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The provider of this service changed - see old profile

We are carrying out a review of quality at The Heights Care Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection summaries and ratings from previous provider


Overall summary & rating

Requires improvement

Updated 16 October 2019

About the service

The Heights is a residential care home providing personal and nursing care for up to 36 people, with a range of medical and age-related conditions, including arthritis, frailty, mobility issues, diabetes and dementia. The service is divided over two floors. On the day of our inspection there were 29 people using the service; 14 people were on the ground floor and 15 on the first floor.

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

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

We found people were at significant risk of harm from inadequate staffing levels. We received overwhelming feedback from people using the service, staff and relatives that there were not enough staff deployed to meet people’s identified care and support needs in a safe and consistent manner. Staff were unable to ensure people’s safety and welfare. Care plans contained evidence, in the daily notes, of the potential risk to individuals and the frustration of staff at the impact of inadequate staffing levels. Staff told us they did not have enough time to read care plans. They said they relied upon discussions with other staff and staff handovers. This has resulted in people not receiving the consistent care and support they required. There was not enough staff deployed to ensure people’s safety in the event of a fire and there was a lack of effective contingency measures in place to cover short notice staff absences. This placed people at risk of potential harm. Where accidents or incidents had occurred, lessons were not always learned to prevent the same thing happening again.

Medicines were stored, administered and disposed of safely by staff who were trained to do so. Systems and processes were in place to safeguard people from abuse. Staff understood the signs of potential abuse and how to respond appropriately.

We found people were at risk of dehydration. Food and fluid records did not indicate people had been provided with enough to drink. There was no documentary evidence of actions to be taken when fluid intake had been recorded as being very low. Staff did not always have the necessary training to meet people’s needs. Guidelines for staff followed best practice guidance and some staff had said they had received training, but this was inconsistent. We have made a recommendation with regard to the training.

People were not provided with adequate levels of personal care. Staff told us they did not always have time to support people with their personal hygiene. Furthermore, several records showed people had not been provided with assistance with oral care. Infection prevention and control measures were in place but not always adhered to and the premises were not clean in all areas.

People were supported to have 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 did not always have time to spend with people which impacted on their caring approach, we did see kind, friendly and respectful examples of caring on the day. People were not provided with adequate levels of personal care. Staff told us they did not always have time to support people with their personal hygiene. Furthermore, several records showed people had not been provided with assistance with oral care.

Quality assurance systems were not consistently effective. The registered manager had not completed regular audits and quality assurance monitoring.

Despite concerns being highlighted and regularly brought to the attention of the registered manager, there had been no change and no improvement. This had resulted in a culture of despondency and frustration amongst staff, who told us they felt they were not listened to, supported or valued.

Rating at last inspection

Rated as Good, report published 3 Febr

Inspection areas

Safe

Requires improvement

Updated 16 October 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 16 October 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 16 October 2019

The service was not always caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 16 October 2019

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 16 October 2019

The service was not always well-led.

Details are in our well-led findings below.