Little Heath Care & Support

Little Heath Care and Support is a care home providing personal and nursing care to up to 64 people. At the time of our inspection, 61 people were living at the service. The service provides support to people who are living with dementia as well as those with care, physical or sensory needs. Little Heath Care and Support is a purpose built care home with bedrooms on two floors and access to communal areas, gardens and facilities such as a shop and hairdresser salon.

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

Risks to people and their safety was monitored and managed so they were supported to stay safe. The living environment and equipment were regularly checked to reduce and manage risks. The registered manager was in the process of creating environmental risk assessments. Effective infection prevention and control measures were in place.

People were kept safe from avoidable harm because staff were trained and understood how to protect them from poor care and abuse.

People appeared relaxed and comfortable living at Little Heath Care and Support and staff knew them well. Staff respected people’s privacy and dignity and understood and responded to their individual needs. Information was recorded and shared appropriately to enable staff to help people get the support they needed in the way they preferred.

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.

Staff supported people with their medicines in a way that met their needs. People were supported to access specialist support and routine health checks. Staff worked with other health and social care services to promote good outcomes for people and keep them safe.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Some people and relatives told us they felt more staff were needed. Staff were safely recruited by the provider.

There were clear lines of accountability and staff received training to ensure they were confident in their roles. Staff were passionate about the service and committed to providing high quality, person-centred care. The actions of staff reflected the vision of the provider.

Effective assurance processes were in place and the quality and safety of the service was well monitored. Systems helped identify shortfalls and areas for improvement. Audits were carried out regularly and overseen by the provider to ensure people received a safe and well run service. Performance information was reviewed by the management team and used to learn and make changes to develop and improve 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 and update

The last rating for this service was requires improvement (published 5 July 2022).

At the last inspection, there were breaches of two regulations. 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.

At our last inspection we recommended the provider referred to best practice guidance about recording in in relation to medicines management. At this inspection we found the provider had taken action to improve in this area.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 6 and 7 April 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

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 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 Little Heath Care and Support 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.

Little Heath Care and Support is a care home providing accommodation, nursing and personal care for up to 64 people. At the time of the inspection 54 people were living at the home. The home was purpose built with facilities over two floors. There were two units on each floor. The two units on the ground floor had Bramble and Fern and the first-floor units had Willow and Bracken.

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

The inspection identified areas of improvement relating to the management of risk. This included people’s nutrition and hydration, skin integrity and moving and handling. Improvements were also required to the recording of time specific medicines, the recording of fridges which stored medicines and the recording of medicines carried over from the previous month. We recommend the provider seeks best practice guidance to address the recording of medicines management.

Improvements were also required to staff and visitors wearing personal protective equipment such as surgical masks as during our inspection we observed at times these were not always worn as required. These shortfalls had not been identified through the providers quality assurance system and processes.

People were supported by enough staff and by staff who were kind and caring, however some staff were unfamiliar with people’s moving and handling needs and their specialist equipment. Staff felt well supported and it was a nice place to work. Staff had a good understanding of equality and diversity and that people should be treated as individuals. Staff had checks completed prior to working with vulnerable adults and staff felt people were safe. People received their medicines safely and were supported by staff who gave them choice and control.

Staff had access to personal protective equipment and regular testing. The service was clean and odour free. Relatives felt able to raise any concerns should they have any and the provider had a complaints process should anyone feel unhappy about the care received. Management was accessible and approachable with an ‘open door’ policy.

People could access various activities and we observed staff giving people choice about what they wanted to eat and drink. Incidents and accidents were logged including actions along with safeguarding incidents. People had referrals made to health care professionals including GP’s when required. Care plans contained important information about the person’s histories, such as hobbies, interests, employment and family information.

Rating at last inspection

This service was registered with us on 1 April 2020 and this is the first inspection.

Why we inspected

This was a planned inspection to check whether the provider was meeting legal requirements and regulations, and to provide a rating for the service as directed by the Care Act 2014.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards or 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.

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

We found the following examples of good practice.

We were safely showed around the whole home, we did not enter people’s bedrooms. When rooms become vacant, they remained locked for a period of time with deep cleaning taking place. Staff signed on a board outside of these rooms that they had been decontaminated and cleaned. As the home were not taking any new admissions at this time the rooms remained locked.

The home was exceptionally clean throughout. Housekeeping and laundry practices were overseen by housekeeping staff. The designated management team of each area completed daily walk arounds to check the home was clean to a satisfactory standard and that staff were following good practice. This included wearing the appropriate PPE. Plans were in place for a contractor to complete fogging of some areas of the home. Fogging uses an antiviral disinfectant solution which cleans and sanitises large areas of a building quickly and effectively.

The reablement centre and care home had a separate designated entrance and exit distanced from each other. Posters were displayed which explained the safety procedures in place at the home. Due to the Covid-19 outbreak the only visitors to the home were professionals or relatives that were able to visit loved ones who were receiving end of life care. These visits were kept to a minimum and visitors were asked to adhere to the home’s infection control procedures.

On arrival visitors were asked to sign in and had their temperature checked. They were provided with personal protective equipment (PPE) that included gloves, aprons and facemasks. They were then shown to the area of the home they were visiting.

People had been supported to maintain contact with their loved ones, by pre booked window visits, phone and video calls. Newsletters were also sent to people’s loved one to keep them up to date on information. The home had its own social media page which kept people and loved ones connected. A friends and family meeting was also held using a video call facility. Senior managers also attended the meeting. We were told that this went well.

Daily activities continued to take place for those people who were not required to self-isolate. Activities were organised by the staff team. People had been busy making Christmas photo scrap books for loved ones.

The management team told us that they were currently not accepting any new admissions to the home due to the outbreak of infection. When people were admitted to the home, risk assessments were completed, and people were isolated for 14 days with full PPE wore by staff.

Some people in the home were living with dementia, and unable to understand the need for social distancing. Staff were aware of the need to mitigate the risks associated with people being in close contact with one another. The home had sought advice from Public Health regarding one person who if tested positive would not be able to isolate as they like to walk around the home. Plans had been put into place to pre-empt this situation.

The home took part in regular testing for COVID-19. Staff were tested weekly, and people were tested monthly. Testing was currently being completed more regularly of people due to the outbreaks. Staff and people that had tested positive or displayed symptoms were immediately isolated. The provider maintained spreadsheets of the positive cases and graphs centred around the outbreak. These were helpful and showed how the virus had spread.

Little Heath Care & Reablement had policies and procedures in place. Staff had received infection control training and were kept up to date with any changes in guidance and information. Staff were given practical training on how PPE should be used.

The management team told us they were very well supported by the local GP surgery which was located across the road. We were told the surgery had gone out of their way to support the home.