CQC report explained · a nursing home
What the CQC found at Heatherdene Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected by trained staff, safe recruitment, regular risk assessments and suitable staffing levels. Medicines were received, stored and given correctly.
- Effective?
- Good
- Staff had training, supervision and competency checks. People received support with nutrition, hydration and healthcare, and care was adapted to their individual needs.
- Caring?
- Good
- Staff were kind and respectful. People were involved in decisions, and their privacy, dignity, independence and relationships were promoted.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed. The home offered activities, communication support and a complaints process that investigated concerns.
- Well-led?
- Good
- The manager was visible and approachable. Feedback, audits, staff meetings and other checks were used to monitor and improve the service.
What inspectors found, December 2019
Heatherdene Nursing Home was rated Good; inspectors found safe, kind and personalised care, with some care records still being improved.
This was an unannounced planned inspection on 24 October 2019. One inspector and a nurse specialist spoke with people living in the home, relatives and staff. They reviewed care records, medicines records, staff files and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines practice, clean surroundings and good systems for managing risks. People were supported with their health, food, drinks and daily choices.
Inspectors found kind staff who knew people's preferences and treated them with dignity. Care plans were personalised, activities were available and relatives were kept informed. The home had been rated Good at the previous inspection, published on 26 April 2017, and this rating remained unchanged.
Safe staffing and medicines
People said staff were available when needed. Inspectors found safe recruitment, suitable training and correct medicines procedures.
“Medicines were received, stored, administered and managed correctly.” from the report
Personalised care
Care plans included people's routines, preferences, communication needs and health requirements. Relatives said staff knew the small details that mattered to their family members.
“Care plans were personalised, thorough and detailed to ensure staff could understand people's individual needs.” from the report
Kind and respectful staff
Staff showed patience and a good rapport with people. Inspectors saw people being asked for consent and supported with privacy and choice.
“People were supported by kind and caring staff.” from the report
Activities and relationships
The home provided group activities and community links. People who stayed in their rooms were offered individual visits from the activities co-ordinator.
“People that were cared for in their room were visited by the activities co-ordinator at least three times a week” from the report
Open management
People, relatives and staff found the manager approachable. Quality checks, feedback and staff meetings supported oversight of the home.
“There were quality assurance processes in place to ensure oversight of the safety and quality of the service at management and provider level.” from the report
Best-interest records being improved
minorThe home was still working to record best-interest decisions in a clearer format. Inspectors saw examples and received further examples after the inspection.
“There was work being completed around documenting best interest decisions in a clearer format.” from the report
More detailed end-of-life plans not complete
minorEnd-of-life plans were present in care files, but more detailed plans were still being completed. Nobody was receiving end-of-life support during the inspection.
“the registered manager was in the process of completing more detailed end of life plans.” from the report
- 01How are best-interest decisions recorded now, and what changes were made after the inspection?
- 02Have the more detailed end-of-life plans now been completed for people who need them?
- 03How do you review staffing levels when people's needs increase?
- 04How are people who stay in their rooms offered activities and one-to-one time?
- 05How do you monitor drinks and hydration for people at risk of dehydration or urinary tract infections?
This was an unannounced comprehensive inspection covering all five CQC questions, and the ratings in all five areas remained Good. This explanation was written from the published report of 19 December 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.
What inspectors found, April 2017
Rated Good; inspectors found safe, kind and personalised care, with some records needing improvement.
This was an unannounced comprehensive inspection on 31 March 2017. Inspectors spoke with people living in the home, relatives, staff and health professionals. They observed care and reviewed care, medicines, staffing, training, complaints and quality records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and listened to. Inspectors found enough staff, safe medicines systems, suitable training and care plans that reflected people's needs.
The inspection checked improvements needed after the previous inspection in February 2016. Mealtimes now offered more choice and were enjoyed by people. Meetings and complaints were being recorded, with actions shared and reviewed.
Inspectors found two record-keeping shortfalls during the visit. Guidance for some as-required medicines did not initially include a pain assessment or review of effectiveness. There was also no clear recorded reason for some people remaining on continuous bed rest. Both points were addressed during or after the inspection.
Safe care
Risks such as falls, skin damage, nutrition and moving and handling were assessed and managed. Medicines were stored, given and recorded safely.
“There were systems in place to make sure risks were assessed and measures put in place where possible to reduce or eliminate risks.” from the report
Good mealtimes
People had choices, suitable support and access to drinks throughout the day. The report says this improved from the previous inspection.
“This inspection found that improvements had been made to the dining experience and people were complimentary about the choices of meals available.” from the report
Kind and respectful staff
Staff knew people well and supported their dignity, independence and personal choices.
“Staff communicated clearly with people in a caring and supportive manner and it was evident that they knew people well and had good relationships with them.” from the report
Activities and personal choices
A dedicated activity worker organised activities based on people's interests. People could choose how to spend their time and where to eat.
“There was an activity programme that reflected people's interests.” from the report
Listening and improvement
The home recorded actions from resident, family and staff meetings, then checked whether those actions had worked.
“At the next meeting these would be discussed and evaluated as to whether the actions had worked.” from the report
As-required medicine records
needs fixingSome guidance for as-required medicines did not initially include a pain risk assessment or a review of whether the medicine worked. This was introduced by the second day of the inspection.
“PRN guidelines were in place, but lacked a pain risk assessment or evaluation of effectiveness of medicine.” from the report
Bed-rest decisions not fully recorded
needs fixingThe report found no clear recorded reason for some people remaining on continuous bed rest, or who had been involved in the decision. The home later confirmed this had been addressed.
“However there was no clear rationale documented for those people who remained on continuous bed rest or of who had been involved in the decision making.” from the report
- 01How do you now record pain assessments and check whether as-required medicines have worked?
- 02How are decisions about continuous bed rest recorded, reviewed and discussed with the person or their representative?
- 03How do you make sure the wider choice of meals found at this inspection has been maintained?
- 04How are actions from resident, family and staff meetings followed up and checked?
- 05How are care plans updated when a person's health or daily preferences change?
This was an unannounced comprehensive inspection covering all five rating areas and checking improvements required after the February 2016 inspection. This explanation was written from the published report of 26 April 2017 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 Heatherdene Nursing Home
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- December 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 17 January 2011.
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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