CQC report explained · a nursing home
What the CQC found at Heatherstones
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 were not managed safely. Inspectors found missed doses, discrepancies between stock and records, inaccurate controlled drug records and unclear recording of thickener added to drinks.
- Effective?
- Requires improvement
- People's health needs were generally supported, but they were not always offered choices about meals. Care records also lacked detail about care provided, and there was no call bell system.
- Caring?
- Requires improvement
- Inspectors saw limited interaction between staff and people, and no clear encouragement of independence. Surveys and care records did not fully show people's views or involvement in decisions.
- Responsive?
- Good
- Care plans were regularly reviewed and included people's preferences. People were supported to maintain relationships, join activities at home and in the community, and raise complaints.
- Well-led?
- Requires improvement
- Quality checks did not identify the medicines problems, and accidents and incidents were not analysed for patterns. There was also no evidence that action followed feedback from satisfaction surveys.
What inspectors found, December 2023
Rated Requires Improvement; inspectors found unsafe medicines management, weak oversight and limited involvement, although people received activities and personalised support.
This was an unannounced inspection over three days. Inspectors spoke with people, relatives and staff, and reviewed care records, medicine records, recruitment files and management records.
The overall rating was Requires Improvement. Safe, Effective, Caring and Well-led were all rated Requires Improvement. Responsive was rated Good.
Inspectors found missed or incorrectly recorded medicines, including concerns about controlled drugs and thickener used in drinks. There was no call bell system, and records did not always show that people had been involved in care decisions or offered choices about meals.
The home was clean and people were supported with health appointments, family relationships and activities. The provider must send an action plan, and CQC said it would monitor progress with the local authority.
People felt safe
People and relatives told inspectors they felt safe. Staff had safeguarding training and knew how to respond to incidents.
“Relatives and people felt safe at Heatherstones.” from the report
Clean and maintained
The home was clean and tidy. Equipment checks were completed and rooms included personal items and photographs.
“The service was clean and tidy, there were lots of personal items and photographs around the home and in people's bedrooms.” from the report
Health support
People attended routine health appointments and received support from health professionals. Staff sought emergency medical attention when needed.
“People were supported to attend routine appointments and regular reviews.” from the report
Activities and relationships
People were supported to keep in touch with family and friends and to take part in activities at home and in the community.
“People were supported to take part in activities at home and in the community.” from the report
Medicines were not safe
seriousInspectors found missed doses, stock differences and inaccurate controlled drug records. Thickener use was not recorded consistently, which was particularly concerning for people at risk of choking.
“Medicine administration records demonstrated that people did not always receive medicines as prescribed.” from the report
Weak quality checks
seriousMedicine audits did not find the problems identified during the inspection. The home also did not analyse accidents and incidents for patterns or show follow-up from survey feedback.
“The provider's quality systems were not robust enough to assess, monitor and improve the service” from the report
Limited involvement and communication
needs fixingThere was no clear evidence that people helped make decisions about their care. Feedback was not adapted for people who were non-verbal, and information was not available in enough formats.
“It was unclear if and how people and been involved in making decisions about the care.” from the report
Not enough staff interaction
needs fixingInspectors found staff spent much of the day in the kitchen rather than with people. They did not see staff encouraging independence.
“There was a lack of interaction between staff and people.” from the report
No call bell system
needs fixingThe layout separated staff and residents, and there was no call bell system. Inspectors were unclear how staff would respond to an emergency when in another part of the building.
“There was no call bell system in place, it was unclear how staff would respond to an emergency when they were based on one side of the building.” from the report
- 01What changes have you made to prevent missed medicine doses and stock discrepancies?
- 02How are controlled drugs and thickener now recorded and checked?
- 03How can people call for help or raise an emergency when staff are in another part of the building?
- 04How do you record and show that each person has been involved in decisions about their care and meals?
- 05What action has followed the inspection findings about staff spending time with people and supporting their independence?
This was an unannounced full inspection of the care home, covering all five CQC questions; it also included infection prevention and control checks. This explanation was written from the published report of 21 December 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, February 2022
St Anne's Community Services - Heatherstones: targeted inspection found good infection control, but the service was not rated.
Inspectors visited on 13 January 2022 with one day's notice. This was a targeted inspection of infection prevention and control during the COVID-19 pandemic. They also asked about staffing pressures.
The inspectors were assured that the home managed infection risks well. This included testing, vaccination checks, personal protective equipment, social distancing, visiting arrangements, hygiene and outbreak planning. Staff had received extra training about using protective equipment.
The service was inspected but not rated. This means the visit did not give a scored rating for the overall service or for safety.
Infection risk management
The registered manager had identified and managed COVID-19 risks to people, staff and visitors.
“The registered manager had identified, assessed and mitigated all COVID-19 related risks to people, staff and visitors.” from the report
Protective equipment
Staff had suitable protective equipment throughout the home and had received extra training in how to use it.
“Staff wore appropriate PPE and had access to this throughout the home.” from the report
Visiting arrangements
The home tested professional visitors and relatives, checked vaccination evidence for relevant visitors and kept families informed about visiting.
“Systems were in place to keep people's friends and relatives informed about visiting arrangements.” from the report
Inspectors raised no specific concerns in this report.
- 01How are COVID-19-related staffing pressures affecting staffing levels and care now?
- 02What testing and vaccination checks are currently required for visitors and professionals?
- 03How do you make sure staff use protective equipment correctly, and when was their latest training?
- 04What is the current process for preventing and managing an infection outbreak?
- 05How are families being kept informed about visiting arrangements?
This was a targeted inspection of infection prevention and control, with questions about staffing pressures; the service was inspected but not rated. This explanation was written from the published report of 12 February 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 Heatherstones
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- December 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- February 2022Inspected but not ratedSafe: Inspected but not rated
- August 2018Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Requires improvement
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 15 March 2011.
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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