Archived: Heathcote House

Updated 19 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.

The inspection took place on 18 November 2016 and was unannounced.

The inspection team consisted of one inspector and one 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. Our expert had experience of services for older people.

Before we carried out our inspection we reviewed the information we held about the service. This included any statutory notifications that had been sent to us. A notification is information about important events which the service is required to send us by law. We also reviewed the 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.

We spoke with eleven people who used the service, three relatives of people who used the service, two care staff, two agency care staff, the senior team leader and the registered manager. We also gathered feedback from one adult social care professional from the local authority older people’s team.

We reviewed four people’s care plans, five medication records, four staff files, staffing rotas and records related to the monitoring of the quality and safety of the service.

Updated 19 January 2017

The inspection took place on 18 November 2016. The inspection visit was unannounced.

The service provides extra care housing for people living in each of the 24 flats within the same secure building. At the time of our inspection 25 people were resident. Staff are onsite 24 hours a day and people who use the service are able to summon help outside of their normal contracted care visits by using a call bell system. Although aspects of the service operate in a very similar way to a registered care home, the Care Quality Commission only regulate the provision of personal care in services such as this.

There was a registered manager 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.

Staff had received training in safeguarding people from abuse. Staff understood their responsibilities in this area and safeguarding concerns had been appropriately referred to the local authority for investigation and CQC notified.

Risks people faced were assessed and there was sufficient guidance for staff to follow to reduce the likelihood of people coming to harm. People were supported to remain as independent as possible through risk assessment.

Safe staffing levels had been assessed but the service sometimes operated with fewer than the assessed safe levels of staff. Staffing had been recognised as a concern and action had been taken to try to ensure consistent staffing as much as possible.

Medicines were not consistently well managed. The provider’s audit system had identified a significant number of medication errors and had taken action to address them. However this had not been effective in significantly reducing them and this was now a priority for the manager. Records related to medicines were clear but could have benefitted from a little more information to guide staff. We have made a recommendation with regard to how the service manages medicines.

Training and support was provided for staff to help them carry out their roles and increase their knowledge. There was an induction process in place and staff received regular appraisal

People gave their consent before care and treatment was provided. Staff had received training in the Mental Capacity Act (MCA) 2005 and demonstrated a good understanding of it. The MCA ensures that, where people lack capacity to make decisions for themselves, decisions are made in their best interests according to a structured process.

People were supported with their eating and drinking and staff helped to ensure that people had access to the food and drink they might need after staff had left for their next call. Staff also supported people well with their day to day health needs and worked in partnership with other healthcare professionals.

Staff were caring and people were treated respectfully and their dignity was maintained. Relationships between the staff and those they were caring for and supporting were very good. Agency staff were used as consistently as possible to try to minimise concerns people had regarding staff not being familiar with their needs. The communal areas of the service provided opportunities for social interaction which was noted as having a positive effect on people’s quality of life.

People were involved in planning and reviewing their own care and were encouraged to provide feedback about the service. There was a commitment to preserving people’s own skills and maintaining their independence.

A formal complaints procedure was in place but none had been received. Informal complaints were dealt with appropriately.

Staff understood their roles and were supported by the management team. There was an open culture which staff and people using the service valued.

Comprehensive quality assurance systems were in place to monitor the quality and safety of the service.