CQC report explained · a residential care home
What the CQC found at Heath Cottage
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Medicines were stored, recorded and given safely. Inspectors also found suitable risk assessments, enough staff, safe equipment and effective infection control arrangements.
- Effective?
- Good
- People received suitable food and drink, including the correct consistency where there was a choking risk. Staff had induction, training and supervision, and mental capacity and DoLS processes had improved.
- Caring?
- Good
- This key question was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Audits covered areas such as care, infection control, consent and nutrition. People, relatives and staff were involved through meetings and surveys, and inspectors found a positive culture.
What inspectors found, August 2021
Rated Good; inspectors found safe, effective and well-led care, although some relatives felt parts of the home looked tired and dated.
This was an announced, focused inspection. Inspectors checked whether improvements had been made after the previous inspection, which had rated the home Requires Improvement and found breaches relating to safe care, consent and governance.
Inspectors found the home was now meeting the relevant legal requirements. Medicines, risk assessments, infection control, staffing checks and safeguarding systems were found to be safe. People received suitable food and drink, staff had training and supervision, and the home worked with health professionals.
The home was rated Good overall. Safe, Effective and Well-led were each rated Good. Caring and Responsive were not inspected during this visit, so their previous ratings were used when calculating the overall rating.
Medicines were safer
Medication records were complete and medicines were stored securely. People and relatives said medicines were given safely and on time.
“During the inspection we looked at three medicines administration records (MAR's) which were all completed accurately with no missing signatures by staff.” from the report
Staffing and training
Inspectors found appropriate recruitment checks, enough staff and training, induction, supervision and appraisals.
“An induction programme was provided to staff when they first commenced employment to ensure staff had an understanding of what was required within their roles.” from the report
Support with eating and drinking
People at risk of choking received the right food and drink consistency. Weight was monitored and referrals were made for dietetic support when needed.
“People at risk of choking and aspiration received the correct consistency of food and drink.” from the report
Improved management checks
The home had introduced audits and used feedback from people, relatives and staff to identify improvements.
“An effective audit system was now in place and covered areas such as care delivery, infection control, skin care, seeking consent and nutrition/hydration.” from the report
Positive culture
People received the care they needed, and staff described good teamwork and support from management.
“Staff told us there was a positive culture at the home, with good team work throughout.” from the report
Parts of the building looked dated
minorSome relatives felt parts of the home environment were tired and dated. The provider accepted the feedback but said some improvements would be difficult because of the building's layout and age.
“However, some relatives told us they felt the home environment was 'tired' and 'dated' in certain areas.” from the report
- 01How do you currently check that medicines are recorded accurately and given on time?
- 02How do you assess and review risks such as falls, skin damage, moving and handling, and nutrition?
- 03What improvements have been made, or are planned, for the areas relatives described as tired and dated?
- 04How do you support people who may lack capacity to make decisions, including the use of sensor mats, bed rails or covert medication?
- 05How do you gather feedback about the caring and responsive aspects of the service, which were not inspected in this visit?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used for the overall rating. This explanation was written from the published report of 3 August 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.
What inspectors found, August 2019
Rated Requires Improvement; inspectors found kind, personalised care but concerns about safety, consent and management.
This was an unannounced comprehensive inspection on 3 July 2019. Inspectors spoke with people living at the home, relatives, staff and managers. They also reviewed care plans, staff records, medicine records and other documents.
People generally said they felt safe and were treated kindly. Inspectors found good care, respect, personalised support, food and activities. However, some trip and fire risks were not managed well, parts of the home were not kept clean, and medicines were not always stored or recorded safely.
The home did not always follow the legal process for decisions about consent. Its checks and audits did not identify all the problems found. The overall rating fell from Good at the previous inspection, published in January 2017, to Requires Improvement.
Kind and respectful care
People and relatives described staff as kind and caring. Inspectors saw staff treating people with dignity and supporting their independence.
“People living at the home spoke positively about the standard of care provided and that staff treated people well.” from the report
Personalised support
Care plans recorded people's life histories, interests, choices and support needs. Inspectors saw people's preferences being followed.
“People's care plans contained person-centred information about their life story and included details regarding their childhood, employment, school years, hobbies and interests and details about their family.” from the report
Food and healthcare
People said they liked the food. Staff provided support at mealtimes, suitable food textures and access to healthcare professionals.
“We saw people received food and drink of the correct consistency, such as fork mashable diets, when they had been assessed as being at risk of choking and aspiration.” from the report
Activities and relationships
People could choose from activities and were supported to maintain contact with relatives and friends.
“There were different activities available for people to participate in if they wished to.” from the report
Fire and trip risks
seriousSome fire doors were held open inappropriately, and trailing wires created a risk of falls. Communal areas were also sometimes left without staff when people needed help.
“Some fire doors in the home were held open by inappropriate means with things such as door wedges and curtain ties.” from the report
Infection control
seriousFood was left on the dining room floor and people walked through it. Protective aprons were not always stored safely, creating a risk of contamination.
“We observed lots of food was left on the floor at both breakfast and lunch and was not cleaned up by staff.” from the report
Consent decisions
seriousThe home did not always complete decision-specific capacity assessments and best-interest discussions for sensor mats and covert medication.
“These people lacked capacity however and decision specific capacity assessments and best interest discussions had not taken place regarding these decisions to ensure consent was provided.” from the report
Quality checks
needs fixingAudits were carried out, but they did not reliably identify the safety, medicine and consent problems found by inspectors.
“Further improvements were required to overall governance arrangements to ensure they were effective in identifying some of the concerns found at this inspection and that regulatory requirements were met.” from the report
- 01What action have you taken to keep fire doors closed properly and remove the trailing wires?
- 02How are food debris and protective aprons now managed to reduce infection risks?
- 03How are thickened drinks, creams and medicines stored, recorded and checked now?
- 04How do you complete decision-specific capacity assessments and best-interest decisions for sensor mats or covert medication?
- 05How do your audits now identify and correct safety, medicine and consent problems?
This was an unannounced routine comprehensive inspection covering all five CQC questions, with the home and care provided both assessed. This explanation was written from the published report of 30 August 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 Heath Cottage
6 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- August 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- January 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016Requires improvementstayed Requires improvementSafe: Requires improvement
- October 2015Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 8 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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