9 July 2019
During a routine inspection
Heeley Bank Care Home is a nursing and residential home, which at the time of this inspection was providing personal and nursing care to 59 older adults, some were living with dementia. The home comprises of three units, one for residential care, one for nursing care and one for people with dementia related conditions. The service can support up to 67 people.
People’s experience of using this service and what we found
The service had made some improvements since the previous inspection but not all feedback had been robustly addressed before we came to inspect. We found improvements were still required in key areas including the management of medicines, staff support and the homes auditing and quality monitoring processes.
People had not always received their medicines safely. We identified issues with documentation and record keeping. The home was responsive to feedback and took steps during and after the inspection to address these concerns.
A new manager was appointed at the home in May 2019 and they had relevant experience in how to run a service effectively. The service had quality assurance process in place which monitored all aspects of the services provided, however more work was required to ensure they were identifying the types of issues we found during inspection.
Staff were recruited safely and there were enough of them to keep people safe and to meet their care needs. People and relatives acknowledged there had been a number of personnel changes at the home over the last 12 months. Permanent staff knew people and their needs well, and we saw caring interventions throughout our inspection, albeit some people told us these interventions were sometimes task-led.
Staff were receiving appropriate training which was relevant to their role and people's needs. However, staff were not properly supported by the management team through regular formal supervisions where they could discuss their on-going development needs.
People told us they felt safe living at the home. Relatives we spoke with also raised no concerns about the safety of their loved ones. Staff were knowledgeable about how to identify and report any safeguarding concerns, which had been reported to the local authority as per the reporting procedure. Accidents, incidents and falls were documented, with lessons learned discussed as a staff team to help prevent a reoccurrence.
People's needs were assessed, and care was planned and delivered in a person-centred way, in line with legislation and guidance. We have made two recommendations about advance care planning and support plans for people who display behaviours which may challenge.
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.
People spoke positively about the food and drink provided, confirming they were offered choice and received enough.
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 18 July 2018) and there were multiple breaches of the regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made/sustained, and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two inspections.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to the management of medicines, the support staff received and governance systems and processes.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.