Headingley Court Care Home

Headingley Court is a care home providing nursing and personal care for up to 25 people. At the time of our inspection 24 people were using the service.

The provider had a system in place to safeguard people from the risk of abuse. Staff received training in protecting people from abuse. Risks associated with people's care had been identified and guidance was in place to ensure staff provided safe care. Medicines were managed in a safe way. The provider had procedures in place to ensure people were protected from the risk and spread of infection. The home was clean and tidy.

Accidents and incidents were recorded, and the registered manager completed an analysis to ensure trends and patterns were identified and action taken to mitigate future risks. Health and safety checks of the building and equipment were maintained.

The providers recruitment policy ensured staff were recruited safely and pre-employment checks were carried out. There were enough staff available to respond to people in a timely 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.

We observed staff interacting with people and found they provided person centred care and support. People were offered choices and given the opportunity to express their views. People and their relatives were given opportunity to attend a monthly meeting to express their opinions. The registered manager completed a 'you said, we did' information points to show how they had responded to people's suggestions and ideas.

Audits were in place to ensure the service operated to the standards expected by the provider. Where issues had been identified, action plans were devised and items actioned in a timely way.

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 good (published 25 November 2021).

Why we inspected

We received concerns in relation to leadership, person centred care and staffing. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of 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 Headingley Court 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.

Headingley Court is a care home providing personal care and nursing. It can accommodate up to 25 people. There were 25 people using the service at the time of the inspection.

People’s experience of using this service

People were safe. We observed staff ensured people’s safety. People we spoke with told us they felt safe. Staff understood safeguarding and whistleblowing procedures. We observed there were sufficient staff employed to meet people’s needs. Staff we spoke with also confirmed this. There was a safe recruitment process, which ensured only staff suitable to work with vulnerable adults were employed. Accidents and incidents were effectively monitored, which ensured staff learned when things went wrong. Risks to people were identified and assessments were in place, which contained good detail to ensure risks were managed safely. People were protected by the prevention and control of infection. Medication systems were in place and followed by staff to ensure people received their medicines as prescribed. Documentation was further improved by the registered manager following our inspection to address some minor issues we identified.

Staff we spoke with were very knowledgeable about people’s needs. We observed that care provided was person-centred and individualised. Staff had received effective training to ensure their knowledge was up to date. Staff were supervised and supported. 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. People had access to health care professionals. Staff worked closely with other professionals to ensure people's needs were met. Feedback we received from commissioners was positive; they had seen improvements in the care and support provided to people.

People we spoke with told us staff were extremely kind and caring. Relatives we spoke with were positive about the care and support provided and told us they had noticed improvements in all areas over the last few months. Staff respected people’s privacy and promoted their dignity. We observed interactions between staff and people who used the service and they were extremely positive, inclusive, respectful and person-centred, promoting people’s well-being. Care and support was delivered in a non-discriminatory way and the rights of people with a protected characteristic were respected.

There was a quality monitoring system in place. The registered manager and the provider had identified areas they needed to improve following our inspection in January 2021. They had devised an action plan and had worked to complete the actions and make improvements. The audits continued and action was taken to ensure improvements were sustained and embedded into practice. Relatives felt listened to and said complaints were appropriately dealt with and resolved. People we spoke with told us their views were obtained to continually drive improvements to the service. Feedback from staff was extremely positive about the improvements to the service. They worked better as a team and were well supported.

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

Rating at last inspection

The last rating for this service was inadequate (published 17 March 2021) and there were multiple breaches of 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.

This service has been in Special Measures since 17 March 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last 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.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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

The registered manager had introduced new quality monitoring systems with the support of the management team. We found the systems which had been implemented had driven some improvements. However, we identified some areas still required more effective quality monitoring to ensure all areas for improvements were identified. The registered manager acknowledged this and was aware more work was required to implement robust systems which required embedding into practice and sustained to continue to drive improvements.

We were not fully assured by infection prevention and control policies and procedures. The provider was not robustly promoting safety through the layout and hygiene practices of the premises. However, issues were addressed following our site visit by the registered manager.

Staff we spoke with told us the service was improved, they felt more supported. There was better communication between management and staff, relatives and people who used the service.

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 inadequate (published 17 March 2021).

Why we inspected

We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains inadequate.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

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 coronavirus and other infection outbreaks effectively.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information.

Special measures

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements. If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Headingley Court is a care home providing personal and nursing care for younger adults with a physical disability. It can accommodate up to 25 people. There were 23 people using the service at the time of the inspection.

