About the service:Heffle Court is a residential care home. There were 37 people living there at the time of the inspection. The service specialises in providing nursing and care to older persons who are living with dementia, some of whom may show challenging behaviours. Some of the people were also living with a range of care needs, including arthritis, diabetes and heart conditions. Most people needed support with their personal care and mobility.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
People’s experience of using this service:
• Staff had a good understanding of the risks associated with the people they supported. Risk assessments provided further information for staff. People were protected from the risks of harm, abuse or discrimination. Staff ensured they considered a range of areas to reduce people’s risk of harm. This included making sure people’s arms were fully protected when moving people using hoist slings and by making sure people sat on their own pressure relieving cushions in the lounge.
• If a person did have an accident or was involved in an incident, records were clear and, where relevant, there was 24-hour follow-up to review how they were.
• People were supported to take their medicines when they needed them. Records relating to medicines were clear, this included where people where prescribed medicines like Warfarin, where the dose can vary over time.
• There were enough staff on duty to ensure people received the support they needed. For example, the activities worker told us there were enough staff deployed to ensure people received the support they needed when they took people out on trips in the service’s minibus.
• Staff were supported and provided with the skills they needed to meet people’s needs, this included recent training in reporting and recording skills.
• People were supported in the way they needed to eat and drink. All meals, including liquidised meals, were attractively presented. All staff had been trained in supporting people who needed textured foods.
• Staff followed national guidelines on meeting people’s needs and had good relationships with GPs and other external professionals. For example, all staff on the residential floor had a good understanding of supporting people who were living with diabetes, this also included training and supervised practice on giving people insulin injections.
• Staff were aware of their responsibilities under the Mental Capacity Act (MCA) and Deprivation of Liberties Safeguards (DoLS).
• Staff were very aware of the importance of gaining consent from people before they supported them. For example, one person was leaning to one side in their chair and looked uncomfortable. The member of staff sought their permission to place a cushion on that side of their body, so they were not leaning too far. The also explained what they were doing and why.
• There was a relaxed atmosphere, with people who were able to, walking about as and when they wanted, choosing where to sit in sitting rooms.
• People had positive interactions with staff. For example, one member of staff was sitting with two people at a table, there was lots of laughter and engagement between the three of them and all three clearly enjoying each others' company.
• Staff were always polite to people. One person came out of their room suddenly, the member of staff who was passing the person’s room pushing a trolley, stopped and said, “Did I startle you, I am sorry.”
• One person was confused about where they were, the time and day of the week. A member of staff held a calm relaxed conversation with them, orientating them to what was happening and where they were.
• People had clear care plans which outlined how their needs were to be met, in a person-centred way.
• Staff sought people’s permission to be involved with activities and supported them with engagement.
• The registered manager was keen to develop a range of ways to receive people’s opinions about the care they received.
• The registered manager was experienced in their role and open to new ideas. Her values included the promotion and improvement in the lives of people who were living with dementia in a way that suited each individual.
• The registered manager was supported by senior staff who were keen to innovate and develop care practice; they also actively supported more junior staff.
Rating at last inspection:
Good (report published 16 September 2016)
Why we inspected:
This was a planned inspection based on the rating at the last inspection.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.