3 October 2022
During an inspection looking at part of the service
About the service
Heathcotes (Arnold) is a residential care home registered to provide personal and nursing care to up to ten people. The service provides support to people who have mental health support needs, learning disabilities and/or autistic people. At the time of our inspection there were five people using the service.
People’s experience of using this service and what we found
Right Support
People lived in a property in which some fire doors were defective. This created a potentially increased risk of harm in the event of a fire. The provider told us they would rectify those issues. Waste management was not safe. External waste bins were overflowing and had attracted rodents. Parts of a person’s individual living area required repair and refurbishment and floor coverings in some communal parts of the building required replacement. Staff did not always wear protective face masks and, when they did wear them, did not always wear them appropriately. Some relatives told us they felt the service could involve families more than they currently did. The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative. Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced. People had a choice about their living environment and were able to personalise their rooms.
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.
Right Care
People had appropriate care plans and risk assessments in place and staff understood how to support people. The inside of the care home was generally hygienic and homely. People were supported by enough staff to meet their care needs. People’s prescribed medicines were managed appropriately. Staff understood how to protect people from the risk of abuse and how to report any concerns. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.
Right Culture
People were supported to maintain contact with their relatives and were encouraged to engage in community-based activities. People told us they knew how to complain if they were unhappy about anything at the care home. Staff told us they felt supported by the registered manager and told us they believed improvements in the service were being made. Staff placed people’s wishes, needs and rights at the heart of everything they did. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.
We have made a recommendation about the management of premises checks and maintenance works at the premises.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Requires Improvement (published 18 December 2019) and there was a breach of regulation. At this inspection we found improvements had been made and the provider was no longer in breach of regulation 9 (Person-centred care). However, the provider was found to be in breach of regulation 15 (Premises).
Why we inspected
The inspection was prompted in part due to concerns received about the support provided for people who were expressing distress or agitation; and to check the staffing levels at the care home. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of Safe, Responsive, and Well-led only.
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.
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 remains Requires Improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the Safe section of this full report.
The provider has subsequently told us they intend to take action to mitigate the risks we identified during the inspection, by carrying out identified maintenance and refurbishment works to the property.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heathcotes (Arnold) on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches of regulation in relation to the fire safety arrangements, maintenance processes, and the management of household waste at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.