CQC report explained · a residential care home
What the CQC found at 103 Heath Street
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- People were protected from avoidable harm, with suitable risk plans, staffing, recruitment and medicines systems. Some rust was found on bathroom and shower room radiators, and maintenance was planned.
- Effective?
- Outstanding
- Staff worked closely with health professionals and followed detailed plans for nutrition, swallowing, pain, oral health and other needs. Inspectors found people's health and wellbeing had improved through this support.
- Caring?
- Good
- Staff were observed treating people with kindness, dignity and respect. People were supported to make choices, stay independent and maintain important relationships.
- Responsive?
- Outstanding
- Support was highly personalised and adapted to people's changing needs, communication methods, interests and wishes. Inspectors found particularly strong end of life care.
- Well-led?
- Good
- The manager promoted a person-centred culture and worked well with relatives, staff and professionals. Audits, feedback and improvement plans were used to monitor and improve the service.
What inspectors found, April 2020
Rated Outstanding; inspectors found excellent personalised care, with safe, kind and well-led support.
The unannounced inspection took place on 24 January 2020. One inspector observed care, reviewed records and spoke with staff, relatives and visiting professionals. People could not describe their experience directly, so inspectors also used an observation method.
The home supported five people with learning and/or physical disabilities, and could support up to six. Inspectors found people received highly personalised support, with choice, independence and involvement in their care.
The home was rated Outstanding overall. Effective and Responsive were rated Outstanding. Safe, Caring and Well-led were rated Good. The overall rating improved from Good at the previous inspection in October 2017.
Personalised support
Care plans were detailed and reflected people's individual preferences, communication and support needs. Relatives and professionals were involved in planning care.
“People's support plans were individual and contained detailed guidance for staff to follow to support people in line with their preferences.” from the report
Health support
Staff worked proactively with health professionals. This helped improve people's eating, manage pain and reduce anxiety.
“People were supported to access healthcare professionals to ensure their health and wellbeing was maintained.” from the report
End of life care
The home supported people to remain in their home at the end of life where possible. Staff followed personal wishes and involved important people.
“People received exceptional care at the end of their life that met their wishes.” from the report
Choice and activities
People were supported to take part in activities they enjoyed, both at the home and in the local community. Staff adapted activities to keep people safe.
“People took part in activities in the local community.” from the report
Staffing and safety
Inspectors found enough staff were available and that recruitment was safe. Staff understood safeguarding, risk management and medicines procedures.
“There were enough staff available and deployed effectively to meet people's needs.” from the report
Rust on bathroom radiators
minorSome areas of rust were found on radiators in the bathroom and shower room. Inspectors said this could pose an infection risk, and maintenance was planned.
“We noted that the radiators in the bathroom and shower room had some areas of rust, which could pose as an infection risk.” from the report
- 01Has the rust on the bathroom and shower room radiators been repaired, and how was the infection risk checked?
- 02How will you make sure staffing levels remain suitable if my relative's needs change?
- 03How would you communicate with my relative and help them express choices or concerns?
- 04How would you support my relative with eating, swallowing or other nutritional risks?
- 05How would you record and follow my relative's end of life wishes?
This was an unannounced comprehensive inspection covering all five key questions, and the previous Good overall rating was changed to Outstanding. This explanation was written from the published report of 8 April 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2017
Rated Good overall, but inspectors found the home was not consistently safe and rated Safe as Requires Improvement.
This was an unannounced inspection on 18 July 2017. One inspector visited the home, spoke with relatives and staff, observed care, and checked care plans, risk assessments, medicines records, accident reports and quality checks.
The home supported up to six people with a learning disability and was full on the inspection day. Staff were caring, trained and supported people with food, drink, activities, healthcare and medicines. Inspectors also found that people's privacy, dignity and rights were respected.
The main problem was safety. Safeguarding concerns had not always been prevented from happening again, and one investigation was only partly substantiated while another was still ongoing. Staffing was enough to meet people's immediate needs, but vacancies and domestic work reduced the time available for activities and personal attention.
The overall rating of Good means the inspection found the service was performing well overall, but it did not meet the higher standard in every area. Safe was rated Requires Improvement, while Effective, Caring, Responsive and Well-led were all rated Good.
Kind and respectful care
Inspectors saw staff engaging with people and responding to their individual needs. Privacy and dignity were maintained during personal care and treatment.
“People were cared for and supported by staff who were kind and attentive to their needs and their rights to privacy and dignity was respected.” from the report
Staff training and support
Staff received relevant training, induction and regular supervision. Inspectors found they understood people's care needs and how to support them safely.
“People were cared for by staff who were skilled and supported in their role by the management team.” from the report
Personalised activities
Staff understood people's interests and dislikes. People were supported with activities in the home and in the local community.
“People had access to range of social activities and stimulations.” from the report
Support with food and health
Staff knew about special diets and thickened drinks. People had access to dietetic, speech and language, nursing and other healthcare support.
“People were supported by staff to eat and drink sufficient amounts to promote their health.” from the report
Medicines support
Staff who managed medicines had training and competency checks. Medicines were stored securely and administration records were signed.
“People were supported by skilled staff to take their prescribed medicines.” from the report
Safeguarding concerns
seriousInspectors found that practices did not always protect people from harm or stop harm happening again. One safeguarding investigation was partly substantiated and another was still ongoing.
“Practices did not always safeguard people from the risk of harm.” from the report
Staff time and vacancies
needs fixingThere were vacant posts during the inspection. Although staff were available when needed, comments suggested domestic work and staffing pressures reduced time for activities and individual attention.
“More staff would be nice then we would be able to spend more time with people and take them out more often.” from the report
Acting on signs of pain
needs fixingOne relative said staff did not respond promptly when their relative appeared to be in pain, and the relative had to insist that a GP was called.
“I had to insist that the GP was called.” from the report
Using family feedback
minorFamilies could complete surveys and attend forums, but the manager could not say what changes had been made because of their comments.
“However, the registered manager was unable to inform us of any changes to the service with regards to comments made by families.” from the report
- 01What action has been taken since the inspection to prevent the safeguarding concerns from happening again?
- 02Were the vacant support worker and assistant manager posts filled, and how many agency or bank staff are currently being used?
- 03How do staff recognise when someone is in pain, and how quickly will they contact a GP or other healthcare professional?
- 04What changes have been made in response to feedback from families?
- 05How are staff given enough time to support people with activities and outings as well as domestic tasks?
This was an unannounced inspection covering all five CQC questions and the overall quality of the home. This explanation was written from the published report of 17 October 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of 103 Heath Street
3 rated inspections over 5 years: the service has improved, from Good to Outstanding.
- April 2020Outstandingcurrent ratingup from GoodSafe: GoodEffective: OutstandingCaring: GoodResponsive: OutstandingWell-led: Good
- October 2017Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 4 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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