Archived: Heanton

Updated 23 February 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.

We undertook an unannounced focussed inspection of Heanton on 22 December 2015. We had received concerns about staffing levels and risks to people not being managed well. This included pressure care and managing behaviour which may challenge the service. The inspection was completed by two inspectors over one day. The team inspected the service against two of the five key questions we ask about services: is the service safe and is the service effective?

Before our inspection, we reviewed the information we held about the home, which included incident notifications they had sent us. A notification is information about important events which the service is required to tell us about by law. We reviewed the information received from the local safeguarding team as well as the service’s own action plans to address issues the safeguarding processes had highlighted.

During our visit we met with five people to gain their views about the care and support they received. Not everyone was able to verbally share with us their experiences of life at the home. This was because of their dementia/complex needs. We therefore used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We also spoke with seven visiting relatives. We met with 13 care staff, and the manager, director and lead on dementia care, dementia care specialist advisor, training coordinator for the company and spoke via a video link to the provider. We looked at 10 people’s care records which included risk assessments, care plans and at staffing rotas over a four week period.

Following the inspection we spoke with one health care professional.

Updated 23 February 2016

This inspection was unannounced and took place on 10 and 13 November 2014. There were 49 people living at the service. When we last inspected on 28 July 2014 in response to some concerns raised by family whose relative lived at Heanton, there were a number of areas where improvements were needed. These were breaches in regulation and included care planning, infection control, equipment, staffing levels, records and quality assurance. Following this inspection the registered manager sent us an action plan showing how she intended to make improvements and provided a timescale for those improvements. We used this information as part of this inspection to check how well embedded any new ways of working were and whether this had impacted on the quality of care and support people were receiving. At this inspection they had addressed all the areas that needed improving.

Heanton is registered to provide nursing and personal care for up to 58 people. The home is divided into two units, Williamson unit on the ground floor and Chichester unit on the first floor. Both units provide nursing care for older people living with dementia with the Williamson unit supporting people with higher physical nursing needs.

There is a registered manager in post. 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 and associated Regulations about how the service is run.

Some relatives fed back that the service was not always responsive to people’s needs and we observed one incident which could have been prevented if staff had been more responsive and ensured a staff presence in the dining areas at the start of the meal time. The registered manager agreed to address the issues identified.

Since the last inspection, there had been improvements in infection control and in ensuring the environment smelt fresh and was clean. The provider had replaced much of the old flooring and some of the furnishings, which had improved the appearance and odour at the home. Staff were aware of the infection control policies and procedures and were following them to help prevent any spread of infections. The registered manager had ensured there was a ‘breakout box’, which detailed what staff needed to do in the event of an outbreak of an infectious disease.

Bathroom facilities were being upgraded. The service were in the process of completing a refurbished wet room on the ground floor and there were more plans to refurbish other bathroom areas to enable people to have more accessible washing facilities in clean and comfortable bathrooms. Wheelchairs were being cleaned and maintained along with other equipment and systems were in place to ensure this was checked.

Care was well planned and being delivered by a staff group who understood people’s needs. Staff were available in sufficient numbers and had the experience and competencies to work with people with complex needs. Our observations showed staff providing care and support in a kind and compassionate way. Staff had on going training and supervision to ensure they were working effectively. Where issues were identified with staffs’ attitude or ethos, this was picked up quickly and actions taken to address any concerns.

People were assisted to engage in a variety of activities with two full time activity coordinators. This service had been expanded to cover evenings and Saturdays. There was an activities room with a wide range of equipment to help stimulate memories and discussion.

People were supported to enjoy a relaxed mealtime. Where people needed support to eat and drink, staff provided this in a kind and respectful way.

There was a strong management team in place which staff and relatives had confidence in. Staff felt their views and opinions were listened to. Systems were in place to review the quality of care and support being delivered and to gain the views of people, their relatives and staff to help improve the service.