Background to this inspection
Updated
17 May 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.
This inspection took place on 29 March 2016 and was unannounced. The inspection was undertaken 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 service.
Before the inspection, the provider completed a Provider Information Return. This is form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
We reviewed the information that we had about the service including statutory notifications. Notifications are information about specific important events the service is legally required to send to us.
We spoke with five people that used the service, three relatives and five members of staff. We also spoke with the operations manager and registered manager.
We reviewed the care plans and associated records of four people who used the service. We also reviewed documents in relation to the quality and safety of the service, staff recruitment, training and supervision.
Updated
17 May 2016
This inspection took place on 29 March 2016 and was unannounced. The last full inspection took place on 8 January 2015 and, at that time, three breaches of the Health and Social Care (Regulated Activities) Regulations 2014 were found in relation to safeguarding service users from abuse and improper treatment, safe care and treatment and need for consent. These breaches were followed up as part of our inspection.
Heather House is registered to provide personal and nursing care for up to 36 people. At the time of our inspection there were 20 people living in the service. On the day of the inspection we were informed by the operations manager that the provider intended to close the service. On the following day we were sent a copy of a letter sent to people advising them of the impending closure date. In the letter the provider has stated that they propose to close the service no later than 30 April.
There was a registered manager in place on the day of our inspection. 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.
Staffing levels were not sufficient to support people. Unexpected staff absences such as sickness were not adequately covered and this position was confirmed by the registered manager.
Staff were not consistently supported through a regular training and supervision programme.
In some areas of the building the premises were not suitable for the purpose for which they were meant to be used. Some bathrooms were not fully operational and there was a lack of adequate storage facilities throughout the service.
Systems were not being operated effectively to assess and monitor the quality and safety of the service provided.
In January 2015 people were not protected from the risk of infection because appropriate guidance had not been followed. During this inspection sufficient improvements had been made, although further work was required.
In January 2015 we found that the provider had failed to notify the Commission or local authority of safeguarding incidents. We found sufficient improvements had been made.
In January 2015 there were inadequate processes in place to support people to make best interests decisions in accordance with the Mental Capacity Act 2005 (MCA). During this inspection sufficient improvements had been made.
Medicines were generally managed safely. The administration of topical medicines requires improvement.
Records showed a range of checks had been carried out on staff to determine their suitability for the work. For example, references had been obtained and information received from the Disclosure and Barring Service (DBS).
People’s nutrition and hydration needs were met.
People were treated with kindness and compassion. Staff knew people well, understood their support needs and were familiar with people’s personal preferences.
Relatives were welcomed to the service and could visit people at times that were convenient to them. People maintained contact with their family and were therefore not isolated from those people closest to them.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.