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Heanton Nursing Home Outstanding

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Outstanding

Updated 21 September 2018

This inspection was completed on the 18 and 23 July 2018 and was a planned comprehensive inspection looking at all five key questions. Prior to this, the last inspection was completed as a responsive focussed inspection which took place in March 2018. This was in response to a specific incident of someone swallowing a hazardous substance. The Care Quality Commission (CQC) wanted to ensure people were safe and systems were in place to prevent any further incident occurring. In March 2018 we only looked at the key questions of safe and well-led. We did not identify any areas of concern and the service improved to a rating of overall good.

Heanton is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Heanton accommodates up to 52 people in one adapted building. The service is divided into three separate units which the service calls ‘houses’ by the name of Watersmeet, Exmoor and Williamson. Williamson is on the ground floor and caters for people living in the earlier stages of dementia. Also on the ground floor is a smaller house - Exmoor. This caters for people with complex needs due to their dementia needs. Upstairs there is one house - Watersmeet for people living with dementia who were in a repetitive stage or advanced stage of their dementia. The provider has developed and implemented this care model based on the household model of care pioneered in the USA by LaVrene Norton, Action Pact and Steve Shields. At the time of the inspection there were 51 people living at 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.

Staff offered care and support which is exceptionally caring and compassionate. People mattered and staff had a detailed understanding of people’s likes, preferences and wishes. People were asked to think of a wish and staff went out of their way to achieve this. Some staff came in on their day off to take people out for trips and meals out. Staff visited people in hospital in the own time, to keep in contact and show they cared. Staff knew people and their families well and worked in a person centred way.

The visions and values were imaginative and people were at the heart of the service. The registered manager and senior leaders led by example. The service was really well led and creative in the way they developed the service. They had developed bespoke training which gave staff the enthusiasm to embrace their vision and values to provide a family and home like environment where people felt safe and loved. This was evident in our observations, in records and in the way staff spoke passionately about people. There were strong links with the local community. The management team looked for ways to ensure people, their family and staff were involved in the running and improvement of the service.

The service was exceptional at helping people to express their views so that all staff understood their views, preferences, wishes and choices. They did this by ensuring staff had the skills to understand and interpret people’s complex ways of communicating.

There were sufficient staff with the right skills and understanding of people’s needs and wishes. Some concerns had been expressed following the inspection about insufficient staff on duty. The provider was open and honest in identifying there had been times when they had been short on their preferred numbers in the last month or so. However, the provider, registered manager and staff team all agreed that people’s needs and safety were not compro

Inspection areas

Safe

Good

Updated 21 September 2018

The service was safe.

Medicines were safely managed, although we made a recommendation which was actioned around recording topical creams.

People were kept safe because recruitment procedures were robust and staff understood what to do if they had concern around abuse.

The service was staffed at an appropriate level to safely meet people's needs.

The premises and equipment were maintained to keep people safe.

Effective

Good

Updated 21 September 2018

The service was effective.

The provider was committed to maintaining a homely environment. This was work in progress and some improvements were needed for some bedrooms and corridors.

Staff received the provider�s bespoke training which was based on the provider�s model of care and CQC�s key line of enquiries. This ensured staff delivered a high standard of individualised care to people.

Staff understood their responsibilities in relation to the Mental Capacity Act (MCA) (2005) and Deprivation of Liberty Safeguards (DoLS). Appropriate applications had been made to the DoLS team and best interest decisions were being made where people lacked capacity.

People were supported to maintain their health and wellbeing and their nutritional needs were well met.

Caring

Outstanding

Updated 21 September 2018

The service was exceptionally caring.

People, relatives and professionals all gave glowing accounts of staffs� caring and compassionate attitude.

Individualised care for people was promoted and embedded into everyday practice. They were highly motivated and offered care and support that was exceptionally compassionate and kind.

Staff relationships with people were strong, caring and supportive. Staff spoke confidently about people�s specific needs and how they liked to be supported.

Staff showed a real empathy for the people they cared for and treated people like family members.

Responsive

Good

Updated 21 September 2018

The service was responsive.

Care plans contained information to help staff support people in a person-centred way and care was delivered in a way that best suited the individual.

Staff were committed to ensuring people experienced end of life care in an individualised and dignified way.

People�s social needs were met and they were encouraged to follow their interests.

There were regular opportunities for people and those that mattered to them, to raise issues, concerns and compliments.

Well-led

Outstanding

Updated 21 September 2018

The service was exceptionally well led.

The management team established a strong, open and visible culture within the service. They led by example and staff responded by providing high quality care to the people.

Staff and healthcare professionals spoke positively about the management team and how they were developing the new service and including them.

The management and staff teams continuously sought to improve and develop the service. They had bespoke effective quality assurance systems in place to review and assess the quality of service and monitor how it was run.

The views of people using the service, relatives and staff were at the core of quality monitoring and assurance arrangements.