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

We found systems and processes used to ensure the service was running safely were not effective. They had not identified required improvements, therefore they were not effective to ensure the service was running safely. We observed lack of leadership, direction and oversight. Staff told us they did not feel listened to.

Risks associated with people’s care were not always identified or managed in a way that kept people safe. Incidents and accidents were not effectively reviewed to ensure lessons were learnt to drive improvements. We identified some shortfalls in the way people’s medicines were managed. We were not fully assured people were protected by the risk and spread of infection, although this was addressed by the registered manager.

Staff were not always deployed effectively to ensure people’s needs were met. We observed people who were meant to be supported on a one to one basis with no support. We observed staff were not present in communal areas, we observed people waiting for assistance and staff not having time to talk to people. Staff had not consistently received specific training to meet people’s needs. Staff did not receive effective competency checks on their performance and abilities to ensure they carried out their roles and responsibilities safely. There were systems in place to safeguard people from abuse. However, we referred a safeguarding concern to the Local Authority, which we identified at inspection.

Staff told us they did not always get opportunity to spend time with people, they were rushed and often short staffed. Therefore, staff did not always support people appropriately. Care and support we observed was task orientated and not person-centred. Staff did not always show concern for people’s well-being. For example, we observed people left with no interaction or stimulation for long periods of time.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. There was lack of evidence to show that people were involved in decisions about their care, support and treatment. Relatives we spoke with told us there was lack of communication during the pandemic.

We identified a closed culture, people did not have their human rights upheld, protected characteristics were not recognised or respected and equality was not promoted.

We saw people were referred to health care professionals and advice obtained. However, from documentation it was not always clear if the advice was followed. Therefore, it was not clear if people’s needs were being met. Care plans did not always detail people’s current needs, were difficult to follow, were contradictory, inconsistent and not person centred.

The service was purpose built and the adaptation and design could meet people’s needs. Complaints were recorded in line with the provider’s policy.

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 good (published 4 February 2020)

Why we inspected

The inspection was prompted due to concerns received from the local authority commissioners and safeguarding referrals. These were regarding, risks not being managed and allegations of abuse. We completed a site visit to look at the safe, effective and well led key questions. Following the concerns, we identified at this visit, we included the key questions of caring and responsive, therefore we have looked at all key questions.

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 coronavirus and other infection outbreaks effectively.

The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see all sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ’Headingley Court’ 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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, consent to care and treatment, person centred care, staffing and governancet at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Headingley Court is a purpose built home providing care and support for up to 25 people with nursing needs. At the time of our inspection, the home was fully occupied. The home provides accommodation on one level.

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

People received safe care and support by staff who had been appropriately recruited, trained to recognise signs of abuse or risk and understood what to do to safely support people. Medicines were given safely to people by trained and knowledgeable staff, who had been assessed as competent, although we have made a recommendation regarding medication. There were enough staff who were appropriately deployed to meet people's needs. Infection control was well managed and the home was well-maintained and free from hazards.

People’s needs were assessed before they moved into the service to ensure the home would be able to meet their needs. 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. Staff had been recruited safely and received training appropriate to their role. Staff received supervision and appraisal to develop their skills and knowledge. People were supported to eat a balanced diet, had a choice of meals and any dietary preferences were catered for.

Everyone we spoke to was consistent in their views that staff were very kind, caring and supportive. People were relaxed, comfortable and happy in the company of staff and we saw positive staff interactions during the inspection. People's independence, privacy and dignity was promoted, and their views and opinions sought and valued. People were treated with dignity and compassion. They were supported to be as independent as possible and express their views about their care and support

Each person had a care plan that contained details about their choices and preferences. These plans had been reviewed regularly and updated when needed and provided accurate and clear guidance for staff about how to support people. People continued to be supported to lead full and active lifestyles, follow their interests, and take part in social activities. People knew how to make a complaint and were confident their concerns would be dealt with effectively. Where appropriate, people's end of life wishes were recorded.

The registered manager was proactive in ensuring they had a visible presence within the home and operated an open-door policy ensuring that any low-level concerns were dealt with promptly preventing escalation. The management team used quality assurance processes to review the quality and safety of the care provided.

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

Rating at last inspection

This service was registered with us on 10 January 2019 and this is the first inspection.

Why we inspected

This was a planned inspection as the service had yet to be rated since it registered with the CQC.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner.