CQC report explained · a nursing home
What the CQC found at Little Heath Care & Support
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that people were protected from avoidable harm and that risks, medicines, infection control and safeguarding were generally managed well. They noted that some environmental risk assessments were still being completed, and one person's legal authorisation had expired before a repeat application was made.
- Effective?
- Good
- This question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Caring?
- Good
- This question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Responsive?
- Good
- This question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Well-led?
- Good
- Inspectors found clear management responsibilities, regular audits and better oversight of records, risks and improvements. Staff were described as supported and committed to person-centred care.
What inspectors found, March 2023
Little Heath Care & Support was rated Good; inspectors found safe, caring support and better management, but noted some concerns about staffing, risk assessments and communication.
This was an unannounced focused inspection on 9 February 2023. Inspectors checked whether improvements had been made in Safe and Well-led after the previous inspection. They spoke with people living in the home, relatives, staff and other professionals, and reviewed care records, staff files and management documents.
The home was rated Good for Safe and Good for Well-led. Inspectors found that risks, medicines, infection control, safeguarding and staffing were generally managed safely. They also found stronger checks, audits and action plans to monitor quality.
The overall rating changed from Requires Improvement to Good. The previous breaches relating to safe care and treatment and good governance had been addressed, so the home was no longer in breach.
Improved safety systems
The home had improved its care records, risk monitoring and management checks since the previous inspection. It was no longer in breach of the safe care and treatment regulation.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 12.” from the report
Medicines management
Inspectors found that medicines were given as prescribed and records, stock checks and monitoring were clear and accurate.
“We checked medicines monitoring records, stock recording and information about time specific medicines. These were all clear, complete and accurate.” from the report
Kind and respectful staff
People appeared relaxed and comfortable. Staff knew people well, respected their privacy and responded to their individual needs.
“People appeared happy and comfortable around staff. This was seen through body language, as well as warm, friendly and fun interactions.” from the report
Stronger oversight
The home had introduced more daily checks, regular audits and action plans to identify shortfalls and track improvements.
“Audits were carried out regularly, and action plans were in place and reviewed to ensure improvements were achieved.” from the report
Environmental risk assessments
needs fixingRisk assessments for some equipment and parts of the environment had not yet been completed. The registered manager was still working on these, and inspectors recommended making this a priority.
“However, risk assessments of equipment and the environment were not always completed.” from the report
Staffing pressure
needs fixingInspectors found enough staff during the visit, but some people and relatives said they sometimes waited and that staffing was particularly concerning at weekends.
“The staffing levels are a real concern, it is especially noticeable at the weekend.” from the report
Expired authorisation
needs fixingOne person's legal authorisation had expired within the previous 10 days. A repeat application was submitted during the inspection.
“We found one person's authorisation had expired within the previous 10 days.” from the report
- 01How many staff are usually on duty at weekends and during the busiest periods?
- 02Have the general environmental and equipment risk assessments now been completed?
- 03How will you make sure each person's fluid target is individual and clearly recorded?
- 04How do you check that DoLS or other legal authorisations remain current?
- 05How will relatives be kept informed when there are changes or concerns about their family member?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection. This explanation was written from the published report of 8 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 2022
Rated Requires Improvement; inspectors found kind, person-centred care, but risks, records and quality checks were not always managed safely.
This was the home's first inspection. Inspectors visited on 6 and 7 April 2022. They spoke with people, relatives and staff, observed care, and checked care plans, medicine records and quality checks.
People were generally treated kindly and given choices. Inspectors rated the home Good for effective, caring and responsive care. Staff were trained, people received healthcare referrals, meals offered choice, and activities were available.
However, inspectors found gaps in records and care linked to repositioning, nutrition and hydration, skin care and moving and handling. Some medicine records were incomplete, staff and visitors did not always wear masks as required, and quality checks had not found these problems. Safe and well-led care were both rated Requires Improvement.
Kind and respectful staff
People and relatives were positive about the care. Inspectors saw staff supporting people's dignity, independence and choices.
“People and relatives felt staff were nice and supportive.” from the report
Staff training
Staff had training for their roles, including safeguarding, infection control, manual handling and dementia care. Nurses had training for specialist procedures.
“People were supported by care staff who had received training relating to their role.” from the report
Choice and activities
People were offered choices about meals, drinks and daily routines. They could join activities such as exercises, sensory sessions, arts and crafts and nail care.
“People were encouraged and supported to participate in a variety of activities within the home.” from the report
Healthcare support
People were referred to GPs, dieticians and other healthcare professionals when needed. Relatives said they were kept informed about changes.
“People had referrals to health care professionals when required.” from the report
Risks and care records
seriousRepositioning records had gaps and conflicting timings. Inspectors also found incomplete information about nutrition, hydration, skin care and moving and handling.
“Three people who required support with their repositioning had gaps within their records, for one person this was over six days.” from the report
Moving and handling practice
seriousSome staff were unfamiliar with people's specialist equipment and needs. One person's moving and handling support was not in line with their care plan or best practice guidance.
“The support provided was not in line with best practice guidance or in line with the persons individual care plan and risk assessment.” from the report
Infection control
seriousInspectors saw staff and visitors not always wearing surgical masks as required. This was a breach of Regulation 12.
“During our inspection we observed two staff who were found not to wear their surgical mask as required.” from the report
Quality checks
seriousThe home's monitoring systems had not identified the shortfalls found during the inspection. This was a breach of Regulation 17.
“The providers quality assurance systems and processes were not always identifying shortfalls identified during our inspection.” from the report
Medicine records
needs fixingPeople received their medicines, but records for time-specific medicines, medicine fridges and medicines carried over from the previous month needed improvement.
“Medicines were stored safely, although improvements were required to the recording of time specific medicines, the recording of fridges which stored medicines and the recording of medicines carried over from the previous month.” from the report
- 01What has changed to make sure repositioning records are complete and match each person's care plan?
- 02How do you now check that nutrition and hydration records show whether people's needs are being met?
- 03How are staff trained and briefed about specialist equipment and moving and handling needs before starting a shift?
- 04What checks are now used for time-specific medicines, medicine fridge temperatures and medicines carried over from the previous month?
- 05How do managers check that staff and visitors wear personal protective equipment correctly?
This was a planned comprehensive inspection covering all five CQC questions, including the home's premises, care and infection prevention measures. This explanation was written from the published report of 5 July 2022 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 Little Heath Care & Support
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2022Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2021Inspected but not ratedSafe: Inspected but not rated
- April 2020
Registered with the Care Quality Commission on 1 April 2020.
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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