CQC report explained · a residential care home
What the CQC found at Heather Vale
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found medicines were not always managed safely, and risk assessments and emergency evacuation plans were incomplete or not kept up to date. Infection control was mostly good, but some hand-washing facilities were not available at the point of care.
- Effective?
- Good
- This question was not inspected at this visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not inspected at this visit. Inspectors nevertheless observed kind and respectful care.
- Responsive?
- Good
- This question was not inspected at this visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- The home had supportive managers and an open approach, but its audits and action plans did not consistently identify or resolve safety problems.
What inspectors found, October 2021
Heather Vale is rated Requires Improvement; inspectors found kind care and enough staff, but medicines, risk records and oversight were not reliable.
This was an unannounced focused inspection on 14 July 2021. Three inspectors spoke with people, relatives, staff and a health professional. They observed care and checked care plans, medicines, recruitment and management records.
The home had enough staff, safe recruitment and kind care. Infection control was mostly managed well, and staff worked with health professionals. People were supported to make daily choices and personalise their rooms.
Inspectors found repeated problems with medicines, risk assessments and care records. Audits had not found or fixed these problems, including errors with as-needed medicines, medicine fridge temperatures and records after falls. The home breached Regulations 12 and 17.
The overall rating fell from Good at the previous inspection to Requires Improvement. This inspection only looked at Safe and Well-led. The other question ratings were carried forward from the earlier comprehensive inspection.
Enough staff
Inspectors found there were enough staff to meet people's needs, and recruitment checks had been completed safely.
“There was sufficient staff to meet the needs of the people using the service.” from the report
Kind and respectful care
Staff showed kindness, compassion and respect. They supported people's daily choices and used calm approaches when people were anxious or confused.
“All the staff we observed showed people respect and encouraged daily choices.” from the report
Infection control
Most infection prevention measures were in place, including safe admissions, effective use of protective equipment and support for visits under current guidance.
“We were assured that the provider was using PPE effectively and safely.” from the report
Working with health professionals
The home worked with health and social care professionals to support people's ongoing health needs, including through weekly clinical reviews.
“The provider worked with a range of professionals to ensure people received the required care.” from the report
Medicine safety
seriousAs-needed medicine protocols were not always available, and repeated fridge temperature errors had not been identified or addressed. This increased the risk of people receiving medicines incorrectly or not receiving them when needed.
“Some areas of the medicines were not managed well.” from the report
Incomplete risk information
seriousCare plans and risk assessments did not always contain the information needed for people's long-term conditions. Emergency evacuation plans were also not always completed or updated.
“Risks to people were not always in place to fully mitigate or manage risk effectively in order to keep people safe.” from the report
Weak quality checks
seriousAudits and the provider's action plan did not identify important ongoing risks, including medicine errors and problems with records after falls. This meant there was not a joined-up approach to improvement.
“Auditing systems were not always effective or used to drive improvement in the quality and safety of the service provided.” from the report
Inconsistent records after falls
needs fixingRecords did not always follow the home's process for recording observations and actions for 72 hours after a fall.
“However, we found this was not consistent with all the recorded falls.” from the report
Bathing records
needs fixingRecords for some people showed fewer opportunities or longer gaps between bathing and shower support. Inspectors could not be assured this support was provided consistently.
“Bath and shower records for some people noted they had less opportunities or longer periods between receiving this support.” from the report
- 01What has been done to stop errors with as-needed medicines and medicine fridge temperatures?
- 02How are risk assessments and emergency evacuation plans checked and updated when people's needs change?
- 03How are falls records now checked to make sure observations and actions are recorded for the required 72 hours?
- 04What changes have been made to the auditing system and action plan since this inspection?
- 05Have the required hand-washing facilities been installed in all ensuite bathrooms?
This was a focused inspection of Safe and Well-led only; the other question ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 15 October 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, January 2020
Heather Vale was rated Good overall; inspectors found safe, kind and personalised care, but leadership systems were not yet fully established.
This was an unannounced inspection on 21 November 2019. Inspectors spoke with people living in the home, relatives, staff and a visiting health professional. They reviewed care records and records about staffing, medicines, complaints and management.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, safer medicines systems, suitable care planning, kind staff and activities that people enjoyed. People were supported with their health, food, communication, choices and relationships.
Well-led was rated Requires Improvement. Management systems had been restarted after earlier problems, but the provider had not yet shown that these improvements were fully embedded and lasting. The overall rating improved from Requires Improvement at the previous inspection, and the home was no longer in breach of regulations.
Staffing and safety
Inspectors found enough staff to provide care promptly. Risks linked to people's health, the environment and equipment were being managed safely.
“At this inspection we found risks to people's safety associated with their health condition, environment and any equipment used for their care, were safely managed.” from the report
Kind relationships
People and relatives spoke positively about staff. Staff knew people well and supported their dignity, independence and rights.
“Staff were respectful and interacted with people in a kind, caring manner.” from the report
Personalised care and activities
Care was tailored to people's choices and needs. People could join activities, maintain relationships and take part in community life.
“Overall people's care was now person centred and inclusive.” from the report
Improved practice
The home had acted on problems found at the previous inspection. The earlier breaches had been addressed and the service was no longer in breach.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Leadership systems not yet established
needs fixingThe provider had restarted monitoring and management arrangements, but had not yet shown that they were lasting. Earlier problems included staffing, records, activities, medicines monitoring and cleanliness oversight.
“However, this was not yet fully embedded and demonstrated as ongoing or sustained.” from the report
End of life planning
minorThe manager recognised that people's end of life wishes and needs needed more proactive assessment and agreement. Planned changes included new instructions for staff and revised records.
“The manager had recognised further work was needed to ensure people's end of life care needs were proactively assessed and agreed with them.” from the report
- 01How have you shown that the new management and quality monitoring systems have remained consistent since the inspection?
- 02How do you currently check staffing levels and make sure staff are available promptly when people need help?
- 03How are medicines, care records, activities and environmental cleanliness checked and reviewed?
- 04How do you assess and record each person's end of life wishes, especially if they cannot easily express their views?
- 05How are people and relatives involved in meetings and decisions about daily life and care?
This was a planned inspection covering all five key questions, including the premises and the care provided; the previous rating was Requires Improvement. This explanation was written from the published report of 8 January 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.
Every inspection of Heather Vale
4 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- October 2021Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2020Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- November 2018Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 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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