CQC report explained · a residential care home
What the CQC found at Heaton Vale
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines records and the medicines policy were not always clear or complete. Hazardous substances were not securely stored or risk assessed at the time of inspection, although action was taken during the visit.
- Effective?
- Requires improvement
- The home did not always follow the principles of the Mental Capacity Act when restrictions were placed on people's choices. Staff training, personalised care planning and access to healthcare were positive.
- Caring?
- Good
- People and relatives were positive about the care. Staff knew people well, respected privacy and dignity, and supported choice and independence.
- Responsive?
- Good
- Care plans reflected people's routines, communication needs, interests and preferences. People were supported with activities and community involvement, although staffing problems had sometimes limited planned activities.
- Well-led?
- Requires improvement
- Management systems did not reliably identify and resolve risks or keep complete records. Relatives also gave mixed feedback about communication and involvement.
What inspectors found, July 2023
Rated Requires Improvement; inspectors found kind, personalised care but gaps in medicines, consent records and safety oversight.
Inspectors made unannounced visits on four dates in May 2023. They spoke with people, relatives and staff, observed care, and checked care, recruitment and management records.
People were generally treated with dignity and respect. Care was personalised, people were supported to make choices and be independent, and the caring and responsive areas were rated Good.
However, safety, effectiveness and leadership were rated Requires Improvement. Inspectors found medicines records were not always complete, some restrictions were not properly assessed under the Mental Capacity Act, and known safety actions had not been completed.
The overall rating means the home was not consistently meeting the expected standards. This was a fall from Outstanding at the previous inspection, published in November 2017.
Kind and respectful care
People and relatives spoke positively about the support. Inspectors saw staff treating people with dignity and understanding their individual needs.
“People were treated with dignity and respect by staff knowledgeable about the person and their support needs.” from the report
Personalised support
Care plans included information about people's routines, preferences, communication and what mattered to them. Staff offered choices in ways suited to each person.
“Care plans were personalised with key information about the person and how best to support.” from the report
Staff training and support
Recruitment checks were robust. Staff received induction, relevant training, supervision and appraisal.
“Staff completed an induction programme when they joined the service.” from the report
Medicines records and policy
needs fixingMedicine administration records did not always contain the detail needed for occasional medicines and creams. The provider's policy did not clearly explain staff responsibilities for some medicines.
“Medicines administration records' (MAR) were not always completed in line with best practice to ensure they were accurate” from the report
Unsafe storage of hazardous substances
seriousSome hazardous substances were not securely stored or risk assessed. An internal audit had already identified the need for locks, but the action had not been completed before inspection.
“At the time of inspection we found that substances relating to COSHH were not suitably secured or risk assessed, and this put people at risk of harm.” from the report
Restrictions and consent
seriousThe home did not always show that it had followed the Mental Capacity Act before restricting access to cigarettes or certain foods.
“We found the provider was not always working within the principles of the MCA.” from the report
Incomplete oversight and records
seriousDaily records were inconsistent, and management systems had not ensured that identified safety actions were completed. This led to a breach of Regulation 17.
“Systems were either not in place or robust enough to demonstrate risks to people's physical health was mitigated and restrictions on people were appropriately assessed.” from the report
Staffing and activities
needs fixingRelatives and staff said staffing levels had sometimes prevented people from taking part in planned community activities. The report also records recent improvement and continuing recruitment.
“Relatives told us that challenges in staffing levels meant that people could not always complete planned activities in the community.” from the report
Communication with relatives
minorRelatives gave mixed feedback about communication and involvement in reviews. CQC recommended that the provider improve how information is shared with relatives.
“We recommend the provider reviews how information is shared with relatives to improve communication.” from the report
- 01What has changed in the medicines policy and how are records for occasional medicines and creams now checked?
- 02How are restrictions on food, cigarettes or other choices assessed under the Mental Capacity Act and recorded in each person's care plan?
- 03Have all locks and other measures for safely storing hazardous substances now been fitted and checked?
- 04How many staff are normally available for community activities, and how often are activities cancelled or delayed because of staffing?
- 05How will relatives be kept informed and involved in reviews and decisions about their family member's care?
This was an unannounced inspection of the care home and regulated personal care, covering all five CQC key questions; 8 of the 10 people using the service received personal care. This explanation was written from the published report of 6 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, November 2017
Rated Outstanding in every area; inspectors found safe, caring and highly person-centred support.
This was the first comprehensive rated inspection since the home registered with the CQC in January 2016. The inspection visits took place on 30 and 31 August and 5 September 2017. The inspector met four people, spoke with three people and contacted two relatives. They also spoke with staff and managers and checked care records, medicines, recruitment, training and quality checks.
Inspectors found that people were safe and received their medicines as prescribed. Staff understood how to manage risks, protect people from abuse and support people to have more independence. Staff had detailed training and worked with health and social care professionals to meet people's needs.
The report describes staff as kind, patient and respectful. People were involved in decisions about their care and supported to maintain family relationships, develop skills and take part in activities, work and community life. Care plans were detailed and built around each person's goals and preferences.
The home was rated Outstanding for Safe, Effective, Caring, Responsive and Well-led. This means the inspector found care that was consistently very good and had an exceptional level of quality in all five areas examined.
Strong safety planning
The home used detailed risk assessments to help people gain independence while managing risks. Staff also understood safeguarding and what to do if someone might be harmed.
“Clear and robust risk assessment management plans (RAMP) had been completed to enable support workers to safely promote and maintain people's independence.” from the report
Safe medicines
Records showed medicines were checked, stored securely and administered as prescribed. Controlled medicines were also accurately recorded and reconciled.
“Records showed medicines delivered to Heaton Vale had been checked in by two designated support workers who were trained in this topic.” from the report
Skilled and trained staff
New staff completed a detailed induction, supervised shadowing and training suited to people with learning disabilities and autism. Staff also received regular supervision and development.
“New support workers also completed a mandatory two week period of shadowing (working under the supervision of an experienced support worker), formal observations and monitoring before they were able to work unsupervised” from the report
Kind and respectful care
Inspectors saw staff listening patiently and giving people time and space. People were treated with dignity and supported to make their own choices.
“Support workers showed patience and listened intently to what people were telling them.” from the report
Personal goals and community life
Care plans focused on each person's aspirations, such as travelling independently, going on holiday, working and taking part in activities. Progress was recorded step by step.
“People's support plans were comprehensive and had been developed in collaboration with the person.” from the report
Open leadership
The management team encouraged feedback and used audits, meetings and reviews to identify improvements. Staff described a supportive and collaborative culture.
“Extensive quality assurance systems were in place and fully utilised.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you assess and update my relative's risk plan as they develop more independence?
- 02What autism, learning disability and behaviour support training would the staff supporting my relative have completed?
- 03How would my relative be involved in writing and reviewing their support plan and personal goals?
- 04How would you support my relative to maintain family relationships and take part in activities, work or community life?
- 05How do you make sure medicines, including any controlled medicines, are checked and recorded correctly?
This was the first comprehensive rated inspection after registration, and inspectors examined all five areas: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 30 November 2017 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Heaton Vale
2 rated inspections over 6 years: the service has slipped, from Outstanding to Requires improvement.
- July 2023Requires improvementcurrent ratingdown from OutstandingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017OutstandingSafe: OutstandingEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- January 2016
Registered with the Care Quality Commission on 14 January 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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