Heffle Court

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People were safe and well cared for at Heffle Court. We did receive some concerns from a relative about their loved one’s care, but this was addressed with management quickly. The environment was noted to need repair, but management provided us with a detailed plan of how they are going to address this, and action had already started. The service had a strong culture for learning and processes were in place to ensure staff learnt lessons following any incidents. Staff had a good knowledge of safeguarding, how to identify signs of this and how to report any concerns. They were also working within the principles of the Mental Capacity Act (MCA) 2005. People spoke positively about staff and how responsive they were when needed. Risks to people had been assessed and guidance to staff was clear in how to minimise these.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had systems in place to identify any learning which could be taken forward following any accidents or incidents. This included sharing of findings with staff and across locations. Where needed, additional meetings or handovers were held with staff to ensure messages are conveyed as quickly and accurately as possible.

Staff spoke of a positive learning environment. They told us meetings took place following incidents to allow discussion as part of the lessons learned exercise. Any actions required were identified and taken forward. For example, refresher training or following up on documentation to ensure it was up to date and reflected changes to people’s health and support needs.

People and relative’s feedback was generally very positive. A relative expressed concerns about their loved one’s care, but this was discussed with management so that changes could be made, and lessons learnt. The management team have since met with the relatives to address the concern. All other feedback received was positive regarding the learning culture at the service.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff were able to tell us how they would respond if they felt someone was at risk of abuse and demonstrated a good understanding of safeguarding procedures. We spoke to a registered nurse who told us, "If I had any concerns about a safeguarding I would usually raise with [registered manager], or now one of the support managers, although I have raised things myself at weekend, so I am comfortable with the process." Another staff member said, “If any concerns seen, they are raised, following accidents/incidents or even a near miss we do a lessons learned for staff, it is an extra meeting, so that we can discuss and share, talk it through and learn.”

Safeguarding policies were in place, up to date and relevant to the service and people using it. The safeguarding policy set out clear guidance for staff to follow and what is expected of them should people be at risk of or experiencing harm or abuse. Staff received regular training to ensure they knew how to identify and report safeguarding concerns and the registered manager had oversight of this.

People told us they felt safe and were well looked after. Relatives confirmed that they felt their relatives were safe, they told us staff communicated with them and updated them if there were any concerns. For example, one person told us, "Staff are caring, he's looked after, and he is safe" and "Residents' safety is a high priority. On a recent visit I accidentally set the call button off when I moved the mat next to [person’s] bed and I was impressed by the swift arrival of the staff to make sure she was OK and the genuine relief and caring shown that she hadn't fallen out of bed."

Our observations identified that people were safe and had access to moving and handling equipment needed to support them safely. We discussed with the registered nurse and management some delays with accessing equipment through the Occupational Therapy department. One person’s referral had not been followed up for some time and relatives expressed frustration regarding this. They felt that communication could have been improved by the home to keep them up to date with what was happening. Since our visit, a meeting has been undertaken to discuss and address concerns.

Staff demonstrated a good understanding of people’s needs and associated risks. This was supported by documentation and risk assessments to inform staff how to meet people’s needs safely. For example, one person who was very frail had care plans and risk assessments in place to ensure they were safe and comfortable. This included regular repositioning to help maintain skin integrity and prevent the risk of pressure area damage. Staff were able to tell us about this person’s needs.

Risks were assessed and reviewed, and information provided for staff to support them to keep people safe. The provider had systems and policies in place which were up to date and relevant to the service and people using it. They offered clear guidance on what staff should do to minimise any risks as well as how to report something when things go wrong.

People and their relatives were involved in decisions about their care. This included assessing risks surrounding their needs and developing ways to minimise these. Feedback from relatives was generally good and they felt the home managed risks well. One family did feedback that slings were not always named for the individual. We received confirmation from the provider that a new labelling machine had been purchased to prevent names washing off when items were laundered.

Staff were seen to respond to people’s needs to keep them safe and minimise any assessed risks. Equipment was maintained and checked regularly and despite some observed scuffs and scratches to some people’s wooden bed frames, equipment was safe to use.

Systems and processes were in place to monitor equipment and the environment. Staff told us they would raise any concerns with the registered manager and felt confident these would be followed up.

Processes were in place to ensure the registered manager had oversight of the environment. The management team carried out a daily walk around looking at all aspects of care and safety. This took place at varying times of the day. Spot checks were completed to identify any issues or concerns which needed to be addressed, this includes environmental checks, fire safety and cleanliness, kitchen areas clean and food stored safely.

People’s feedback was predominantly positive about the environment, although relatives expressed that it was looking a bit tired in places. One relative did comment that communal areas on the first floor sometimes looked a bit untidy but felt that staff were very busy. Another relative said, "It's not the Ritz but the staff are caring, he's looked after, and he is safe. They are very kind here, just run ragged at times.”

People’s rooms and communal areas were kept clean; however, we saw that some decor in bedrooms and communal areas needed to be updated. There were scuff marks to walls and door frames, and some wooden bed frames which were scratched. Management were aware work was needed and had a plan to achieve this.

The provider had a robust system in place to ensure staffing levels were sufficient and staff had the right skill mix to meet people’s needs. Staffing levels were altered depending on people’s needs, the manager completed a daily walk around which included checks that enough staff were available. A supervision schedule was used to ensure staff received support and were able to air any concerns or development ideas. The provider had systems to ensure safe recruitment of staff and new staff received a thorough induction.

There were enough staff to be attentive and meet people’s needs. We carried out observations and saw staff interactions with people in communal areas and in people's rooms. Staff spoke to people politely showing kindness and consideration. Staff knew people well and were able to tell us about their needs. When people needed assistance, staff took the time to sit with them and people were not rushed. When people were anxious, staff spent time with them and used distraction to alleviate their anxiety. For example, by offering drinks and sitting with them in quiet areas if preferred.

Feedback from people and relatives was generally positive. Three relatives felt that staff were extremely busy but commented that they did a very good job and were very kind. People told us, "We have these lovely staff, they are here if you need anything." and "I love it here everyone is so lovely". Relatives told us their loved ones were very happy and liked the staff, identifying particular staff members who they said were wonderful. One told us, "Staff are fabulous they let me know if anything I need to know about [Person]. If I have any questions I can go to [registered manager] or other staff (both are just brilliant).

Feedback from staff was mixed, some staff did tell us there were times of the day that were particularly busy. Staff told us about the mornings, “It’s our busy time while we get everyone up and dressed then it quiets down a bit”. This was particularly evident on the nursing floor, where we saw staff rushing to answer bells and assist people throughout the morning. We saw that staff answered bells as promptly as they could and responded to people asking for help, with staff asking a second staff member to assist them for people who needed 2 staff for safe moving. Staff felt that they worked together well. One told us, "We have to use agency time to time, this works Ok, usually it’s the same ones all the time, so they know the place."

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.