Archived: Heeley Bank Care Home

Updated 8 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

On the first day of inspection the inspection team consisted of 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.

On the second day of inspection the inspection team consisted of one inspector and a specialist advisor who was instructed to look at the management of medicines at the home. The specialist advisor was a pharmacist.

Service and service type

Heeley Bank Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Prior to the inspection we reviewed information and evidence we already held about the home, which had been collected via our ongoing monitoring of care services. This included notifications sent to us by the home. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. We also sought feedback from partner agencies who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We spoke with 14 people who used the service and eight relatives about their experience of the care provided. We spoke with 14 members of staff including the manager, the regional director, two visiting managers employed by the provider, kitchen staff, maintenance staff, domestic staff, administrator nurses and care workers.

We reviewed a range of records. This included four people’s care records, three staff personnel files and multiple medication records. We also looked at other records relating to the management of the home and care provided to people living there.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at evidence of action taken to address concerns discussed during feedback at the end of the inspection.

Updated 8 October 2019

About the service

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.