CQC report explained · a residential care home
What the CQC found at Heightlea
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Good
- People were protected from abuse and risks were assessed. Medicines and infection control were managed safely, although fire safety improvements were still being completed and one agency worker was regularly working 70-hour weeks.
- Effective?
- Requires improvement
- Capacity assessments were not specific enough to the decisions people needed to make. Care plans contained some outdated information and did not set sufficiently challenging goals to promote independence.
- Caring?
- Good
- People were happy and comfortable, and staff were described as kind and respectful. People were involved in decisions, had their privacy respected and were supported to be as independent as possible.
- Responsive?
- Good
- Staff understood people's preferences and supported a wide range of activities, relationships and community trips. A lack of staff who could drive sometimes restricted people's freedom to go out.
- Well-led?
- Requires improvement
- The new provider had introduced audits, support for managers and improvement plans. However, known problems with capacity assessments, care planning and goal setting had not yet been resolved.
What inspectors found, June 2023
Heightlea rated Requires Improvement; inspectors found safe, caring support but weaknesses in consent records, care planning and management oversight.
Inspectors carried out an unannounced visit on 20 April 2023. They spoke with all five people living at the home, staff, managers, relatives and health professionals. They reviewed care plans, medicines records, daily records, incidents, staffing and recruitment information.
The home was rated Good for Safe, Caring and Responsive. People were protected from abuse, received medicines as prescribed, and were supported by kind staff who respected their choices. People took part in activities at home and in the community, although a lack of drivers sometimes limited outings.
The home was rated Requires Improvement for Effective and Well-led. Capacity assessments were too general and some care plans were inaccurate, out of date or did not set sufficiently challenging goals. The provider knew about these problems but had delayed fixing them while planning a new digital care planning system.
This was the first inspection since the new provider took over and registered the home. The previous provider's rating, published in October 2022, was Inadequate. The new provider had made improvements, but CQC required further action and will monitor progress.
Kind and respectful staff
People were comfortable with staff and could ask them for support. Relatives described improvements in the quality of care.
“Staff were kind and respected people as individuals.” from the report
Safe medicines support
Medicines were stored appropriately, records were accurate and audits were completed. Errors were investigated and learning was shared.
“People were safely supported with their medicines as prescribed. Medicines were stored appropriately, and Medicine Administration Records (MAR) had been accurately completed.” from the report
Choice and independence
People chose how to spend their time, helped make decisions and were supported to develop skills and do things for themselves.
“People were supported to do as much as possible for themselves and independence was promoted.” from the report
Activities and community life
People took part in varied activities, including voluntary work, shopping, meals out, visits and trips into the community.
“On the day of our inspection people were supported to access a range of activities in the community and in the service.” from the report
Decision-making records
seriousThe home relied on general assessments from the previous provider. There was not enough evidence that people's capacity and best interests had been assessed for specific restrictive decisions.
“The provider had failed to assess people's capacity in relation to specific decisions.” from the report
Outdated care plans and goals
needs fixingSome care plan information was inaccurate or out of date. Goals did not provide enough challenge or show people's progress clearly.
“This meant the service was continuing to use care plans developed by the previous provider. These records did provide staff with guidance on people's needs but some information was inaccurate and outdated.” from the report
Staffing and drivers
needs fixingThere were five staff vacancies and agency staff were being used. One agency worker was regularly working 70-hour weeks, and a lack of drivers sometimes stopped people going out.
“However, one member of agency staff was regularly working 70 hour weeks.” from the report
- 01Have all residents' capacity assessments now been reviewed for each specific decision?
- 02Have care plans been updated so they accurately reflect current needs, goals and progress?
- 03What steps have been taken to ensure restrictive practices are properly consented to or recorded as best-interest decisions?
- 04Have the five staff vacancies been filled, and has the use of very long agency shifts stopped?
- 05How often can each person go out now, and has the shortage of drivers affected their planned activities?
This was the first inspection of the newly registered home and covered all five key questions, including infection prevention and control; the previous provider's rating had been Inadequate. This explanation was written from the published report of 23 June 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.
Every inspection of Heightlea
7 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- June 2023Requires improvementcurrent ratingup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2022Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2022Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2022Requires improvementdown from GoodSafe: Requires improvementResponsive: GoodWell-led: Requires improvement
- May 2018Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017Goodstayed GoodSafe: Good
- February 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2022
Registered with the Care Quality Commission on 21 November 2022.
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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10 live-in carers within about two hours of Cornwall
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Most charge £980 to £1,200 a week. 8 can care for a couple. 12 years' experience on average.
“He had been a little anxious before she arrived, but has since stated that he would be very happy for her to care for him again”
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