Heron Hill Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Assessments were carried out by people with the right skills. The care home’s clinical lead, who had received an award for care planning, had oversight of the quality of people’s care plans.

People were involved as much as possible in their needs assessment and care plans were focussed on their strengths and what they could do for themselves. One person’s care plan showed a clear history of how their care needs had changed over time, from prior to their placement to what was in place to meet their current needs. There was a clear focus on supporting the person with their wellbeing and promoting as much independence as possible with their mobility.

Where appropriate, families, carers, advocates, professionals and other stakeholders were meaningfully involved in the assessment of people’s needs and reviews.

Staff kept clear, comprehensive care records to support reviews and there was evidence of appropriate action taken in response to changes in people’s needs.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff we spoke with understood the importance of ensuring care delivery met the required standards.

People were supported to maintain an excellent nutritional and fluid intake, to support with ensuring their continued health and wellbeing. This was recorded effectively in people’s daily records or on enhanced monitoring charts, where required. We observed during our inspection that people were being offered regular drinks by staff, with this being consistently recorded in their daily records. One staff member told us, “[When required], for specific residents, we set targets for fluid intake and focus on increasing this.”

Where people were being monitored for their weight, we saw regular checks of this were recorded. If this weight fell out of range, prompt referrals to health teams were made. We saw evidence of how people’s assessments and support was leading to improved outcomes. One relative told us, “My [person] had lost a lot of weight but is now weighed every week and is gradually gaining weight again.” Another relative told us, “[Person] really enjoys their food and has improved in their overall health due to regular meals and healthy choices.”

Where people lived with other risks such as with their skin integrity, we saw multi-factorial risk assessments in place including the effect of hydration and medicines on people’s care. People’s care records showed grading of ulcers and included advanced pressure strategies. Staff supported people to reposition in line with their care plans, recorded any issues and referred to the relevant specialist health agency, when required. We saw a review of one person’s skin integrity resulted in a change of airflow mattress.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Clinical leaders ensured the staff team were fully informed of updates to the service and changes in people’s needs. This was done via exceptionally detailed handover meetings and documentation included in people’s care records. One staff member told us, “The nurses are very supportive. We know people’s pre-admission needs and the handover meetings are very good. We are always informed of changes in people’s needs.”

The staff team worked very effectively across all floors and specialisms. One staff member told us, “Since [the registered manager] started, the home no longer works in silos on each unit. It used to be an ‘us and them’ culture but now it’s very much about teamwork. Communication is much better.”

The staff team worked very effectively with external services. One professional visiting the service told us, “Care staff will contact me between planned reviews if they have any concerns and I will follow up relevant requests with the GP practice for the residents as appropriate.” One relative told us, “Staff are always one step ahead with appointments and health issues.”

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service had introduced innovative technology to improve people’s health and manage their risks more effectively. A digital pain check device, which used facial recognition technology, was being used to identify pain for people who may not be able to verbalise when in pain. A falls detection system was in place to identify, monitor and analyse people’s falls which resulted in faster response times and staff being deployed more effectively.

The service worked effectively in partnership with health and social care teams. Ensuring people had access to any support or equipment they required. People were supported to access external appointments, when required.

People had excellent oral care plans in place, detailing their preferences, and any support needs. Daily records showed people were supported to maintain independence as much as possible with cleaning their teeth or dentures. For example, one person was able to brush their teeth themselves after staff had supported them to prepare the toothpaste.

People were enabled to access emergency health care ensuring they received prompt care and treatment. The local GP practice carried out regular ward rounds to ensure people had regular review of their medicines, or emerging clinical concerns. One person told us, “When I have needed the doctor, the home has just made the call. They are very quick to spot a health problem and deal with it promptly.”

People had clear communication plans in place, detailing any reasonable adjustments required. Guidance ensured staff understood the individual needs of each person. Staff were able to recognise changes in people’s presentation or emotional state and escalate issues where required. One staff member told us how they observe one person, who has difficulty expressing themselves verbally, to familiarise themselves with how they express their likes and dislikes and to provide a more personalised care experience.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Where required, the service worked with health partners to monitor people’s care. This included completing food and fluid charts, photographing people’s skin and recording people’s behaviours. This monitoring, carried out with people’s consent or in their best interests, promoted improved outcomes.

Regular care plan reviews enabled staff to have full oversight of the health and social care needs of all people; and reviews led to changes in people’s care and to positive outcomes. For one person, who had developed a skin issue, staff identified the issue quickly, reviewed their care plan, monitored the condition and made a referral to the appropriate health professional. The person’s relative told us, “[Person] had [skin issue] which the home photographed and immediately contacted the doctor. It healed up in no time.” Another person with a specific health condition and whose diet and fluid needs were being monitored, was being supported to choose healthier food options and their fluid intake had increased.

People and their relatives were involved as partners in their care and people were supported to maintain their independence around decision making. One relative told us, “I do a lot of my [person’s] care with the staff. They teach me and make me feel useful. I assist [person] with their food. It’s varied and always plentiful.”

We observed a flash meeting chaired by the clinical lead and attended by lead nurses. The meeting demonstrated an excellent approach to monitoring people’s needs and sharing updates about their health status and upcoming appointments. Lessons were shared about improving communication with health partners as well as new referral processes.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Consent forms about people’s care were in place and signed, where required, and we observed staff seeking people’s consent before providing support. One staff member told us, “I always seek and gain consent. I respect residents’ wishes and allow them to express themselves.”

People told us their consent was always sought, and they were involved in decisions about their care and support.One person told us, “I have been here for many years and feel part of the team. I am always asked about what I want.”

The service assessed people’s mental capacity where required and, where appropriate, those with legal authority were involved in making best interest decisions. When we discussed with the service the need to ensure people were given all the necessary information to make informed decisions about a falls detection system and pain detector devices, the service put a plan in place straight away to involve people.