Heather Grange

Heather Grange is registered to provide accommodation and personal care for up to 70 people. There were 56 people living in the home at the time of the inspection. Accommodation is provided in single occupancy rooms, all of which had an ensuite shower facility.

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

People told us they felt safe living in the home, and they were happy with the service provided. Improvements had been made to the management of medicines and people received their medicines safely. Staff had received safeguarding training and had access to the provider’s policies and procedures. There were sufficient numbers of staff deployed to meet people's needs and ensure their safety. The provider operated an effective procedure for the recruitment of new staff. Individual and environmental risks had been assessed and managed. People were protected from the risks associated with the spread of infection. The premises had a good standard of cleanliness throughout the building.

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.

The management team carried out a series of audits to check and monitor the quality of the service and ensure records were completed accurately. The registered manager provided clear leadership and considered the views of people, their relatives and staff in respect to the quality of care provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection and update

The last rating for the service was requires improvement (published 9 November 2021) and there was a breach of a regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced focused inspection of this service on 5 October 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the management of medicines.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heather Grange 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.

Heather Grange is registered to provide accommodation and personal care for up to 70 people. There were 43 people living in the home at the time of the inspection. The home is a purpose built and set in its own grounds in a residential area of Burnley. Accommodation is provided in single occupancy rooms, all of which had an ensuite facility. The home had separate suites known as Village, Woodlands and Garden. Garden suite specialised in providing care for people living with dementia.

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

People told us they liked the staff working at the home and confirmed they usually responded promptly to any requests for assistance. We observed warm and respectful interactions with staff and people throughout the inspection. The manager and staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. The home had a good standard of cleanliness and staff adhered to infection prevention and control policies and procedures.

Whilst Police checks and references had been obtained prior to new staff working in the home, we noted there were gaps in one staff member’s history of employment. The manager assured us this issue would be addressed.

Medicines were not managed safely which placed people at risk of harm.

The provider had established systems to ensure lessons were learnt from any incidents and the manager understood their responsibility to be open and honest when something went wrong. The staff carried out risk assessments to help people to retain their independence and receive care with minimum risk to themselves or others. The provider had arrangements to check the safety of appliances, installations and equipment. All safety certificates were complete and up to date.

The provider had a comprehensive schedule of audits which covered all aspects of the operation of the service. There was limited evidence to demonstrate people had been consulted about the service. The manager agreed to address this issue immediately.

Rating at last inspection

The last rating for this service was requires improvement (published 8 June 2019). The service remains rated requires improvement. This service has been rated requires improvement following two consecutive inspections.

Why we inspected

We received concerns in relation to the management of medicines. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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.

The overall rating for the service has remained the same. We found evidence the provider needs to make improvement. Please see the safe section of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heather Grange on our website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

During this inspection, we identified a breach in relation to the management of medicines.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Heather Grange is a residential home registered to provide accommodation and personal care for 70 people with a range of needs. At the time of the inspection, 59 people lived at the home. The home was split into four suites known as Village one, Village two, Garden and Woodlands. People living with dementia were provided with care and support on Garden suite.

People’s experience of using the service

People told us they felt safe living at Heather Grange. Staff understood how to safeguard people from abuse and report any concerns. People confirmed there were usually sufficient numbers of staff available to meet their needs. The provider had an effective recruitment procedure, which ensured only suitable staff were employed in the home. All areas of the home had a good standard of cleanliness. Risks to people’s health and safety had been assessed, recorded and reviewed at regular intervals.

The provider did not always manage people’s medicines safely which placed people at risk of harm.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, the systems in the service did not always support this practice. We found staff had not carried out appropriate assessments for one person who expressed a wish to go out alone. A senior manager spent time with the person on the second day of inspection with a view to developing an appropriate risk assessment. People’s needs were assessed prior to them using the service.

The provider had appropriate arrangements to ensure all staff received training relevant to their role. New staff completed an induction training programme. The manager had devised a schedule to ensure all staff had a one to one meeting with their line manager.

People were supported to eat a nutritionally balanced diet. However, we observed staff focussed on tasks when supporting people with their meals and did not always respond in a timely way to people’s wishes. People had mixed views about the quality of the food provided. We recommended the provider improved people’s dining experiences. The area manager explained a food forum had been held in the home and this had resulted in a change in the menus. People were supported to maintain their health and a visiting healthcare professional provided positive feedback about the service.

We saw staff treated people with kindness and respect and spent time getting to know them and their specific needs and wishes. Our observations during the inspection, were of positive and warm interactions between staff and people who lived in the home. Whilst all people had a detailed care plan, there was limited evidence to demonstrate people had been consulted and involved in the care planning process. We also found staff had not fully explored and recorded people’s diversity needs.

People were aware of how they could raise a complaint or concern if they needed to and had access to a complaints procedure.

The provider’s quality assurance processes were not always effective in achieving positive outcomes for people. The manager was fully supported by senior managers who visited the home on a regular basis. They had developed action plans to ensure improvements were made to the service.

Rating at last inspection:

This was the first inspection of the service. The provider registered in December 2018.

Why we inspected:

This was a planned comprehensive inspection.

Enforcement

Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow-up

We will continue to monitor the service to ensure that people receive safe and high- quality care and re-inspect in line with the rating for the service. We may inspect sooner if we receive information of concern.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk