CQC report explained · a residential care home
What the CQC found at Heathfield House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe, staffing levels were considered sufficient and medicines were managed safely. Inspectors found that incident records did not always identify lessons learned, although the provider introduced a lessons learned form after the inspection.
- Effective?
- Good
- Staff had relevant training and people were supported with food, healthcare and health checks. Some areas of the home looked tired and needed updating, but the provider said improvements had started.
- Caring?
- Good
- The report did not give a separate Caring rating. Inspectors said people received kind and compassionate care, and staff respected their privacy, dignity, choices and individual needs.
- Responsive?
- Good
- Care plans were detailed and person-centred, and people were supported with activities, relationships and healthcare. Inspectors found that care information was not always in a format suited to people's communication needs.
- Well-led?
- Good
- The home had regular audits, care plan reviews and staff support systems. Managers responded to the issues raised and reported that improvements had been made after the inspection.
What inspectors found, October 2023
Rated Good; inspectors found kind, person-centred care, but identified gaps in incident learning, communication formats and some parts of the environment.
This was an unannounced, focused inspection on 18 July 2023. One inspector and a nurse specialist advisor visited the home. An Expert by Experience later contacted families. Inspectors spoke with four people, three staff and two relatives.
The home supported 10 people with learning disabilities or mental health needs, with staff available 24 hours a day. Inspectors found people were safe, treated kindly and supported to make choices. Care plans were detailed and staff understood people's individual needs.
The inspection identified some improvements needed. Incident records did not always show what had been learned after accidents. Some care information was not in an accessible format. Parts of the building and an old medicines trolley needed updating. The provider said action had been taken after the inspection.
The overall rating was Good. Safe improved from Requires Improvement at the previous inspection, while Effective, Responsive and Well-led remained Good. This was not a full comprehensive inspection, so some ratings were carried forward from the 2019 inspection.
Kind, respectful care
People told inspectors they were happy with the care. Staff understood people's needs and supported privacy, dignity, choice and independence.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Good person-centred planning
Care plans included detailed guidance about each person's routines, needs and preferences. People and relatives were involved in planning and reviewing care.
“Care plans were written in a person-centred manner.” from the report
Safe staffing and medicines
Inspectors found enough staff to meet people's needs. Medicine records, storage checks and staff competency assessments were in place.
“Medicines were managed safely. The provider had a process for the management and administration of medicines to ensure they were given as prescribed.” from the report
Responsive management
The manager acted when inspectors raised concerns and said changes had been made to incident forms, emergency plans, communication formats and the environment.
“The registered manager was responsive when the issues identified during the inspection were discussed. They implemented an action plan and made improvements following the inspection.” from the report
Incident learning was incomplete
needs fixingTwo incident records described what happened and the immediate response, but did not record further action or lessons to reduce future risks. The provider said a new lessons learned form was being used after the inspection.
“There was no information noted on any additional actions taken or any lessons learned to reduce further risk.” from the report
Communication information was not always accessible
needs fixingCare plans identified communication needs, but the format of the information did not always reflect those needs. The provider later said pictorial care plans had been developed for people who would benefit from them.
“People's communication needs were identified in their care plans, but this was not always reflected in how information was provided.” from the report
Some areas needed updating
minorInspectors found rust, damaged fixtures, an old carpet and a dirty, rusty medicines trolley. The trolley was replaced and a redecoration programme had started after the inspection.
“Some areas of the home looked tired and were in need of updating or replacement.” from the report
One resuscitation record was inconsistent
needs fixingOne person's end-of-life plan said they wanted resuscitation, while a DNACPR document said they did not. The provider said this would be reviewed with the person and relatives, and later said DNACPR records had been checked.
“There was also a do not attempt cardiopulmonary resuscitation (DNACPR) document stating they did not want resuscitation.” from the report
- 01What changes have been made to record lessons learned after incidents and accidents?
- 02How will my relative's care information be provided in the communication format they understand best?
