounced. It was a comprehensive inspection. The last inspection had been on 15 February 2015. At that time we rated the service as Good.
People were happy at the home and felt that they received good care. There was a system of policies and audits in place. However, on review of the documentation we found some risk assessments had not been updated, to reflect changes in people’s care needs and some of the people did not have essential risk assessments in place. Similarly, some of the care plans did not reflect the care people were receiving and some people did not have relevant care plans. The impact of this was minimised, as the staff knew the people under their care and the care each person required. However, this lack of up to date risk assessments and care plans, could potentially put people at risk, of receiving inadequate or inappropriate care. The management team were implementing changes, to improve the standard of the documentation. However, at the time of the inspection these changes had not insured that all people had contemporary and complete records. You can see what action we told the provider to take at the back of the full version of the report.
At the time of our inspection a registered manager was 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. The registered manager was based at the sister home and was not available on the day of the inspection. The day to day management of the home was the responsibility of the care manager. The home had a system of audits and quality assurance in place. However, these had not improved the quality of the documentation in regards to personal risk assessments or care plans.
There was a system in place for determining the level of dependency of the different people and thereby calculating the number of staff required. However, there was little flexibility within the staff numbers. On occasions when people’s dependencies changed staff were very busy and it impacted on the ability of the care manager to complete the more administrative parts of their role, for example reviewing and updating the care plans.
There were environmental risk assessments in place and the home had been adapted to suit the needs of the people living there, with a lift between the different floors. The home was clean and tidy and was odour free and people enjoyed an enclosed garden. There was an infection control policy in place and we saw evidence of the use of personal protective equipment, including gloves and aprons.
There was a comprehensive training schedule for all staff. This included training on safe-guarding and the Mental Capacity Act (MCA). All staff received supervision and appraisals at regular intervals. There was a system in place for orientating and supporting any new member of staff. New staff had the appropriate checks, prior to starting work, to ensure they were appropriate for the job and could work within the care industry.
The staff were committed to keeping people safe and could tell us the principles of safe guarding. Similarly, people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were given choice within their daily lives, including how they wanted to spend their time and how they wanted to dress or decorate their rooms. People told us they felt happy in the home and were able to talk to the care manager about any concerns. They also told us they had good relationships with the staff and we observed people being treated with dignity and respect.
Staff were trained in the safe administration of medication. We witnessed people receiving their medicines in a safe and dignified manner. The medicines were kept appropriately and there was a system in place for the ordering and disposal of medications.
Any accidents and incidents within the home were reviewed to see if there were any lessons to be learnt. This was discussed at the regular staff meetings. There was also a complaints procedure in place, which was clearly displayed on the walls. People also received a written copy of this policy when they first arrived and they could request an audio version if they preferred. This was one example of how the staff aimed to make information more accessible to people, in compliance to the Accessible Information Standard (AIS).
There was an activity program in place and this had recently been increased, following people’s feedback. Within the activity program each person received one to one time with the activity lead. This also enabled people to feedback about what they liked about the home and the activities and facilities on offer. People were able spend the day how they wanted. Visitors could visit within reasonable hours and were made to feel welcome.
The home had a chef during the working week but there was a meal delivery service at weekends. People told us they liked the food prepared by the chef but were less keen on the weekend food. This system was under review, following people’s feedback. We observed a weekday lunch. We saw people receiving nutritious and tasty looking food and enjoying the meal time. There was ready access to fluids throughout the day and people, who were identified as being at risk of dehydration or malnutrition, were monitored, to enable changes to be identified and addressed.
Staff had a good working relationship with other health care professions. People were helped to access health services as required. If appropriate, the staff referred people to a local scheme, which provided specialist support and advice for people as they approached the end of their lives.
The staff were proud of the homely atmosphere within the home and people told us that they felt well cared for.
At this inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities 2014). You can see what action we told the provider to take at the back of the full version of this report.
The inspection took place on 15 December 2015 and was unannounced.
