Archived: Heritage Care Centre

Updated 13 September 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 21 and 26 July 2016 and was unannounced. This inspection was undertaken by two inspectors, an expert by experience and a specialist advisor. An expert by experience is a person who has personal experience of using or caring for someone who uses services like this. On this inspection the specialist advisor was a qualified nurse.

Before we visited the service we checked the information that we held about it, including notifications sent to us informing us of significant events that occurred at the service. We asked the provider to complete a Provider Information Return (PIR) prior to our inspection. The PIR is a report that providers send to us giving information about the service, how they met people's needs and any improvements they are planning to make.

We spoke with eight people using the service, three relatives and 12 staff members including the registered manager, chef, activities co-ordinator, nurses, care workers and domestic staff. We looked at records including care records, training records, staff records, and audits.

During the inspection, we spoke with two visiting professionals. After the inspection, we contacted eight health and social care professionals to gather their views and received responses from four of them.

Updated 13 September 2016

This inspection took place on 21 and 26 July 2016. The first day of the inspection was unannounced. We told the provider we would be returning for the second day. This was the first inspection since the provider registered with the Care Quality Commission, the service was previously registered under a different provider.

Heritage Care Centre is a care home for people requiring nursing or personal care. It is split over three floors and has four separate units for people. All bedrooms are single occupancy with ensuite facilities. At the time of the inspection, there were 68 people using the service across the four units. The units on the ground floor were for people that required nursing care. The units on the first floor were for people living with dementia and who required nursing care.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People using the service and their relatives told us that staff were caring and friendly. People said they felt safe in the presence of care workers and we found that care workers were familiar with people’s needs and preferences in relation to their personal care and meals. They knew about their underlying health conditions and how they would support them with this aspect of their needs. Many of the care workers we spoke with had been working at the service for a long time which meant they were able to develop caring relationships with people. We saw many examples of caring interactions between staff and people using the service during our inspection, for example during medicine rounds and at mealtimes.

People were supported to take their medicines appropriately. We observed a nurse on a medicines round during the inspection. They asked for people’s consent and explained what their medicines were for before administering them. The ordering, storing and disposal of medicines were safe.

People told us they enjoyed the food at the home. People had their dietary and cultural preferences met. People on special diets were also supported appropriately. There was a four week rolling menu at the home, with the main meal served at lunch.

We found that there were sufficient staff to keep people safe and to support them. A nurse was assigned to each unit, supported by a number of care workers. Extra staff were called upon if people needed one to one support. The provider had thorough recruitment checks in place which helped to ensure appropriate staff were employed.

Staff received regular supervision from their line managers and said they felt supported. However we found that the training they received was not always being completed in a timely manner. The training matrix indicated that staff were not meeting the provider’s expectations with regards to ongoing training.

There were risk assessment and risk management plans in place which helped to ensure that people were protected from harm. People were assessed against the risk from falls, challenging behaviour, pressure ulcers, malnutrition, infection and dehydration. For each assessed risk there was an associated care plan and care plan evaluation in place which helped to ensure the risk was being managed properly.

The care records were in the process of being transferred across to a new format and the registered manager told us they had not completed this process. Although the new care plans were easy to follow and well laid out, we found that information was missing from the ones that had been completed and in some cases staff were not completing records correctly.

Although staff showed a good understanding of the Mental Capacity Act 2005 (MCA), consent and how to act in the person’s best interests, we found records in relation to these were not always fully complete and did not evidence people’s consent appropriately.

Staff praised the registered manager for her approach and said she listened and they felt supported. There were some vacancies in the management team of the home which the provider was looking to fill; this included a clinical lead and a deputy manager to support the registered manager in her role.

A number of audits took place which meant the provider had a good oversight into any issues that needed attention.

We found two breaches of regulation in relation to staffing and consent. You can see what action we have told the provider to take at the back of the full version of this report.