- 03Have all the planned repairs, replacements and redecoration been completed, including checks of the medicines storage area?
- 04How are activities recorded and personalised for each person rather than using the same activities list?
- 05How will you make sure care plans and DNACPR documents always contain the same current information?
This was a focused inspection of how the home applied the principles of right support, right care and right culture, with infection prevention and control also checked; some ratings were carried forward from the 2019 inspection. This explanation was written from the published report of 24 October 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, September 2019
Heathfield House was rated Good overall, but inspectors found that medicines and some risk information were not always managed safely.
This was an unannounced inspection on 8 August 2019. Inspectors spoke with six people, staff, relatives and a professional. They observed care, checked five care records, medicines, recruitment, training, accidents, complaints, quality checks and the building.
People and relatives generally said the home was kind, supportive and met people's needs. People were supported with daily living skills, healthcare, food, community activities and making choices about their care.
The main problems were with medicine storage and recording some risks clearly enough for staff. The medicine cabinets were in a room that became too hot, and there was not enough specific guidance about a flammable cream, modified food and breathing conditions. The manager took immediate action after inspectors raised these issues.
The overall rating was Good. Effective, Caring, Responsive and Well-led were rated Good. Safe was rated Requires Improvement, which means inspectors found limited assurance about safety and an increased risk that people could be harmed.
Kind and respectful care
People and relatives described staff as kind and supportive. Inspectors observed calm interactions where staff listened, offered choices and treated people with respect.
“We witnessed gentle and caring interactions where staff listened to people and showed them respect.” from the report
Support for independence
People took part in cooking, cleaning, shopping and planning for the home. Some attended college or voluntary work and were supported to learn new skills.
“People were supported to develop independent living skills.” from the report
Good staff support
Staff received induction, training, supervision and team support. Recruitment checks were completed and staff said they could ask for further training.
“The staff had training, support and supervision so they could provide effective care.” from the report
Community involvement
People regularly visited local shops, cafes and parks. Some also went on trips, attended college or did voluntary work.
“People accessed the local community most days, visiting local shops, cafes and parks.” from the report
People helped shape the home
People were involved in care reviews, meetings and staff recruitment. The provider also used feedback and surveys to plan improvements.
“People were involved in staff recruitment interviews, asking their own questions and helping to make decisions about the staff who were employed.” from the report
Medicine storage was too hot
seriousMedicine cabinets were kept in a room where temperatures rose above the recommended range. This could have made medicines damaged, unsafe or ineffective.
“The medicines cabinets were kept in a room which became very hot during the day.” from the report
Flammable cream risk was not assessed
seriousOne person used a highly flammable cream and regularly smoked. The specific risk had not been assessed before inspectors raised it.
“This presented a serious risk which the provider had not assessed.” from the report
Some risk plans lacked detail
seriousInformation about modified food and drinks was inconsistent, creating a possible choking risk. Guidance about two breathing conditions was also not fully recorded in the care plan and risk assessment.
“This lack of detail could mean staff provided biscuits without tea and therefore the person would be placed at risk of choking.” from the report
Some people wanted more activities
minorActivities were largely based on what people wanted to do each day, but some people said they wanted different opportunities. Inspectors discussed this with the manager.
“Some people told us they would like different opportunities to do more activities.” from the report
- 01How are medicine storage temperatures checked now, including the maximum and minimum temperatures reached?
- 02What action was taken after checking whether any medicines were affected by the high temperatures?
- 03How are risks from flammable creams managed for people who smoke?
- 04How are modified food and drink instructions recorded and explained to every member of staff?
- 05What additional activities are now available for people who asked for more opportunities?
This was a planned, unannounced inspection that looked at the premises, care and all five CQC questions, with the previous overall rating still Good but the Safe rating falling to Requires Improvement. This explanation was written from the published report of 4 September 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.
Every inspection of Heathfield House
4 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- October 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2019Goodstayed GoodSafe: Requires improvementEffective: GoodResponsive: GoodWell-led: Good
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 25 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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