CQC report explained · a residential care home
What the CQC found at Heather Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks, staffing, recruitment, safeguarding, infection control and medicines were generally managed safely, although some topical cream administration records were incomplete.
- Effective?
- Requires improvement
- This area was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Caring?
- Requires improvement
- This area was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Well-led?
- Good
- The management team carried out audits, acted on shortfalls and sought the views of people, relatives and staff. Staff understood their roles and felt supported.
What inspectors found, April 2023
Rated Good; inspectors found safe, kind care and improvements in medicines management, but some topical cream records were incomplete.
This was an unannounced, focused inspection on 4 and 5 April 2023. Inspectors observed care, spoke with people, relatives and staff, checked the building and reviewed care, medicines, staff and management records.
The home was rated Good overall. Inspectors found people felt safe, there were enough staff, risks were managed, medicines were generally handled safely and the home was clean. Staff were described as kind and caring, and people were supported to make choices.
The inspection followed a previous Requires Improvement rating and a breach linked to medicines management. Inspectors found enough improvement had been made and the home was no longer in breach of regulations.
Only Safe and Well-led were inspected during this visit. The ratings for the other three areas were carried forward from the last comprehensive inspection.
Medicines improved
Medicines were stored and managed safely. Staff received training and competency checks, and records for receiving, giving and disposing of medicines were generally appropriate.
“Medicines were stored and managed safely. Staff administering medicines received training and had their competency checked to ensure their practice remained safe.” from the report
Enough staff
Inspectors found enough staff on duty to meet people's needs. People said staff usually responded in a timely way.
“We observed there was an appropriate number of staff on duty to meet people's needs during the inspection.” from the report
People felt safe
People said they felt safe and were happy with the care. Staff had safeguarding training and knew how to raise concerns.
“People told us they felt safe and were happy with the care and support they received.” from the report
Kind and person-centred care
Inspectors saw sensitive interactions. Staff knew people's needs and preferences and supported them to make choices.
“People were supported in a sensitive and kind manner. Feedback from people living in the home was positive.” from the report
Strong management checks
The management team used audits and action plans to monitor the service and make improvements. Staff could raise concerns in meetings.
“The management team carried out a number of audits and checks covering all aspects of the service.” from the report
Topical cream records
needs fixingSome records showing whether topical creams had been given were incomplete. The manager knew about this and was working with staff to improve the records.
“We noted there were some omissions in the records for the administration of topical creams.” from the report
- 01How do you now check that every topical cream administration is recorded?
- 02What action was taken after the missing topical cream records were found?
- 03How often are medicines records and staff medicines competencies reviewed?
- 04What changes have been made since the previous inspection's medicines breach?
- 05How will increasing residents' and relatives' meetings from quarterly to monthly work in practice?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the last comprehensive inspection. This explanation was written from the published report of 22 April 2023 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, November 2021
Requires Improvement; inspectors found unsafe medicines management and limited evidence that people were being consulted.
This was an unannounced focused inspection on 5 and 6 October 2021. Inspectors looked only at Safe and Well-led because concerns had been raised about medicines. They spoke with people, staff and managers, looked around the home, and checked care, medicine, recruitment and management records.
The home was clean and staff were kind and respectful. People usually received prompt help. Staff understood safeguarding and incident reporting, and safety certificates and infection control arrangements were up to date.
However, medicines were not managed safely. Some people missed doses because medicines were not administered, there was not always enough stock, records were incomplete, medicines were not always given at the right time, and some medicines were stored outside the recommended temperature range.
The overall rating remains Requires Improvement, as it was at the previous inspection published in June 2019. This was the second consecutive inspection with this rating. The provider was in breach of Regulation 12 and must send an action plan while the CQC continues to monitor the home.
Kind and prompt staff
People said staff usually responded promptly. Inspectors observed warm and respectful interactions.
“People told us they liked the staff working at the home and confirmed they usually responded promptly to any requests for assistance.” from the report
Clean and hygienic home
The home was clean, and inspectors were assured that infection prevention and control arrangements were being followed.
“We were assured the provider was using PPE effectively and safely.” from the report
Safety systems
The home had systems for reporting incidents, reviewing risks and learning lessons. Safety certificates for equipment and installations were complete and up to date.
“The provider had established systems to ensure lessons were learnt from any incidents” from the report
Staff support
Staff understood their roles and said they felt supported by the new manager. The manager was also supported by an area manager and senior managers.
“Staff morale was good, and they felt supported by the manager.” from the report
Medicines were not managed safely
seriousPeople missed some doses because staff did not always administer medicines or because stock was unavailable. Records, timings and storage were also not always safe.
“People missed some doses of their prescribed medicines because there was no stock available in the home for them.” from the report
Medicine records were incomplete
seriousGaps in records meant it was not always possible to tell whether medicines and creams had been given. Guidance for medicines given when needed was also not always available.
“Staff did not complete records of administration accurately because they left gaps on the charts” from the report
Limited resident consultation
needs fixingThe last satisfaction survey was in January 2020, and inspectors found no evidence of recent residents' meetings or checks that earlier actions had worked.
“There was no evidence seen that any checks had been carried out to make sure any action was effective and there was no evidence of recent residents' meetings.” from the report
Recruitment record gap
minorPolice checks and references had been obtained, but one staff member's employment history had a gap. The manager said this would be addressed.
“we found gaps in one staff member's history of employment.” from the report
- 01What action has been taken to prevent missed medicine doses and ensure every prescribed medicine is in stock?
- 02How are medicine administration records and cream records now checked for gaps or errors?
- 03How do staff know when to give medicines prescribed for use when needed, and how is their effect recorded?
- 04How are medicines stored and fridge temperatures checked and acted on?
- 05When was the most recent residents' meeting or satisfaction survey, and what changes resulted from it?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from previous comprehensive inspections. This explanation was written from the published report of 9 November 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 Heather Grange
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- April 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Good
- November 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- June 2019Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2018
Registered with the Care Quality Commission on 10 December 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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85 live-in carers within about an hour of Lancashire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.