Background to this inspection
Updated
4 March 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 was planned to check 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.
The inspection took place on 28 January and was unannounced. The inspection was carried out by two inspectors and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We reviewed information we held about the service. This included statutory notifications the registered manager had sent us. We looked at information received from people that used the service and their relatives, from the local authority commissioners and the statutory notifications the registered manager had sent us. A statutory notification is information about important events which the provider is required to send to us by law. Commissioners are people who work to find appropriate care and support services which are paid for by the local authority.
The service has recently come under new ownership and we had not asked the new provider to submit a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. However, we gave the provider opportunity to share any relevant information with us and discussed developments planned for the service.
We spoke with 11 people living in the home, nine relatives, seven members of the care staff, the activities co-ordinator, the chef, the deputy manager, the manager and a member of the provider’s management team. We did this to gain views about the care and to ensure that the required standards were being met.
We spent time observing care in the communal areas to see how the staff interacted with the people living in the home. Most people were able to speak with us in detail about the care and support they received. However, for people who were unable to speak to us, we used our short observational framework tool (SOFI) to help us understand their experience of care.
We looked at the care records for seven people to see if they accurately reflected the way people were cared for. We also looked at records relating to the management of the service, including staff recruitment files, training records, staff rotas and quality checks.
Updated
4 March 2016
This inspection took place on 28 January 2016 and was unannounced. Our last inspection took place on 28 October 2013 and at the time we found the service was meeting the standards that we checked.
The Heathers provides accommodation and nursing care for up to 53 older people in two units, the general nursing unit on the ground floor and the EMI unit on the upper floor. The EMI unit provides support for people living with more advanced dementia. At the time of the inspection, 46 people were using the service. 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.
Improvements were needed to ensure risks to people's health and safety were managed on a consistent basis. People told us they received their medicines when they needed them but improvements were required to ensure medicines were recorded and administered as prescribed. Staff sought people’s consent before providing care but people’s capacity to make their own decisions was not always assessed when needed. Where people may lack capacity, it was not clear how they had been supported to make decisions in their best interests. You can see what action we told the provider to take at the back of the full version of the report.
Safeguarding procedures were in place to keep people safe from harm. People felt safe living at the home and if they had any concerns, they were confident these would be addressed quickly by the management team. Staff had been recruited using clear guidance and staff received training so they had the skills and knowledge to provide the support people needed. The service offered a choice of meals and people could decide where they wished to have their meals.
People were offered opportunities to join in group activities and were supported to follow their own interests. Staff knew people well and spent time chatting with people. Staff were kind and caring and provided emotional support and comfort when people were distressed. People told us the food was good at the home and they were supported and encouraged to eat and drink enough to maintain a healthy diet. People accessed the support of other health professionals to maintain their day to day health needs.
People and their relatives felt comfortable approaching the registered manager and staff with any concerns and were confident action would be taken. The registered manager investigated and monitored complaints and made improvements to the service where needed. Some improvements were needed to ensure the quality monitoring checks carried out by the registered manager were effective in maintaining and improving the care people received. People and their relatives were asked for their views on some aspects of the service and the provider was looking at other ways to gather feedback to drive continuous improvement.