CQC report explained · a nursing home
What the CQC found at Heathfield Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks were assessed and staff had guidance to reduce them. Inspectors found enough staff, safe recruitment, safe medicines systems and effective infection prevention measures.
- Effective?
- Good
- People's needs were assessed before they moved in. Staff had suitable training and supervision, and people were supported with food, drink, healthcare and decisions about their care.
- Caring?
- Good
- People were treated with kindness, compassion, dignity and respect. Staff knew people's preferences and supported independence and personal choices.
- Responsive?
- Good
- Care plans recorded people's preferences and families were involved where possible. People were supported with communication, activities, relationships, complaints and end of life wishes.
- Well-led?
- Good
- The home had regular audits, meetings and action plans to identify and fix shortfalls. People, relatives and staff were asked for their views, and the manager was described as approachable.
What inspectors found, March 2023
Rated Good; inspectors found safe, kind and personalised care, with all five ratings improved from Requires Improvement.
This was an unannounced inspection on 13 February 2023. One inspector spoke with people, relatives and staff, and checked care plans, medicines, safety records and staff files.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people felt safe, received their medicines, had enough staff support and were treated with kindness and respect.
The home had previously been rated Requires Improvement in July 2021. The provider had made improvements to care records, medicines records and quality checks. The home was no longer in breach of the regulations at this inspection.
Inspectors found one medicines-recording weakness during the visit. Information about two possible when-required medicines had not been linked together, but this information was added after the inspection.
Kind and respectful care
Staff knew people well and supported their choices, dignity and independence. They responded to emotional distress and helped people stay connected with relatives.
“People were treated with kindness and compassion. Staff knew people well and their choices and preferences.” from the report
Personalised activities
People could choose from activities and were supported to spend time with others, see relatives and go out. Activities were also offered to people who preferred to stay in their rooms.
“People were supported to take part in social activities of their choice.” from the report
Improved oversight
The home had introduced regular audits and action plans. Inspectors found that identified problems were acted on and checked again.
“At this inspection, there was now an effective system in place to monitor the service.” from the report
Linked medicines instructions
needs fixingSome instructions for two possible when-required medicines for anxiety or pain had not been linked together. Staff understood the arrangements, and the information was added to the records after the inspection.
“There were protocols in place, but these had not been linked together to make sure staff were aware there were two medicines available.” from the report
- 01How do you now check that all when-required medicines have clear, linked instructions?
- 02How will you make sure the improvements to care plans continue while the recording system is changing?
- 03How would you support my relative's specific health risks, such as falls, diabetes, epilepsy or swallowing difficulties?
- 04How would my relative be involved in care reviews and decisions if they could not express their wishes clearly?
- 05What activities, family visits and trips out could be arranged to match my relative's interests?
This was an unannounced inspection of the home that assessed all five CQC questions and included infection prevention and control checks; all five ratings carried over as improved from Requires Improvement at the previous inspection. This explanation was written from the published report of 4 March 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, July 2021
Rated Requires Improvement; the home had made important progress but inspectors found unsafe medicines records, outdated care information and weak quality checks.
Inspectors visited without notice on 3 and 4 June 2021. They spoke with people, relatives and staff, and reviewed care records, medicines records, recruitment files and management audits.
The home had improved since its previous Inadequate rating. Staffing had increased, accident monitoring was better, staff training had improved and people received appropriate food, drink and healthcare support.
However, some care records did not reflect people's current needs. Medicines stock did not match records, infection control during isolation was not fully assured, and management checks had failed to identify these problems.
The overall rating was Requires Improvement. Safe, Effective and Well-led were each rated Requires Improvement. This focused inspection did not reassess Caring or Responsive, so earlier ratings for those areas were carried forward. The home was no longer in special measures.
More staff available
Staffing levels had improved, including at night. People and relatives told inspectors there were enough staff.
“There were sufficient staff across day and night shifts to meet people's needs.” from the report
Better response to incidents
The home had improved how it reviewed accidents and falls. Staff looked for patterns and took steps such as referrals to healthcare professionals.
“The registered manager now reviewed incidents to ensure the appropriate action had been taken.” from the report
Healthcare and nutrition
People were referred to suitable healthcare professionals and staff followed professional advice. Food and fluid records were kept when concerns existed.
“At this inspection, improvements had been made. Dieticians had been involved in people's care and their advice had been followed.” from the report
More positive culture
People, relatives and staff described a calmer service and better communication under the new management.
“At this inspection the registered manager had changed and the new registered manager had made improvements to the culture of the service.” from the report
Choice and consent
Staff understanding of capacity and consent had improved. People were supported to make choices, and applications about restrictions on liberty were kept under review.
“People and their relatives told us they were supported to make choices and decisions by staff.” from the report
Outdated care information
needs fixingSome care plans and risk assessments did not match people's current mobility, health or support needs. This could cause confusion, especially for new or agency staff.
“Some people's changing needs had not been updated into care plans.” from the report
Medicines records did not match stock
seriousInspectors found discrepancies for five people's medicines. The home could not explain why they had happened, and its checks had not found them.
“The records of five people's medicines did not tally with what was in stock.” from the report
Isolation procedures
seriousInspectors were not fully assured about isolation after a hospital visit. Additional protective equipment and signage were not consistently used, and risks had not been assessed.
“We were not assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Weak quality audits
needs fixingManagement audits checked that records existed but did not reliably check whether the information was accurate or whether problems had been fixed.
“Monitoring processes were not yet robust enough to sustain improvement.” from the report
- 01How do you make sure every person's care plan and risk assessment is updated when their needs change?
- 02What new checks make sure medicines stock matches the records every time?
- 03How do you manage isolation after someone returns from hospital, including signage and protective equipment?
- 04How do you check that audits assess the accuracy and quality of records, rather than only confirming that records exist?
- 05What progress has been made since the inspection, and what evidence can you show that the Regulation 17 breach has been addressed?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 17 July 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 Residential Home
6 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2021Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- December 2020Inadequatestayed InadequateSafe: InadequateEffective: Requires improvementWell-led: Inadequate
- April 2020Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- January 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2016
Registered with the Care Quality Commission on 24 February 2016.
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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