CQC report explained · a nursing home
What the CQC found at Heartlands
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2019
Rated Requires Improvement; inspectors found kind, responsive care but gaps in risk records, nutrition monitoring and quality checks.
This was an unannounced inspection on 31 July and 1 August 2019. Inspectors spoke with people living at the home, relatives and staff. They observed care and reviewed care, medicines, staffing and management records.
People were generally treated kindly and with dignity. The home was clean and had activities, community trips and spaces adapted for people living with dementia. People said they felt safe and received their medicines safely.
However, some risk records and care plans were incomplete or not updated quickly. Food and drink records were not always completed for people who had lost weight. Quality checks had not found these problems, so the home was rated Requires Improvement overall.
The caring and responsive questions were rated Good. Safe, effective and well-led were rated Requires Improvement. The report says this meant there was limited assurance about safety and an increased risk that people could be harmed.
Kind and dignified care
Inspectors saw staff supporting people patiently and respectfully. People were involved in choices about their daily routines and care.
“People's privacy and dignity was respected. We observed a staff member quickly and discreetly supporting someone who needed assistance to change their clothing.” from the report
Activities and community links
People could take part in varied activities and trips. Staff also supported people who preferred to stay in their rooms.
“There were a range of interesting activities on offer including film nights, baking, gardening, reminiscence and exercises sessions.” from the report
Clean and accessible home
The home was clean, spacious and well maintained. Its design included features to support people living with dementia.
“The home was maintained to a high standard and had some excellent facilities. This included a cinema room, pub, shop and craft room.” from the report
Safeguarding and incident response
Staff understood how to recognise and report abuse. Accidents and incidents were investigated and action was taken to reduce the risk of recurrence.
“The provider had effective safeguarding systems in place. Staff had received training and understood how to recognise the signs of abuse and how to report.” from the report
Risk records were incomplete
seriousRecords did not always show that required checks or changes in people's needs had been recorded. This included pressure relief and care plans following falls.
“Records to monitor risk were not always completed. For example, one person needed pressure relief every four hours.” from the report
Weight loss monitoring
needs fixingFood and fluid records were not consistently completed for people who had recently lost weight. Kitchen staff were not aware of one person's fortified diet requirement.
“Staff were not consistently recording their food and fluid intake and when we spoke to the kitchen staff they were not aware of this requirement.” from the report
Quality checks did not find problems
seriousAudits did not identify outdated care plans, incomplete risk records, unclear cream instructions or an incorrect specialist mattress setting. This led to a breach of Regulation 17.
“The failure to have effective governance systems in place to monitor the quality of the service demonstrates a breach of Regulation 17 of the Health and Social Care Act (Regulated Activities) Regulations 2014.” from the report
Nursing unit staffing concerns
needs fixingSome people and relatives on the nursing unit said they had to wait for personal care. Inspectors did not see long waits during the visit, and the home had introduced a new staff allocation system.
“The main problem is geared around the lack of staffing.” from the report
Some complaints not resolved
needs fixingPeople knew how to complain, but not all relatives felt their concerns had been resolved satisfactorily.
“We did not get a satisfactory answer and just had to drop things.” from the report
- 01How do you now make sure risk records and care plans are updated promptly after a fall or change in a person's needs?
- 02How do you record food and fluid intake for people at risk of weight loss, and how are special diet requirements shared with kitchen staff?
- 03What changes have been made to staffing and response times on the nursing unit since this inspection?
- 04How do you check that prescribed cream instructions and specialist mattress settings are correct?
- 05How are complaints followed up, and how do you make sure families receive a satisfactory response?
This was a planned, unannounced inspection covering all five questions, with the home and the care provided both looked at; the service had recently been newly registered and its previous rating was Requires Improvement. This explanation was written from the published report of 19 September 2019 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 Heartlands
Each visit the CQC has published, newest first, back to the day the home was registered.
- September 2019Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2018
Registered with the Care Quality Commission on 8 November 2018.
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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