Archived: Heath House

Updated 21 May 2016

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.

This inspection took place on 08 and 09 March 2016 and was unannounced.

The inspection was undertaken over two days. On the first day the inspection was undertaken by two inspectors, a specialist advisor with expert knowledge about the needs of older people, and a pharmacy inspector. One of the inspectors visited the service in the evening to meet with night staff and to observe the evening and bedtime experiences of people living at House Heath. On the second day the inspection was undertaken by two inspectors.

Before the inspection we looked at information we already had about the provider. Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care. We refer to these as notifications. Before the inspection the provider had 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. We reviewed the information from notifications and the PIR to plan the areas we wanted to focus our inspection on. We also contacted the local authority who commission services from the provider for their views of the service.

During the inspection we met with all of the people currently living at Heath House. Some people were able to verbally share their experiences of the home with us, and seven people spoke with us at length. We observed the care and support people received both by using the Short Observational Framework for Inspection (SOFI) and by spending time in the communal areas of the home. We also met the people who were being cared for in bed. During the inspection we spoke with seven relatives, eight members of staff and one healthcare professional.

We looked at parts of the care records of six people to help us determine if people were receiving the care they needed and had requested. We looked at the systems and records in place to monitor safety and quality, we did a review of medicines management for seven people and looked at the recruitment process for three members of staff.

Updated 21 May 2016

We inspected this home on 08 and 09 March 2016. The visit was unannounced. The home was registered to provide personal care and accommodation for up to 50 older people who may also be living with dementia. At the time of our inspection 28 people were living at the home and one person was in hospital.

In April 2015 we inspected the service and found the care being provided was Inadequate. We placed the service into Special Measures and commenced use of our enforcement powers. We inspected the service again in September 2015 and found that while some improvements had been made these had not been adequate or consistent to ensure people would always receive safe care. The improvements had not been sufficient for us to remove the service from Special Measures.

Since that inspection we have maintained regular contact with the registered provider and other organisations also responsible for monitoring the safety and quality of care people receive. The registered provider took action to reduce the number of people it was supporting at Heath House. This had given the registered manager chance to review, change and maintain new and improved ways of working to ensure people are safe and receive the care they require.

This inspection identified that significant improvements had been made to all areas of the service, and it was pleasing to receive feedback that supported this from people living at the home, their relatives, staff and other professionals. These improvements meant the service has not been rated as inadequate for any of the five key questions so we have removed the service from special measures. The service will be expected to maintain the improvements and this will be considered in future inspections.

There was a registered manager in post who was present for this inspection. 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.

People we spoke with told us they felt safe living at Heath House. Staff were aware of the actions they needed to take to ensure people stayed safe, and we observed them working in accordance with the written plans and risk assessments.

Medicines management had improved and people could be certain they would receive their medicines safely and as the Doctor had prescribed.

The number of staff and the management of staff had improved. We saw that this had resulted in people having to wait less time to have their needs met, and that people could more often attract the attention of staff when they needed to. However this was not consistent and we concluded that there were not always enough staff on duty, or available in the correct area of the home to ensure people's needs were met without an undue delay.

People were supported to attend a wide range of health appointments. Nursing and care staff undertook a range of activities every day to ensure people maintained the best possible health. This helped to maintain their physical and psychological well-being.

The quality and choice of food available to people had improved. People were offered a range of food, drinks and snacks that met their cultural, dietary and health needs. Some further work was required to ensure people always had the support they required at meal times, and that the dining experience was pleasant.

Staff had been provided with training about the Mental Capacity Act 2005 (MCA) and we observed staff seeking people's consent and working in ways that reduced the restrictions on people's liberty and independence.

Everyone we spoke with, and our own observations showed that staff worked with kindness and compassion. The staff provided people with the support and reassurance they required to help them stay calm and to feel settled.

People had been offered new and increased opportunities to undertake activities that were of interest to them, which provided stimulation, and which reduced the chance of people being socially isolated.

The registered provider and manager had introduced numerous ways to seek feedback from people, and had used this feedback to further improve and develop the service.

We received consistent information that the service was well led. People and their relatives told us about the confidence they had in the manager, deputy manager and people responsible for leading each shift.

The registered provider and manager had developed an action plan that had been effective at driving forward the quality and safety of the care provided to ensure people received a service that would meet their needs.

You can see what action we told the provider to take at the back of the full version of the report.