CQC report explained · a residential care home
What the CQC found at Heathfield (Horsham) Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, medicines were safely stored and administered, staffing was sufficient, and infection control arrangements were effective.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its rating carried over from the last comprehensive inspection.
- Caring?
- Good
- This key question was not inspected during this focused visit. The report records positive comments about kind, respectful and person-centred care, but does not give a current rating for Caring.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its rating carried over from the last comprehensive inspection.
- Well-led?
- Good
- Inspectors found improved audits, clearer records, good communication and a positive culture. People, relatives and staff were positive about the management.
What inspectors found, February 2023
Heathfield (Horsham) Limited was rated Good after improvements; inspectors found safe, kind care and better management systems.
This was an unannounced focused inspection on 31 January 2023. One inspector spoke with six people, two relatives, six staff members and two visiting health professionals. The inspector reviewed care records, medicine records, staff files and management records.
The home was rated Good for Safe and Well-led. Inspectors found that risks were assessed, medicines were managed safely, staffing was sufficient and infection control arrangements were in place. People and relatives said they felt safe and were treated with kindness and respect.
The home had previously been rated Requires Improvement, with breaches relating to safe care and treatment and good governance. Inspectors found enough improvement had been made and the home was no longer in breach. This focused report only assessed Safe and Well-led. The other ratings carried over from the previous comprehensive inspection.
Safe medicines
Medicines were stored, recorded and given safely by trained staff. Written guidance was available for medicines given when needed.
“People's medicines were safely managed. Staff were storing, recording and administering medicines accurately.” from the report
Risk management
Care plans and risk assessments included people's individual health needs. The home investigated falls and took steps to reduce future risks.
“Risk assessments for people had improved since the last inspection and had been personalised.” from the report
Kind and respectful care
People and relatives described staff as caring and thoughtful. Inspectors observed warm, friendly and respectful interactions.
“People and relatives described the staff as caring and thoughtful and said they were treated with care and kindness.” from the report
Improved leadership
Management systems and records had improved since the previous inspection. Audits were being used to identify problems and support further improvement.
“At this inspection enough improvement had been made and the provider was no longer in breach of regulation 17.” from the report
Staffing and continuity
Inspectors found enough staff on duty, with a suitable mix of skills. People and relatives said staff knew them well.
“People, relatives and visiting health professionals told us that staffing was consistent and staff knew people well.” from the report
Some records still needed checking
minorAudits found some errors or omissions in medicine and care records. The home corrected the issues and gave staff support, but continued checking remains important.
“Audits of medicine and care plans had improved and demonstrated errors or omissions were picked up.” from the report
- 01How do you now check medicine stock records and prevent recording errors from happening again?
- 02How are falls plans and mobility plans updated when a person's needs change?
- 03How will you use audits to identify trends and make sure improvements continue?
- 04How do you make sure staffing remains consistent and that staff know my relative's needs and preferences?
- 05How would you support my relative's particular needs, such as diabetes, epilepsy, dementia or swallowing medicines?
This was an unannounced focused inspection of Safe and Well-led only; the other ratings carried over from the last comprehensive inspection. This explanation was written from the published report of 16 February 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, June 2021
Rated Requires Improvement; inspectors found caring staff and enough staff on duty, but medicines, risk records and quality checks were not reliable.
This was an unannounced focused inspection on 13 May 2021. It was prompted by concerns about falls, pain relief and how the home was managed. One inspector spoke with people, relatives and staff, and reviewed care plans, medicine records, staff files and management records.
Inspectors found problems with medicines, risk assessments and care records. Some medicines were recorded as refused in one place but given in another. Guidance did not always tell staff what to do when pain relief was refused. Risk assessments were generic and did not contain enough detail about people's health needs.
The home's checks had not identified these problems. Staff were caring and respectful, people said they felt safe, and there were enough staff on duty. The overall rating changed from Good to Requires Improvement. The inspection only looked at Safe and Well-led, so the other question ratings were carried forward from the previous comprehensive inspection.
Caring and respectful staff
People appeared comfortable with staff. Staff promoted privacy, dignity and independence, and offered help when needed.
“We observed staff talking with people in a friendly, dignified and respectful way.” from the report
People felt safe
People said they felt safe, and staff understood how to recognise and report possible abuse.
“Systems and processes protected people from the risk of abuse.” from the report
Enough staff on duty
Inspectors found enough staff to support people in a timely way.
“There were enough staff on duty. People told us they received care and support in a timely way.” from the report
Equipment checks
The home had a reliable process for checking and servicing equipment, including when the pandemic disrupted normal arrangements.
“The provider had a robust system for the checking and servicing of equipment.” from the report
Open communication
People and relatives said they could share concerns and were kept informed about incidents and changes.
“Records showed that when incidents had happened, families had been communicated with in a timely way.” from the report
Medicine safety
seriousMedicine records were sometimes contradictory. Staff did not have enough guidance about pain relief or what to do if a person refused medicine.
“PRN protocols for medicines prescribed for pain relief that required more specific storage and monitoring measures were not sufficiently detailed and did not guide staff on next steps if medicine was refused.” from the report
Personalised risk assessments
seriousRisk assessments did not contain enough information about people's individual health risks or the actions staff should take.
“Risk assessments for people were generic and not personalised.” from the report
Incomplete care records
needs fixingCare plans and risk assessments were not always up to date or detailed enough to guide personalised care.
“Some information contained within care plans was not up to date and not reflective of people's current care needs.” from the report
Weak quality checks
seriousAudits had not identified important gaps in medicine guidance and care records. The provider had not fully acted on an earlier recommendation.
“Systems and processes for quality monitoring were not effective and had failed to identify the lack of detailed health information in people's care records.” from the report
Visiting arrangements
minorThe visiting area had not been updated to reflect current government guidance, creating a potential infection risk. The manager said new arrangements had been made after the inspection.
“The provider had not kept up to date with government guidance.” from the report
- 01What changes have you made to PRN medicine records, especially when pain relief is refused?
- 02How do you now make sure each person's risk assessment includes their specific health needs and the actions staff must take?
- 03How often are care plans and risk assessments checked, and who makes sure changes in people's needs are recorded?
- 04What action have you taken to make sure medicine audits identify errors and staff follow the correct administration process?
- 05What was changed about the visiting area after the inspection, and how is it kept in line with current guidance?
This was a focused inspection of Safe and Well-led, prompted by concerns about falls, pain relief and management; the other question ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 10 June 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 Heathfield (Horsham) Limited
5 rated inspections over 8 years: the service has held its Good rating throughout.
- February 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Heathfield (Horsham) Limited →
- June 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Heathfield (Horsham) Limited →
- August 2020Inspected but not ratedSafe: Inspected but not rated
- June 2019Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- June 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 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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