CQC report explained · a nursing home
What the CQC found at The Heathlands Village
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- People were supported safely overall, with enough staff, safe recruitment, incident reviews and a clean environment. However, some risk assessments needed updating, capacity assessments were incomplete, and medicines guidance and storage had shortcomings.
- Effective?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was carried forward to calculate the overall rating.
- Caring?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was carried forward to calculate the overall rating.
- Responsive?
- Outstanding
- This key question was not assessed during this focused inspection. Its previous rating was carried forward to calculate the overall rating.
- Well-led?
- Good
- Leaders had quality checks, regular information about people's health and arrangements for complaints and feedback. The quality assurance system was being strengthened, although some audit actions were not signed off.
What inspectors found, February 2023
Rated Good overall; inspectors found kind, safe care, but the safe rating Requires Improvement because capacity, risk and medicines records needed strengthening.
This was an unannounced focused inspection on 10, 11 and 13 January 2023. Inspectors spoke with people, relatives, staff and professionals. They reviewed care, medicines, incident and management records, and observed care and the home.
The home was rated Good overall and Good for well-led. Safe was rated Requires Improvement, although inspectors found no evidence that people were at risk of harm during this inspection. People said they felt safe, there were enough staff, medicines were given as prescribed and the home was clean.
Inspectors found that formal assessments of people's ability to make decisions were not always completed or reviewed. Guidance for some as-required medicines was not detailed enough, some risk assessments needed updating, and some quality checks were not signed off after issues were identified.
This inspection looked only at Safe and Well-led. The other key question ratings were carried forward from the previous inspection, so the overall Good rating does not mean all five areas were reviewed this time.
Enough staff
Inspectors found enough staff to meet people's identified needs. Staff were also safely recruited and people said help was generally available quickly.
“There were enough staff to meet people's needs.” from the report
Kind and caring staff
People and relatives gave positive feedback about the care. Inspectors observed positive interactions between people and care staff.
“People said the staff were kind and caring.” from the report
Clean environment
The home was clean throughout the inspection, with housekeepers assigned to each unit.
“Oh yes it's clean, you can see they are always cleaning.” from the report
Learning from incidents
Staff knew how to report incidents, and inspectors saw that action had been taken after a recent incident to reduce the chance of it happening again.
“Incidents were reviewed, and risk assessments updated where appropriate.” from the report
Good communication
Relatives said communication with the home was good and that they were involved in agreeing support plans where appropriate.
“Relatives said there was good communication with the home, and they were involved in agreeing their relatives support plan where appropriate.” from the report
Capacity assessments
needs fixingFormal assessments of people's ability to make specific decisions were not always recorded or reviewed when their capacity changed. Inspectors recommended that best practice guidance be followed.
“The electronic care system used at Heathlands did not include a capacity assessment.” from the report
As-required medicines
needs fixingGuidance for some as-required medicines did not explain how a person who could not speak would show they needed the medicine. On one unit, medicines waiting to be returned were not stored in a lockable container.
“Guidance for medicines prescribed 'as required' (PRN) was not consistent across the units.” from the report
Risk records
needs fixingRisk assessments were described as brief, and a small number needed review so they reflected people's current needs.
“A small number of risk assessments needed to be reviewed to ensure they reflected people's current needs.” from the report
Audit follow-up
minorThe home had quality checks, but some identified issues were not signed off to confirm that action had been completed. The quality assurance system was being improved.
“We saw issues were identified, but not always signed off to confirm they had been actioned.” from the report
Masks worn incorrectly
minorOn one unit, some staff wore masks below their noses, despite the home's policy that staff should continue to wear masks.
“On one unit some staff had masks below their noses.” from the report
- 01Have formal capacity assessments now been completed for my relative, and how often will they be reviewed?
- 02How do you record and check how a person who cannot speak should indicate they need an as-required medicine?
- 03Are medicines waiting to be returned to the pharmacist now kept in a lockable container on every unit?
- 04How are risk assessments checked and updated when a person's needs change?
- 05How do managers confirm that issues found in audits have been dealt with and signed off?
This was an unannounced focused inspection of Safe and Well-led, with infection prevention and control also considered; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 10 February 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, March 2019
The Heathlands Village was rated Good overall, but inspectors found safety and medicines issues that meant Safe Requires Improvement.
Inspectors visited on 8, 9, 11 and 25 October 2018. The first day was unannounced. They spoke with people living in the home, relatives, staff and a doctor. They also observed care, checked records, medicines systems, staff files and how the home was managed.
The home was rated Good for Effective, Caring and Well-led. It was rated Outstanding for Responsive. Inspectors found kind and respectful care, many activities, strong support for religious and cultural needs, and compassionate end of life care.
The Safe rating fell from Good to Requires Improvement. Inspectors found unlocked cupboards containing hazardous chemicals and thickeners on a new dementia unit. They also found minor problems with storing creams and recording thickeners. These issues were dealt with during the inspection, but the rating shows that safety systems were not consistently reliable.
Activities and engagement
People had many activities, facilities and opportunities to follow their interests. The home also used volunteers and community links to reduce loneliness.
“The arrangements for social activities were wide ranging. The service continually strived to find innovative ways to stimulate the people who used the service” from the report
End of life care
People nearing the end of life received care that respected their religious and cultural needs. Families could stay close, and there were arrangements for care after death.
“This provided a quieter and more dignified setting for people who were nearing the end of their life and their families.” from the report
Kind and respectful care
Inspectors saw frequent, friendly and respectful interactions. People were supported to make choices and remain as independent as possible.
“We saw polite and respectful interactions between people who used the service and staff.” from the report
Listening to people
People and relatives could raise concerns through forums and complaints processes. Complaints were reviewed and used to identify improvements.
“The service used complaints to drive improvement.” from the report
Staff training and support
The home had a structured induction, mentoring and continuing training. Staff said the training helped them understand people's needs and feel more confident.
“Each new member of staff had an experienced mentor who was familiar with the people whom they supported.” from the report
Hazardous substances not secured
seriousOn the new dementia unit, cupboards were unlocked even though they contained hazardous chemicals and prescribed thickeners. Locks were fitted immediately, but this contributed to the Requires Improvement Safe rating.
“we found unlocked cupboards that contained chemical substances hazardous to people's health and safety and also prescribed thickeners, and which could be harmful if swallowed.” from the report
Medicines-related storage and records
needs fixingInspectors found minor concerns about storing non-medicated creams and recording thickeners outside the computerised medicines system. The home said extra cabinets and changes to the medicines system would address this.
“We found a small number of minor concerns, for example, the storage of non-medicated creams.” from the report
Employment history records
minorRecruitment checks were suitable, but application forms did not collect a full employment history. The form was amended during the inspection.
“We advised that the registered provider should now be taking a full employment history for people rather than 10 years.” from the report
- 01How are hazardous chemicals, prescribed thickeners and non-medicated creams now stored securely on every unit?
- 02How are thickeners recorded and checked under the new medicines system?
- 03What checks confirm that cupboards and other storage areas remain locked and safe?
- 04How were people and relatives supported during the move between units, and what further changes are planned?
- 05How will you monitor staffing when there is last-minute sickness?
This was a comprehensive inspection covering all five CQC questions, the premises and the care provided across the six units. This explanation was written from the published report of 8 March 2019 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 The Heathlands Village
4 rated inspections over 7 years: the service has held its Good rating throughout.
- February 2023Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- March 2019Goodstayed GoodSafe: Requires improvementWell-led: Good
- October 2017Goodstayed GoodSafe: GoodWell-led: Good
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- February 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 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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