CQC report explained · a residential care home
What the CQC found at Heartwell House Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment checks, suitable safeguarding procedures and safe medicine systems. A staircase and damaged chairs were dealt with immediately after concerns were raised.
- Effective?
- Good
- This question was not assessed in this focused inspection.
- Caring?
- Good
- This question was not assessed in this focused inspection, although inspectors observed respectful support and people's rights, choices and independence being promoted.
- Responsive?
- Good
- This question was not assessed in this focused inspection, although people were supported with activities, communication and personal choices.
- Well-led?
- Requires improvement
- The provider had quality checks and responded to feedback, but there was no registered manager. Care plan information was not always clear, policies were undated, and significant events had not always been reported to CQC promptly.
What inspectors found, June 2022
Heartwell House Residential Care Home was rated Good overall; inspectors found people safe and respected, but leadership and record-keeping still needed improvement.
This was an unannounced focused inspection on 5 and 6 May 2022. One inspector spoke with people, a relative and staff, observed care, and checked care, medicine, recruitment and management records.
The home was rated Good for Safe. Inspectors found enough staff, safer recruitment checks, suitable medicine procedures and systems to protect people from abuse. A staircase was made safe after inspectors raised a concern, and damaged dining chairs were replaced immediately.
The home was rated Requires Improvement for Well-led. There was no registered manager, some care plan information was unclear, policies were not dated, and significant events had not always been reported to CQC promptly.
The overall rating was Good. The previous rating was Requires Improvement, and inspectors found enough improvement for the home to be no longer in breach of Regulations 12 and 17. The inspection only covered Safe and Well-led.
Enough staff
Inspectors found staffing levels met people's needs. Staff were available for one-to-one support, including outings and visits.
“A dependency tool was used to calculate the number of staff required, which took account of people's needs.” from the report
Respect and independence
People were encouraged to make choices and have control over their daily lives. Staff understood people's communication needs and supported their rights.
“Staff supported people to have the maximum possible choice, control and independence so they had control over their own lives.” from the report
Safe medicines
Trained staff followed systems for administering, recording and storing medicines. The report also says the home avoided inappropriate use of medicines to control behaviour.
“People were supported by trained staff who followed systems and processes to administer, record and store medicine safely.” from the report
Positive relationships
People, relatives and staff spoke positively about the culture. Staff knew people well and supported activities, family contact and community involvement.
“People and relatives all spoke positively about the culture of the service.” from the report
No registered manager
needs fixingThe home did not have a manager registered with CQC. The provider said a suitable person had been identified, but the appointment was not confirmed.
“The service did not have a manager registered with the Care Quality Commission.” from the report
Care records needed clearer information
needs fixingChanges to care plans and information about legal restrictions were not always clear for staff to follow. The provider said this would be improved.
“The changes made to people's care plans and the DoLS care plans were not always clear for staff to follow.” from the report
Late notifications to CQC
needs fixingThe provider had not always reported significant incidents, accidents and restrictions to CQC promptly. Notifications were later sent retrospectively.
“The provider had not consistently notified CQC about significant events such as incidents, accidents and where there were restrictions placed on people's live.” from the report
Some premises risks
needs fixingAn unsafe staircase was identified and fixed after the inspection. The laundry room had no ventilation, although it was due to be moved during refurbishment.
“We identified one staircase had unsafe flooring and sharp edges, which put people's safety at risk.” from the report
- 01Who is currently managing the home, and when will the manager be registered with CQC?
- 02How do you now check that changes to care plans and DoLS care plans are clear and up to date?
- 03How do you make sure significant incidents, accidents and restrictions are reported to CQC promptly?
- 04Has the laundry room ventilation problem been resolved as part of the refurbishment?
- 05How do you check that building work and other environmental hazards remain safe for residents?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other key question ratings were not assessed in this report, and no one was receiving care from the home care agency. This explanation was written from the published report of 14 June 2022 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, December 2021
Rated Requires Improvement; inspectors found unsafe staffing and environmental risks, while leadership was rated Inadequate.
This was an unannounced inspection on 15 September 2021. One inspector spoke with a person using the home, relatives, staff and managers. They reviewed care, medicines, recruitment and audit records.
Inspectors found that staffing was often not enough to meet people's needs. People were left without staff attention for long periods. Some first-floor windows had no restrictors, and an accessible door led to a building site with hazards.
Medicines, recruitment checks, cleaning and staff interactions were generally positive. However, the home had not acted quickly enough when problems were identified. The overall rating stayed at Requires Improvement, while Safe stayed at Requires Improvement and Well-led fell from Requires Improvement to Inadequate.
Medicines
Medicines were stored and given safely. Records were complete, and staff had suitable training.
“Medicines were stored and administered safely. Medicine administration records (MAR) were accurately completed” from the report
Kind and respectful care
Inspectors saw positive relationships between staff and people. Relatives also gave positive feedback about the care and support provided.
“Staff treated people with kindness, dignity and respect.” from the report
Recruitment checks
The home carried out checks before employing staff to assess their character and experience.
“The provider had safe staff recruitment checks in place.” from the report
Clean environment
The home was clean and maintained. Inspectors were also assured about several infection prevention arrangements.
“The service was clean and well maintained.” from the report
Not enough staff
seriousStaffing was below the usual level on the inspection day, and the usual staffing level was not always enough either. People were left without staff attention and some could not go out when they wanted.
“People were left in communal areas without staff attention for long periods of time.” from the report
Environmental safety risks
seriousSome first-floor windows did not have restrictors. An accessible back door led to a building site with equipment, foundations and trip hazards.
“A door to an outside area was fully accessible to residents, and led on to a small building site with multiple hazards” from the report
Weak management oversight
needs fixingAudits identified some issues, but action was not prompt. Checks also failed to identify the missing window restrictors, and the provider had not shown enough sustained improvement.
“Quality assurance systems were in place, but appropriate and prompt action was not always taken” from the report
Infection control concern
needs fixingInspectors were not fully assured that infection outbreaks could be prevented or managed effectively because staff described cleaning and cooking duties being combined.
“We were not always assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
- 01How many staff will be on duty during the day, evenings and nights, and how will you cover sickness?
- 02How will you provide one-to-one support without leaving other people short of staff?
- 03Have restrictors now been fitted to every first-floor window?
- 04How is the accessible door to the building site now secured, and has the area been made safe?
- 05What action has been taken in response to the warning notices and the previous inspection findings?
This inspection examined Safe and Well-led; the report does not give ratings for Effective, Caring or Responsive. This explanation was written from the published report of 7 December 2021 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 Heartwell House Residential Care Home
9 rated inspections over 7 years: the service has improved, from Inadequate to Good.
- June 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Heartwell House Residential Care Home →
- December 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Inadequate
Read what inspectors found at Heartwell House Residential Care Home →
- January 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2020Goodstayed GoodSafe: GoodWell-led: Good
- December 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016Goodup from Requires improvementSafe: GoodEffective: Good
- February 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2015Inadequatestayed InadequateSafe: InadequateWell-led: Inadequate
- August 2015InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- May 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 10 December 2010.
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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