10 April 2014
During a routine inspection
Below is a summary of what we found. This summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them, people’s relatives and from reviewing records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
Most of the people we spoke with who lived at The Heathers told us that they felt safe and secure and that staff treated them with respect and dignity. Some people we could not communicate with but we did observe and note how they were treated, how they were provided with assistance and what efforts were made to keep them safe.
People we were able to speak with told us that they knew who to speak to if they didn’t feel safe or were unhappy about something. They indicated that staff took great care to ensure that they felt secure and as happy as they could be in their surroundings. A family member of one person we spoke with said "I am confident that any changes, good or bad, would be reported back to us as a family. This gives us great comfort."
We observed training taking place during our visit. We noted a rolling programme of training scheduled to take place throughout 2014. This told us that the management at The Heathers were committed to providing its staff with relevant training to keep them and people living in the home safe.
We inspected the staff rotas and found that there was sufficient staff on duty to meet people's needs throughout the day and night.
The Heathers had initiated a daily programme of identifying and rectifying equipment faults, for example wheelchair malfunctions. Health and Safety records were up to date as were maintenance records for servicing equipment. This meant that people were not exposed to unnecessary risk.
We saw that the home was clean and well maintained.
The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Although no DoLS applications had been made, staff were able to describe the circumstances when an application should be made and knew how to submit one.
Is the service effective?
All aspects of people’s care had undergone a rigorous review since January 2014 to measure and ensure quality, safety and people’s satisfaction.
The Heathers demonstrated that it took great care to ensure the care and wellbeing of the people who used the service. This was shown in individual care plans, continuing risk assessments, daily records and communication records. Where it had been possible we saw evidence of people being involved in decisions about their care and that their needs and wishes were known.
There was a system of recording and managing incidents and complaints which was managed by the quality assurance lead. We saw evidence of how the home responded to issues, or requests, which resulted in the home increasing its levels of effectiveness and satisfaction.
We saw evidence that care plans and risk assessments were reviewed on a monthly basis or as and when required. Reviews with people using the service and their family members were also noted to take place. This told us that the home took reasonable steps to work with families to deliver care in a way which was both satisfactory and re-assuring.
We noted that other healthcare professionals worked with the home to ensure continuity of care where necessary.
Is the service caring?
The Heathers operated an ‘open door’ policy to people living at the service, their families and staff. This meant that staff and management could be approached at any time to listen to and act on any concerns or suggestions.
We noted that people were supported respectfully and courteously. We also noted that people were regularly spoken with in a polite manner by staff. Smiles and words of comfort were offered and interactions seen to be understood by the person spoken with.
Care and support provided was individual and informative.
Was it responsive?
We saw that the home responded to people on an individual basis. People’s likes/dislikes were acted on and we saw every effort made to put the interests and wellbeing of the individual first.
One person we spoke with said “They are letting my partner move into the room with me. Look, there’s a new bed and wardrobe ready for them.” This told us that the provider considered all options when providing for the care and welfare of its service users and their immediate family.
We saw call alarms being responded to in a reasonable time and staff responding to people's needs and questions in a proficient manner. We noted that whilst staff were busy during the inspection that they still took time out to re-assure people, interact with them and generally engage with them.
Food was home cooked, could be eaten in private or in the dining room. We noted that hot and cold drinks were made available throughout the day.
During our visit we noted staff members were working in specific areas of the home. We noted that this enabled them to develop an individual knowledge of each person and their care requirements. For example, how best to communicate with them, their likes, dislikes, and dietary requirements. We noted that comments and thoughts were shared in daily records and shared across the management and care teams as part of regular reviews.
Was it well-led?
Recent staffing changes at The Heathers had resulted in the introduction of a thorough review of the quality assurance system. Part of this review included the decision to put staff in specific areas of the home and was being seen to deliver benefits. One such benefit was the enhanced interaction with and between some of the people living in specific areas of the home.
Management and staff had worked through the teething problems of working in this new this way. This was further strengthened by the recent appointment of a registered manager with a clinical background.
The quality assurance system in place was robust. Learning from incidents/complaints was recorded and shared and any shortfalls in service provision put right.
We found that people’s personal care records, and other records kept in the home, were accurate, safe and filed appropriately and securely.