CQC report explained · a nursing home
What the CQC found at Heathlands Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2023
Heathlands Care Home was rated Good overall, with kind and safe care, but inspectors recommended improvements to medicines, dining and communication.
Inspectors visited on three days between 29 June and 21 July 2023. They spoke with people, relatives and staff, and checked care records, medicines, recruitment records, audits and building safety documents. The inspection was unannounced.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, suitable risk assessments and good infection control. They also found people were treated kindly, involved in decisions and supported with food, healthcare, activities and personalised care.
There were some areas to improve. Inspectors found recent gaps in medicines records, concerns about agency staff knowing people's needs, an inconsistent dining experience and communication that did not always reach people and relatives. They made three recommendations, but recorded no breaches of regulations.
People were kept safe
Inspectors found safeguarding arrangements, risk assessments, building checks and infection control measures. Staff knew how to report abuse or concerns.
“People were protected from the risk of harm or abuse.” from the report
Kind and respectful care
Inspectors observed staff showing patience, understanding and compassion. Staff promoted privacy, dignity and independence.
“We observed caring interactions between staff and people using the service.” from the report
Personalised care
Care plans included people's preferences, life history, goals and support needs. They were reviewed with people's and relatives' views included.
“Care plans were detailed, personalised and stated the outcomes and goals to be achieved for each care intervention.” from the report
Activities and relationships
People had access to different activities and support to keep in touch with family and friends. Inspectors saw people taking part in activities and social events.
“People had access to a range of activities and were supported to maintain links with friends and family.” from the report
Positive leadership
People, relatives and staff generally felt listened to by the management. The home used meetings, surveys and audits to review its service.
“The provider had systems in place to involve people using the service, relatives and staff in the development of the service.” from the report
Medicines records
needs fixingInspectors found some recent gaps in medicines administration records, including entries saying a person had been sleeping when medicines were given. The staff member involved was removed from medicines duties and retraining was arranged.
“We found there some issues with medicine administration records where there were some recent gaps and entries stating a person had been sleeping when medicines were being administered.” from the report
Agency staff knowledge
needs fixingSome people and relatives were not confident that agency staff understood individual needs. The manager said agency staff were being used less often as permanent staff were recruited.
“The agency staff are not aware of what I need help with.” from the report
Dining experience
minorInspectors found that condiments were not offered and some people said the food was too spicy. A recommendation was made to improve the dining experience.
“However, we noted there was no background music playing while people ate and condiments were not offered.” from the report
Communication with families
minorSome people and relatives said they did not always hear about meetings or what was happening in the home. Inspectors recommended improving communication and involvement.
“I seem to miss some things that are going on, because no one tells me.” from the report
No registered manager at the visit
minorThere was no registered manager in post during the inspection. A new manager had been in post for three months and had applied to register, with the application still being assessed.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01What changes have been made to prevent gaps in medicines administration records?
- 02How are agency staff told about each person's individual care needs, and how is their competence checked?
- 03What has changed to improve the dining experience, including making condiments available and responding to food preferences?
- 04How will you make sure people and relatives are told about meetings, activities and other important updates?
- 05Has the new manager's application to become registered been approved?
This was an unannounced inspection covering all five key questions, including infection prevention and control under Safe; all five ratings were given as Good. This explanation was written from the published report of 14 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, March 2021
Inspected but not rated; the home showed kind, well-managed care, but its end-of-life admissions process needed improvement.
This was a targeted inspection about end-of-life care and infection control. Inspectors visited on 20 November 2020 and spoke with relatives and staff, reviewed care and medicine records, and checked quality records. They also made calls to relatives.
The home was following infection control guidance. Relatives generally praised the manager and permanent staff. Inspectors found that end-of-life care was well managed for people who had lived at the home longer.
There were problems when people were first admitted for end-of-life care. Information was not always complete, and some relatives raised concerns about medicines, agency staff and call bells. CQC made a recommendation to improve the admissions process.
The inspection did not give new ratings. The previous overall rating of Good, published in September 2018, remains in place. Safe, Responsive and Well-led were inspected but not rated, and Effective and Caring were not reviewed in this inspection.
Infection control
Inspectors were assured that the home followed national infection control guidance, used PPE and had systems for testing and managing coronavirus outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Longer-term end-of-life care
For people who had lived at the home longer, relatives described good end-of-life care. Records showed medicines were given on time to help with pain and agitation.
“End of life care for people who had been at the service for a longer of time was well managed.” from the report
Respectful care
Staff were observed speaking politely to people and asking permission before entering their rooms. Staff also understood people's end-of-life needs.
“We saw staff treat people with respect, such as talking politely and getting permission to enter people's rooms.” from the report
Approachable management
Relatives and staff said the manager was approachable. The provider carried out audits and said it would continue improving the admissions process.
“The provider completed a range of audits to monitor the quality of the service” from the report
End-of-life admissions
needs fixingThe admissions process did not always gather enough information at the start, partly because the pandemic prevented the usual assessments. CQC recommended that the home seek advice and support to make this process more consistent.
“The admissions process for people receiving end of life was not always robust.” from the report
Medicines and communication
needs fixingA minority of relatives raised concerns about medicines after admission, including pain relief being given late. This suggests families should check how medicine needs are discussed and recorded when someone arrives.
“[Family member's] transfer was done in a hurry...We have had no conversation around end of life care with the home…[family member] kept being given pain medication very late, they were crying in pain.” from the report
Agency staff and call bells
needs fixingSome relatives said non-permanent staff could be abrupt and that call bells were not always answered promptly.
“Some relatives reported issues with the way non-permanent staff treated their loved ones and felt that call bells were not always answered promptly.” from the report
- 01How will you make sure you collect complete end-of-life information before, or soon after, someone moves in?
- 02How do you discuss and record pain relief and other end-of-life medicines when a person is admitted?
- 03How do you check that medicines are given on time, especially for people newly admitted?
- 04How do you monitor agency staff's approach to residents and make sure call bells are answered promptly?
- 05What changes have you made following CQC's recommendation about the end-of-life admissions process?
This was a targeted inspection of specific concerns about end-of-life care and infection control; it did not assess all five key questions, so the previous Good rating from 2018 remains in place. This explanation was written from the published report of 5 March 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 Heathlands Care Home
4 rated inspections over 9 years: the service has held its Good rating throughout.
- October 2023Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2021Inspected but not ratedSafe: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- September 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2014GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 17 November 2010.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Waltham Forest
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,200 a week. 77 can care for a couple. 11 years' experience on average.
“Sidonia is a first class live-in carer whose dedication and thoughtfulness made her stay a happy experience.”
“Charity would take Nan on holidays day trips and shopping adventures”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.