The Heathers provides accommodation and care for up to 25 people with a range of health needs. At the time of our inspection, there were 22 people living at the home. The Heathers is a large detached house on the outskirts of Worthing, situated close to public transport and within walking distance of local shops. All rooms are of single occupancy and the majority have en-suite facilities. Communal areas include a sitting room with sun lounge extension, dining room and smaller sitting area. The home is undergoing refurbishment and redecoration. Accessible gardens surround the home.
A registered manager was 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. The day-to-day running of the home was the responsibility of the senior care manager.
People were protected from avoidable harm and abuse and felt safe living at the home. Staff were trained to recognise signs of potential abuse and knew what action to take. Risks to people were identified, assessed and managed so that staff knew how to mitigate people’s risks. Accidents and incidents were reported and action taken as needed. Premises and equipment were managed to keep people safe. There were sufficient staff on duty at all times and before new staff commenced employment, the provider undertook all necessary checks, to ensure they were safe to work with adults at risk. People’s medicines were managed safely and staff were trained in the administration of medicines. People were protected from the risk of infection and the provider had infection controls in place.
Staff were trained in all essential areas and additional training was provided as needed. New staff followed the Care Certificate, a universally recognised qualification. Staff received regular supervision from senior staff and attended staff meetings. They had a thorough understanding of the requirements of the Mental Capacity Act 2005 and associated legislation and put this into practice. People had sufficient to eat, drink and maintain a balanced diet. They spoke highly of the quality of the food provided. People had access to healthcare professionals and services as required. They were encouraged to personalise their rooms and the provider was undertaking planned improvements across the home.
People were cared for by kind and caring staff who knew them well. One person said, “I enjoy living here; they are very kind and helpful here”. They went on to say, “The staff seem to get on well here too. I can’t complaint at all”. Staff knew people’s preferences, their likes and dislikes and how they wished to be cared for; they treated people with respect. People were involved in planning their care and care plans and risk assessments were reviewed monthly and signed by staff. As people reached the end of their lives, staff looked after them with kindness, respect and dignity.
People received care that was responsive to their needs. Before they moved into the home, the management team undertook pre-assessments to ensure everything was in place to meet people’s assessed needs. Care plans provided comprehensive, personalised information about people. There was a programme of activities organised by a part-time activities co-ordinator. External entertainers came to the home and outings into the community were organised for people. Complaints were dealt with promptly and managed in line with the provider’s policy.
The home was well led and staff felt supported by the management team. People and/or their representatives were asked for their views about the service by an independent social care consultant and action was taken as needed. Residents’ meetings took place. The provider had a range of internal systems and audits in place to measure the quality of the service overall. The consultant also undertook regular inspections of the home and an independent audit and any recommendations were acted upon by the provider.
People told us that they felt they were well cared for and the staff members understood the needs of people well. One staff member said, "Care plans contain a lot of helpful information, we record everything we do and keep care plans up to date."
All the people we spoke with said enough staff were available to support them to fulfil their needs.
We found people's nutritional needs were being met and supported.
Staff were only employed following a structured recruitment and interview process and relevant checks were carried out prior to them starting work.
The home maintained good standards of cleanliness throughout
One person told us they were treated with dignity and the staff knocked on their doors before entering. This person said ''they have been great I would recommend it.''
The people we spoke with were complimentary about the food and the chef. We were told that the chef did that little bit more than expected and one person commented though meals were not always bang on time, ''the chef was marvellous.''
Staff told us people were assessed and the appropriate resources used to meet their needs. We observed that equipment designed to meet the people's needs were readily available.
We found staff were supported and received appropriate training to deliver care to meet people's needs.
The provider told us that feedback from the people, their representatives and other health professionals was used to assess and monitor the quality of the service delivered and to make changes. We noticed safety information was prominently displayed around the home.
During the visit we observed people engaged in an activity, which they appeared to be enjoying. We saw that staff interacted with the people in warm and caring manner. People appeared relaxed and the atmosphere was pleasant and calm.
Everyone that we spoke with said that the home was meeting their needs.
People told us that they felt safe and staff treated them well.
Everyone expressed satisfaction with the staff who worked at the home.
People told us that their views were sought in a variety of ways including questionnaires and residents' meetings.