Heritage Care Centre

Heritage Care Centre is a care homeprovides nursing and personal care for up to 72 older people. At the time of our inspection there were 68 people using the service including those living with dementia. The care home accommodates people in four units, two on the ground floor and two on the first floor.

People’s experience of using this service and what we found

We found, and people and their relatives told us that they felt Heritage Care Centre was a safe place to live and staff thought it was a safe place to work. Risks to people were regularly assessed and reviewed. This enabled them to take acceptable risks, enjoy their lives and live safely. Accidents, incidents and safeguarding concerns were reported, investigated and recorded. There were appropriately recruited staff in suitable numbers to meet people’s needs. Medicines were safely administered. The home used Personal Protection Equipment (PPE) effectively and safely and the infection prevention and control policy was up to date.

The home’s previous registered manager had retired, and interim cover had been put in place by the provider. This meant that whilst the management and leadership were transparent and had an open, positive and honest culture, the staff did not always experience the same level of support they had previously. This was because different managers had different styles and this led to some confusion for staff. A new manager had been identified who was very familiar with the home and registered as a manager at another home in the organisation. They were commencing in post in the very near future. The organisation’s vision and values were clearly set out, understood by staff and followed. Areas of responsibility and accountability were identified, and a good service maintained and reviewed. Audits were thoroughly carried out and records kept up to date. Community links and working partnerships were established and kept up to minimise social isolation, where possible. Healthcare professionals said that the service was well managed and met people’s needs in a professional, friendly and open way.

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.

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 outstanding (published 27 December 2018). The overall rating for the service has deteriorated to good. This is based on the findings at this inspection.

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

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.

We did not inspect the key questions of effective, caring and responsive.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heritage Care Centre 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 care home had robust and effective measures in place to prevent and minimise the risk of catching or spreading COVID-19 for people using the service, staff, relatives and friends that visited the care home.

Managers and staff appropriately wore personal protective equipment (PPE) during the inspection. Staff received up to date infection prevention and control (IPC) and COVID-19 training, that was routinely refreshed.

IPC and PPE policies and procedures were regularly updated to reflect ongoing changes to COVID-19 related guidance and were followed by staff. They included specific Covid-19 related risk assessments for people, and contingency plans for managing adverse events, such as COVID-19 outbreaks and staff shortages.

Whilst care home access was restricted, due to an outbreak, designated people were permitted to visit their relative or friend in line with Government COVID-19 care home guidelines. All visitors to the care home had to follow the providers IPC guidance and procedures. This included the inspector during the visit.

Alternative communication arrangements were provided, by the care home, to enable people to maintain important relationships with relatives and friends. People were actively supported by staff, to keep in touch with those who could not visit the care home in-person, via telephone and video calls.

Currently the care home was not taking new admissions due to a Covid-19 outbreak. Once the outbreak passes new admissions will be taken and people will be returning after hospital stays. People will be required to have a negative COVID-19 test and self-isolate for the prescribed period to minimise the risk of the virus spreading.

A ‘whole home’ COVID-19 testing program was adopted by the care home. This meant people living, working or visiting the care home were regularly tested for COVID-19. All staff were vaccinated and people using the service were tested twice per week. The provider was aware of how to apply for COVID-19 home testing kits and had adequate supplies of PPE instore that met current demand and foreseen outbreaks.

The care home had a rolling program of continuously cleaning high touch surfaces, such as light switches, grab rails and door handles. This meant the care home was clean, hygienic and detailed records were kept of cleaning schedules to maintain this. The cleaning and all other staff were fully aware of their crucial role and responsibilities.

The care home thoroughly assessed infection risks to everyone living, visiting and working there. When people were deemed to be disproportionately at risk from COVID-19, appropriate action was taken to minimise the impact. All staff including those most at risk from underlying health care conditions or other relevant factors, had specific risk assessments in place.

The care home used the same block booked agency staff to reduce the danger of infection. Staff worked exclusively in the care home and on specific designated floors to reduce the risk of spreading infection.

The provider's IPC policy was up to date and last reviewed on 24 January 2022.

Heritage Care Centre has been established for a number of years and has previously been managed by different providers. This was the first inspection of the service since it was taken over by MMCG (2) Limited.

Heritage Care Centre 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.

Heritage Care Centre provides personal care with nursing for up to 72 older people, some with a diagnosis of dementia. The home is split into four units, two on the ground floor and two on the first floor.

There was a registered manager at the service. 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 and their relatives were extremely positive about the care and support they received from staff. We saw some examples of outstanding care being provided to people during the inspection, with staff showing real and genuine empathy towards people. The strong, person-centred culture at the service was embodied by the registered manager and this was passed down to the rest of the staff team.

Respect for privacy and dignity was embedded in the home and people were supported to maintain relationships that were important to them and engage in things that were of personal importance to them as individuals.

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 only deprived of their liberty to receive care and treatment when this was in their best interests, the provider sought legal authorisation to do so under the Mental Capacity Act 2005 (MCA).

The provider demonstrated its commitment to promote a positive culture within the home by being open and transparent to new ideas and collaborative working which had a positive impact on the care provided to people. We received positive feedback from health and social care professionals about the good working relationship they had with the service.

There was a strong emphasis on quality assurance within the service which was led by a quality team and the internal management team within the service. There was an emphasis on continuous improvement which was done through the results of any audits, learning from complaints and incidents and accidents. These were all used as a learning opportunity, and feedback was provided to staff to drive improvements.

The staff team were recruited on the values that they demonstrated and were motivated. There was a high level of compliance in relation to staff training and said they felt well supported. There were opportunities to progress within the organisation.

People told us they felt safe and their rights were protected by staff. People’s support needs, including in relation to their medicines, nutrition and ongoing health needs were managed well. Staff made appropriate and timely referrals to health professionals if needed and acted upon recommendations given.