Archived: Heron House Care Home

Updated 11 August 2015

We undertook an unannounced focused inspection of Heron House Care Home on 27 July 2015. This inspection was undertaken to check that improvements to meet legal requirements planned by the provider after our comprehensive inspection of 13 January 2015 had been made. The focused inspection was undertaken to check that the management of the home had systems in place to improve the quality and standard of people’s care and that people received care that met their individual needs.

The inspection team inspected the service against three of the five questions we ask about services: is the service effective; is the service responsive and is the service well-led. This is because the service was not meeting legal requirements in relation to these questions and also because of concerns we had received since 13 January 2015.

The inspection was undertaken by two inspectors and a pharmacist inspector. Before the inspection we looked at all of the information that we held about the home. This included information from a local authority contracts manager; information from the provider’s action report, which we received on 29 May 2015, and information from notifications received by us. A notification is information about important events which the provider is required to send to us by law.

During the inspection we spoke with 12 people, four people’s relatives, a visiting health care professional and a visiting social care professional. We also spoke with a regional director, the manager, the deputy manager, and a member of catering staff, an activities co-ordinator, six registered nurses and a member of care staff. We looked at 11 people’s care records and 15 people’s records in relation to their medicines. We observed people’s care to assist us in our understanding of the quality of care people received.

We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Updated 11 August 2015

Heron House Care Home is registered to provide accommodation, support and care, including nursing care, for up to 92 people, some of whom have mental health needs. At the time of our visit 72 people were using the service. The home is arranged on one level and divided into four named units; Heron Court, Wendreda, Eastwood and Nene.

This unannounced inspection was undertaken on 13 January 2015. At our last inspection on 23 September 2014 we found breaches of regulations relating to care and welfare, management of medicines, supporting staff and assessing and monitoring the service provision. Following that inspection the provider sent us an action plan to tell us what improvements they were going to make by no later than 09 December 2014. During this inspection we looked to see if these improvements had been made and also if the provider was meeting the other regulations. Some improvements had been made and some of the breaches of regulations identified at the previous inspection were now being met.

The home did not have a registered manager in post, because they left their post in December 2014, although their name remains on our register as we have not yet received an application to cancel their registration. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. We saw that staff had followed guidance and were knowledgeable about submitting applications to the appropriate agencies. Where people lacked the capacity to make decisions, they were sometimes supported to make decisions that were in their best interests. However, people were sometimes given medication hidden in food without this being assessed to be in their best interest.

There was a sufficient number of staff to look after people and provide people with the care that they needed. Arrangements were made to fill 23 staff vacant posts and to reduce the usage of agency care and nursing staff.

Pre-employment checks were completed on staff before they were judged to be suitable to work at the care home.

People’s risks of choking had been risk assessed and had their call bells within their reach.

Staff were aware of their roles and responsibilities in reporting incidents that had placed people at risk of harm.

People’s privacy and dignity was respected at all times, including when they were supported with taking their medication and personal care. People and their relatives were involved in developing and reviewing the care plans. The majority of staff were kind and caring.

There was a process in place to ensure that people’s health care needs were assessed. However, improvements were needed in relation to assessing people’s pain and the management of people’s behaviours that challenge others.

Staff were better supported than at our last inspection and the standard and quality of their work was kept under review. New staff received induction training to ensure they understood their roles and responsibilities. Staff training and development needs were identified and actions were taken to improve the training of staff.

People were supported to engage in hobbies and interests that they enjoyed taking part in. People were supported to maintain relationships with their relatives and make friends with each other.

Records were not always completed to provide evidence that people were always supported to eat and drink sufficient amounts.

A complaints process was in place which was accessible to people, relatives and others who used or visited the service.

People shared their views and suggestions in relation to food and their hobbies and interests. Staff were enabled to make suggestions to improve the quality of people’s care.

Actions were taken to ensure that emergency lights were operating in the event of a fire. Audits were carried out in relation to people’s nutritional and condition of their skin. An analysis of the incident of falls has been carried out and actions were taken to make people safer from the risk of falling.

Medication and dining experience audits had been carried out but it was unclear what actions were taken in response to the findings.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.