Background to this inspection
Updated
14 June 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.
This was a focused inspection to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 12, (Safe care and treatment), and Regulation 17 (Good Governance) and of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
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
Heartwell House Residential Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
The service did not have a manager registered with the Care Quality Commission. This means the provider was legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with six people who used the service and a relative about their experience of the care provided. Some people who shared their experiences spoke in their preferred language which was not English and those who were unable to talk with us used different ways of communicating including using gestures and their body language. We spent time observing interactions between staff and people to help us understand their experience of the care and support provided.
We spoke with six members of staff including the nominated individual, the deputy manager, senior carers and care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included three people’s care records and five people’s medication records. We looked at two staff files in relation to recruitment and staff support. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, quality assurance records and policies and procedures.
Updated
14 June 2022
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Heartwell House Residential Care Home is a residential care home providing personal and nursing care to 13 people at the time of the inspection. The service can support up to 13 people. This service is also a domiciliary care agency to provide personal care to people living in their own homes but no one was receiving care at home.
People’s experience of using this service and what we found
Based on our review of key questions of Safe and Well-led. The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right Support
The provider made sure people were provided with care and support in a safe and clean environment. The provider was responsive and made safe the staircase used by people to access the upper floor. The areas with ongoing building works had been secured to protect people from the risk of hazards.
Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff made sure people received information about medicines in a way they could understand.
Staff supported people to have the maximum possible choice, control and independence so they had control over their own lives. Staff encouraged people to take part in activities of interest to have a fulfilling and meaningful everyday life.
Right Care
People's dignity and human rights were promoted, and people were encouraged to make day to day decisions about the activities and events they wished to participate in. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.
Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so.
Staff recruitment processes promoted safety. Staff had training on how to recognise and report abuse and knew how to apply it. Staff turnover was very low, which supported people to receive consistent care from staff who knew them well. People were supported by skilled staff who provided one-to-one support for people take part in activities, and visits and when they wanted.
Staff restricted people’s freedom based only on their individual needs and in line with the law.
Right culture
The provider was responsive to our feedback and assured us they would strengthen the systems used to monitor the quality of service in relation to people’s care plans and staffing. The provider told us they were in the process to recruit a manager for the service. They also assured us the reporting procedures would be revised to ensure staff notified CQC promptly about significant events that affects people’s safety.
People’s quality of life was enhanced by the service’s culture. Staff respected people’s rights and acted upon people’s views. The provider sought the views of people individually, in house meetings and through surveys.
Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.
Staff were committed to reviewing people’s care and support on an ongoing basis as people’s needs and wishes changed over time. People and those important to them were involved in planning their care. The service enabled people and those important to them to work with staff to develop the service. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
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 7 December 2021). At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this inspection to check whether enough improvements had been made to meet the regulations. We also checked the service is applying the principles of Right support Right care Right culture.
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.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.