Archived: Heath House

Updated 20 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

It was carried out on the 28 and 29 November by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. This was an unannounced inspection.

Before the inspection, we reviewed the information available to us about the home, such as the notifications that they had sent us. A notification is information about important events which the provider is required to send us by law. Prior to the inspection, the provider also completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection visit we spoke with nine people living at the home and two visiting relatives. We also spoke with two care staff, including a senior carer, the deputy manager and the registered manager as well as the cook and a visiting healthcare professional. We observed how care and support was provided to people.

We looked at two people’s care records in detail and sections within another three people’s care records, and all medicine administration records. We also looked at accidents records, and records relating to the safety and maintenance of the home as well as staff training.

Updated 20 January 2017

This inspection took place on 28 and 29 November 2016.

Heath House Care Home is a service that provides accommodation, personal care for up to 25 people. The home consists of a ground floor and first floor in a converted Victorian building. There were some people living with dementia. During the inspection visit, there were 17 people living in the home.

There was a registered manager employed at the home. 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 home is run.

At the last inspection on 12 October 2015, we asked the provider to take action to make improvements in respect of the quality of care that was provided to people. At this inspection, we found that the necessary improvements had not all been made. People's medicines were still not being managed safely and staff had not assessed and managed risks to people's safety effectively. The systems in place to assess, monitor and reduce the risk of people receiving poor care were not always effective. You can see what action we have told the provider to take at the back of our report.

Risks to people’s individual health and safety had not always been assessed, and there was no guidance for staff to mitigate these risks. This included risks to people of not eating enough, and risks of developing a pressure area. Risks associated with people’s personal activities where necessary, had not always been assessed and mitigated.

You can see what action we have told the provider to take on the back of this report. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

Risks associated with people’s living environment had not been effectively assessed and lessened. There were also aspects of people’s living environment that were unclean, presenting a risk of infection spread. There were problems with people’s living environment which compromised their privacy and dignity.

Staff members did not have guidance about people who were at risk of not eating and drinking enough. The home did not always provide staff with adequate guidance in respect of thickening people’s drinks, and storing thickener safely.

Medicines were stored and administered safely, however there were risks associated with ‘as required’ (PRN) medicines not having clear protocols in place for staff to follow. Staff did not always follow recommendations given by health professionals, and they did not always ensure that people were referred to them when they needed.

There were not always staff available to support people when they needed it and this resulted in falls and delays to people receiving assistance with personal care.

People did not receive a daily choice of meals. They were provided with enough to eat and they had drinks available throughout the day to them.

People did not always receive individualised care based on their own needs and preferences. Care plans did not contain adequate current guidance for staff.

People were supported to engage in activities with staff although these were not always available for people in their rooms or for whom group activities were not suitable.

Most staff were kind and caring. However, some staff demonstrated poor practice, which resulted in some people not being treated with dignity and respect.

The systems in place for monitoring and assessing the quality of the service did not always pick up problems and therefore had not acted to improve the quality of the care provided.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.