Heathbrook House Care Home

Updated 24 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by 2 inspectors, a specialist advisor and an Expert by Experience. A specialist advisor is a qualified health professional. Our specialist advisor was a registered nurse who had expertise in supporting older people and people living with dementia. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Heathbrook House Care Home is care home. People receive accommodation and nursing or personal care as single package under one contractual agreement. Heathbrook House Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager at the home. The new manager had worked at the home for 1 week and they planned to submit an application to register with us.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also reviewed the information we had received about the service since out last inspection. We gathered feedback from the local authority who fund some of the care provided. We used all of this information to plan our inspection.

During the inspection

During the inspection we spoke with 6 people who lived at Heathbrook House Care Home and 3 people's relatives to find out what it was like to live at the home and to gather their experiences of the care and support provided. We spoke with 17 members of staff including the manager, the regional director, nurses, care assistants, an activities assistant, the clinical services manager, regional support managers and an administrator.

We reviewed a range of records. This included 9 people's care records and 15 people’s medication records. We reviewed a range of records relating to the management of the service which included some policies and procedures and a variety of completed audits and checks. We looked at 3 staff files to check they had been recruited safely.

Updated 24 February 2023

About the service

Heathbrook House Care Home is a care home and is registered to provide personal and nursing care for up to 45 older people, including people living with dementia. At the time of the inspection 25 people lived at the home.

People's experience of using this service and what we found

Managerial oversight of the service had improved since our inspection in April 2022. However, some of the provider’s systems and processes to monitor the quality and safety of the service were not yet fully effective. Action was taken in response to our feedback to drive improvement and plans were in place to continually improve and learn lessons. More time was needed to demonstrate improvements made were embedded into practice and sustained over time as occupancy at the home increased.

People thought their home was well managed. Relatives shared mixed views on the leadership of the home. Management changes had occurred since our last inspection and staff explained how those changes had made them feel unsettled and unsupported. Plans were in place to further improve staff morale to ensure staff felt listened to and valued.

People received their medicines when they needed them which demonstrated improvement had been made in this area. Action to ensure current best practice medicine management guidance was followed by staff was taken after our visit.

The home was clean, and staff knew how to manage risks. Action taken since our last inspection had started to improve risk management. Staff were recruited safely, and enough staff were on duty to meet people’s needs. Relatives and staff spoke positively about staffing levels. People felt safe and relatives shared that viewpoint. Staff had completed safeguarding training and knew how to protect people but the providers processes to keep people safe were not consistently followed.

Feedback from people and their relatives was welcomed and listened to. The management team were open and honest during our visit and they used our feedback to focus their improvement activities. Staff knew the people they cared for well and most people’s care records contained enough information to help staff provide safe and responsive care. Further information was added to some people’s care records the day after our visit.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to maintain relationships that were important to them and they were happy with the social activities available to occupy their time. People knew how to complain and a process was in place to respond to complaints.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 16 May 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found some improvements had been made and the provider was no longer in breach of 2 regulations. The provider has remained in breach of 1 regulation.

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the

service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Heathbrook House Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified a continued breach in relation to governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand how they will continue to make improvements. We will work alongside the provider and local authority to monitor progress and continue to monitor information we receive about the service, which will help inform when we next inspect.