CQC report explained · a residential care home
What the CQC found at Heron Court
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2018
Heron Court was rated Good; inspectors found safe, kind and personalised care, with a recommendation to improve meaningful activities.
This was an unannounced, comprehensive inspection on 19 April 2018. Inspectors spoke with people living in the home, relatives, managers and care staff. They also reviewed care records, staff files, training records, audits and meeting notes.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practices, suitable care plans, good access to healthcare and kind, respectful care.
The main shortfall was around activities. Some people said staff had not asked about their hobbies or interests, so the CQC recommended improving how meaningful activities are planned. The overall Good rating remained unchanged from the previous comprehensive inspection in February 2016.
Safe care and staffing
Inspectors found that risks were assessed, medicines were managed safely and staffing levels met people's needs. Improvements had been made after reviewing falls and an infection outbreak.
“There were sufficient numbers of staff to safely meet people's needs, which was confirmed by people who use the service.” from the report
Kind and respectful staff
Staff knew people well and treated them with dignity. They supported independence and helped people maintain important relationships.
“Staff were kind and caring and treated people with dignity and respect.” from the report
Personalised care plans
Care plans included people's life stories, preferences, relationships and wishes. They were reviewed with people and, where appropriate, their relatives.
“The information in people's care plans helped staff to deliver care and support in the way the person wanted.” from the report
Meaningful activities
needs fixingAlthough activities were taking place, two people said staff had not explored their hobbies and interests. The CQC recommended improving the way this information is recorded and used to plan activities.
“We recommend that the service review their systems and processes for capturing information about people's hobbies and interests to support people to engage in meaningful activities.” from the report
- 01How do you find out about each person's hobbies and interests when they move in?
- 02How are individual activities planned for people who do not want to join group activities?
- 03What changes have you made following the CQC recommendation about meaningful activities?
- 04How do you keep night-time staffing under review after the previous increase was linked to fewer falls?
- 05How are care plans reviewed with residents and relatives, including wishes about end of life care?
This was an unannounced comprehensive inspection covering all five CQC questions, and the home and the care provided were both looked at. This explanation was written from the published report of 4 July 2018 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, May 2017
Rated Good; inspectors found staff understood catheter and infection risks, but written care guidance was not always detailed enough.
This was an unannounced focused inspection on 4 May 2017. It followed concerns about catheter care and the prevention and treatment of urinary tract infections. Inspectors spoke with the manager and five staff members, and reviewed care records and health documents.
Staff knew people well and could explain the risks and what to do to keep people safe. They had training in catheter care and urinary tract infections. The home monitored infections, checked fluid intake and referred people to health professionals when needed.
The main weakness was in the written records. Risk assessments were missing or too general, one care record was missing from the file, and some guidance was poorly written. The home acted during the inspection by adding a more detailed risk assessment and management plan.
The overall rating was Good, and Safe was rated Good. This inspection only looked at Safe in relation to catheter care and urinary tract infection risks. The previous comprehensive inspection in February 2016 had rated all five areas Good.
Staff understood individual risks
Staff could identify people with catheters or a higher risk of infection and knew what action to take.
“all of the staff we spoke with were able to tell us which people had catheters or were at risk of getting a UTI and what needed to be done to reduce any risks to keep people safe.” from the report
Staff had relevant knowledge
Staff had received catheter care training and could recognise signs that someone might have a urinary tract infection.
“Staff demonstrated a very good level of knowledge of the signs and symptoms to look for that might tell them someone had a UTI.” from the report
Monitoring and referrals
The home tracked urinary tract infections, monitored fluid intake and referred people to a GP or district nurse when treatment was needed.
“Care records we reviewed confirmed that people at risk had been monitored, urine tests had been completed and if positive referrals were made to the GP or district nurse for treatment.” from the report
Support with drinking
People were offered drinks and food with a high water content. Drinks were also kept within reach.
“We saw that people had jugs of drink within reach in communal areas and also in their bedrooms.” from the report
Care records lacked detail
needs fixingSome catheter risk information was general rather than tailored to the person. One relevant detail about a person's night-time catheter arrangements had not been recorded, although staff knew about it.
“However, we found that the information recorded on catheter care risks was general rather than tailored to people's individual needs.” from the report
Fluid records were not fully joined up
needs fixingSome catheter fluid balance forms did not include everything a person had drunk that day. The information was available on a separate fluid chart, but inspectors said this made oversight less efficient.
“However, we found that these forms did not always record everything that people had drank in a day so did not provide an accurate picture of people's fluid balance overall.” from the report
One care record was missing
needs fixingInspectors found that one of the two catheter care records they wanted to review was missing from the file.
“Both people had a catheter care plan listed in there care records but we were only able to look at one record as the other was missing from the file.” from the report
- 01What changes were made to catheter risk assessments and care plans after the inspection?
- 02How do you make sure written guidance reflects each person's individual catheter and night-time needs?
- 03How do you check that new or agency staff can find and understand the information they need?
- 04How are fluid intake and urine output records checked together to identify dehydration or infection risks?
- 05How do you monitor urinary tract infections and make sure referrals to the GP or district nurse happen promptly?
This was an unannounced focused inspection of Safe in relation to catheter care and urinary tract infection risks; the other areas were not assessed and the previous February 2016 comprehensive ratings were Good. This explanation was written from the published report of 26 May 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.
Every inspection of Heron Court
3 rated inspections over 2 years: the service has held its Good rating throughout.
- July 2018Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Goodstayed GoodSafe: Good
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 December 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.
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