CQC report explained · a nursing home
What the CQC found at Heatherfield Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and the home had enough trained staff. However, some medicines documentation was incomplete and some staff were not fully aware of individual risk assessments.
- Effective?
- Good
- Care records were person-centred, staff had suitable training and people received timely support from healthcare professionals. Menu choices were not always presented in line with best practice guidance.
- Caring?
- Good
- This question was not inspected during this focused inspection, so no new rating was given.
- Responsive?
- Good
- This question was not inspected during this focused inspection, so no new rating was given.
- Well-led?
- Good
- The management team used audits and action plans to identify and address issues. Staff described managers as approachable, and the home had a positive culture.
What inspectors found, July 2023
Rated Good; inspectors found safe, effective and well-led care, but identified shortfalls in medicines records, risk information and menu choices.
This was an unannounced focused inspection on 21 June 2023. Inspectors reviewed concerns about end of life care and skin integrity, but found no evidence that people were at risk of harm from these concerns.
The home was rated Good for Safe, Effective and Well-led. Inspectors found enough staff, safe recruitment, suitable training, effective work with healthcare professionals and a positive management culture.
There were some areas to improve. Covert medicines records and some care documents were not always complete. Some staff did not know people's individual risks, and people living with dementia were not shown menu choices in a physical or pictorial form. The CQC made recommendations rather than finding legal breaches.
Staffing and recruitment
Inspectors found enough appropriately trained staff. Recruitment checks were completed safely, and agency staff received an induction.
“There were sufficient, appropriately trained staff to care for people safely.” from the report
Person-centred care
Care records contained detailed, person-centred information, and key information was carried through the care documentation.
“Care records were person-centred and detailed.” from the report
Working with professionals
The home worked with healthcare professionals and acted on their recommendations in a timely way.
“People received support from other healthcare professionals in a timely manner.” from the report
Positive culture
Inspectors found a positive culture. Staff said managers were supportive and relatives generally felt the home was managed well.
“The management team and staff had created a positive culture.” from the report
Quality improvement
Audits and a central action plan were used to address problems and make changes.
“The management team had made changes in a timely manner, improving the service continuously.” from the report
Medicines records
needs fixingSome short-shelf-life medicines were not dated when opened, and some topical medicines were not recorded or applied by the correct grade of staff. Covert medicines protocols and some other medicines care documents also needed improvement.
“The management of covert medicines and some documentation was not in line with the provider's policy.” from the report
Awareness of individual risks
seriousSome staff could not explain people's specific de-escalation techniques, and some staff were unaware that one person was at particular risk of choking.
“One person was at particular risk of choking but some staff were unaware of this risk.” from the report
Meal choices for people with dementia
minorPeople chose meals verbally, but the home did not show physical or pictorial menu options at the observed mealtime.
“There were no pictorial menus at the mealtime we observed.” from the report
Family involvement in care planning
needs fixingSome relatives said they had not been involved in care planning or seen the person's care plan.
“A number of relatives said they were not involved in care planning by the service.” from the report
- 01What changes have you made to covert medicines protocols and medicines care plans since the inspection?
- 02How do you make sure every staff member knows each person's current risks, including choking risks and individual de-escalation techniques?
- 03How are people living with dementia shown their meal choices now?
- 04How are relatives involved in care planning, and how can they see and review the care plan?
- 05How do you record lessons learned after incidents and check that all staff have received the learning?
This was an unannounced focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and the overall rating used the previous ratings for the questions not inspected. This explanation was written from the published report of 12 July 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, January 2023
Rated Good after a focused inspection; inspectors found improvements in medicines, staffing and management, although communication could be stronger.
The inspection took place on 9 and 16 November 2022. It was unannounced. Inspectors spoke with people, relatives, visitors, staff and health and social care professionals, and checked care, medicines, recruitment and management records.
The home was rated Good for Safe and Well-led. Inspectors found that risks were assessed, medicines records showed medicines were given as prescribed, staffing had increased and infection control arrangements were suitable.
The home had improved since the previous inspection, which was rated Requires Improvement. The provider had completed an action plan and was no longer in breach of the regulations mentioned in the earlier report.
This was a focused inspection of Safe and Well-led only. The overall Good rating also used the other ratings from the previous comprehensive inspection.
Medicines
The home had a medicines management system, and inspectors found records showing that medicines were given as prescribed.
“There was a system in place to manage medicines. Records showed that medicines had been administered as prescribed.” from the report
Staffing
Inspectors found enough staff to meet people's needs. Staffing levels had increased, and the manager had identified the need for more staff when unexpected behaviours occurred.
“There were sufficient staff deployed to meet people's needs.” from the report
Risk management
Risks were assessed and monitored. The home used measures such as therapy and one-to-one support for people at higher risk of falls.
“Risks were assessed, monitored and managed.” from the report
Quality checks
The home had introduced checks covering different parts of the service and took action when shortfalls were found.
“An effective quality monitoring system was in place. Checks were carried out to monitor all aspects of the service.” from the report
Partnership working
Staff worked with health and social care professionals to help meet people's needs. Feedback about staff knowledge and care was positive.
“Staff worked in partnership with other health and social care professionals to help ensure people's needs were met.” from the report
Communication
needs fixingCommunication systems, handovers and meetings had improved, but several relatives and health and social care professionals said they would like communication to be more effective.
“Several relatives and health and social care professionals explained that more effective communication would be appreciated.” from the report
- 01How will you make communication with relatives more consistent and effective?
- 02How do you decide when staffing levels need to increase because of unexpected behaviours?
- 03How are medicines records checked to make sure every dose is recorded accurately?
- 04What checks are carried out when risks such as falls are identified?
- 05Which ratings from the previous comprehensive inspection apply to Caring, Effective and Responsive?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other ratings carried over from the last comprehensive inspection. This explanation was written from the published report of 26 January 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.
Every inspection of Heatherfield Care Home
9 rated inspections over 8 years: the service has held its Good rating throughout.
- July 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2023Goodup from Requires improvementSafe: GoodWell-led: Good
- January 2023Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2021GoodSafe: GoodWell-led: Good
- November 2020Inspected but not ratedSafe: Inspected but not rated
- May 2018Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Requires improvement
- February 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- May 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2015Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- April 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- August 2013
Registered with the Care Quality Commission on 7 August 2013.
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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