Heffle Court

Updated 6 August 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one inspector.

Service and service type

Heffle Court is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Heffle Court is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

The first day of the inspection was unannounced.

What we did before the inspection

We contacted the local authority market support team for feedback and discussed previous safeguarding enquiries with the local authority. We reviewed information we hold about the service including enquiries and notifications. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We met and spoke with 10 people living at Heffle Court, not everyone was able to tell us their views of living in the home due to their dementia or memory loss. We carried out a number of observations on both the nursing and residential floors throughout the inspection to help us understand the experience of people who could not talk with us. We also spoke to three relatives visiting the home. We spoke to nine staff including, the regional and registered manager, care and nursing staff. We also met the chef and designated housekeeping, administration and laundry staff. We reviewed a range of records. This included three people’s care plans in full and a further three peoples to look at specific areas in relation to their health and care needs. We also reviewed other documentation in relation to people’s safety, including medicine administration, accidents, incidents and risk assessments. We reviewed staffing and competencies, and a variety of records relating to the management of the service, including audits, policies and procedures. Following the inspection, we continued to review evidence provided and sought feedback from visiting professionals.

Updated 6 August 2022

About the service

Heffle Court is a purpose built care home providing residential and nursing care for up to 41 older people. People had a range of health and mobility problems. Some people were also living with dementia and memory loss. There were 37 people living at the home at the time of the inspection.

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

Quality assurance systems were in place. This included checks to review and assess the care provision and documentation. However, these needed to be developed to ensure that observations were carried out to identify bruising and to ensure that this information had been robustly recorded and fed back to staff. There was an overreliance on verbal sharing of information and staff needed to ensure information was clearly documented, for example if a bruise was noted during personal care. This was fed back to the regional and registered manager during the inspection and immediate action was taken. Risk was also mitigated as staff knew people well and we have been assured that improvements have been introduced for documentation and quality assurance.

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 received their medicines safely. Nurses and care staff trained to give medicines ensured medicines were stored, administered and disposed of safely. Clear documentation was in place to support people who required their medicines being given covertly.

Risk assessments were completed to maintain people’s safety. People told us they felt safe living at Heffle Court. One person told us, “Staff cannot do enough for you.” People spent their time in the way they chose. Staff told us about peoples likes, dislikes and preferences. For example, one person liked to sit in the lounge at times, however, staff were aware that they would leave and return to their room or to find a quiet spot to sit if things got lively or noisy.

People, relatives, staff and visiting professionals were encouraged to share their views and feedback was used constructively to facilitate on going improvement. People told us the manager had an open-door policy. Relatives told us communication was good and they were kept informed and updated of any changes. If people had any concerns they told us they would be happy to discuss these with staff or management.

There were safe systems to support effective infection prevention control. The home was open to visiting and COVID-19 measures were reviewed regularly in line with current government guidance.

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 18 April 2019).

Why we inspected

The inspection was prompted, in part, due to concerns received about the provider’s approach to visiting, responding to concerns and risk of a closed culture. A decision was made for us to inspect and examine the concerns across a range of Caring Homes services. We had also received specific concerns regarding Heffle Court in relation to peoples nursing and care needs, medicines, staffing and communication with families.

As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

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 as good, based on the findings of this inspection. However, we have found evidence that the provider needs to make improvements. The provider has taken action to mitigate this risk. Please see the well led section of this full report.

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