• Care Home
  • Care home

Archived: Heath Rise

Overall: Requires improvement read more about inspection ratings

4 Heath Rise, Wellingborough, Northampton, Northamptonshire, NN8 5QN (01933) 676786

Provided and run by:
National Autistic Society (The)

All Inspections

11 March 2021

During an inspection looking at part of the service

About the service

Heath Rise is a care home providing personal care to 4 people with a diagnosis of learning disabilities and/or autism at the time of the inspection.

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

Risks to people had not been consistently assessed or mitigated. Risk assessments were not always kept up to date. Equipment used to reduce risks had not been kept in good working order.

Infection control procedures required improvement. Not all procedures were followed regarding taking staff and visitors temperature. Cleaning schedules had gaps in the records.

Records of care tasks contained gaps in the recording. These issues had not been identified prior to the inspection.

Systems and processes to ensure oversight of the service required improvement. We found limited audits completed and most audits had not been completed since November 2020.

People were supported by staff who knew them well and had been safely recruited. Not all staff had received up to date training. However, the registered manager was in the process of ensuring training was updated.

People received their medicines as prescribed and staff were competent to administer medicines.

Care plans were person centred and detailed for each person. Information was given to people in a format that suited their needs.

The service had not received any complaints within the past 12 months. Complaints, when received, were dealt with appropriately and within the providers timeframe.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and independence

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

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

Rating at last inspection

The last rating for this service was good (published 15 January 2019).

Why we inspected

We received concerns in relation infection control and a COVID-19 outbreak. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection

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.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heath Rise on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to risk assessments, infection control and oversight of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

10 December 2018

During a routine inspection

What life is like for people using this service:

People continued to receive safe care. Staff had been provided with safeguarding training to enable them to recognise signs and symptoms of abuse and how to report them. There were risk management plans in place to protect and promote people’s safety. Staffing numbers were sufficient to keep people safe and the registered provider followed thorough recruitment procedures to ensure staff employed were suitable for their role.

People’s medicines were managed safely and in line with best practice guidelines. Systems were in place to ensure that people were protected by the prevention and control of infection. Accidents and incidents were analysed for lessons learnt and these were shared with the staff team to reduce further reoccurrence.

People’s needs and choices were assessed and their care provided in line with their preferences. Staff received an induction process when they first commenced work at the service and received on-going training to ensure they could provide care based on current practice when supporting people. People received enough to eat and drink and were supported to use and access a variety of other services and social care professionals. People were supported to access health appointments when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The principles of the Mental Capacity Act (MCA) were followed.

People continued to receive care from staff who were kind and caring. People were supported to make decisions about how their care and their privacy and dignity were protected and promoted. Staff had developed positive relationships with people and had a good understanding of their needs and preferences.

People’s needs were assessed and planned for with the involvement of the person and or their relative where required. Staff promoted and respected people's cultural diversity and lifestyle choices. Care plans were personalised and provided staff with guidance about how to support people and respect their wishes. Information was made available in accessible formats to help people understand the care and support agreed.

The service continued to be well managed. People and staff were encouraged to provide feedback about the service and it was used to drive improvement. Staff felt well-supported and received supervision that gave them an opportunity to share ideas, and exchange information. Effective systems were in place to monitor and improve the quality of the service provided through a range of internal checks and audits. The registered manager was aware of their responsibility to report events that occurred within the service to the CQC and external agencies.

Further information is in the detailed findings below.

Rating at last comprehensive inspection: Good (report published 20 July 2016)

About the service: Heath Rise provides accommodation and personal care for up to four adults. People living at the service have complex needs that include Autism spectrum disorder and learning disabilities. At the time of our visit there were four people using the service.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

24 June 2016

During a routine inspection

This inspection took place on 24, 27 and 29 June 2016 and was unannounced. Heath Rise is a care home registered to care for up to four people with learning disability and autism. At the time of our inspection three people were using the service. The home is situated in the suburbs of Wellingborough in Northamptonshire.

At the last inspection of the service on 7 July 2015 we asked the provider to take action to make improvements to, staffing levels, complaints management and the management governance and oversight of the service. The provider sent us an action plan telling us how they planned to improve. We found at this inspection the actions had been completed.

Staffing levels were sufficient to meet people’s current needs. The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Staff training and on-going training was provided to ensure staff had the skills, knowledge and support they needed to perform their duties. Staff supervision systems ensured that all staff received support through one to one and team meetings to discuss their learning and development needs and the needs of the service.

Suitable systems were in place to receive and handle complaints. Management governance systems were in place to regularly monitor the quality and safety of the service.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People using the service had complex communication needs and were unable to directly tell us if they felt safe from abuse. General observations made on the day of the inspection and feedback from relatives indicated that people were protected from the risk of abuse. Staff were aware of what constituted abuse and of their responsibilities to report abuse.

Risks to people using the service and others were assessed, and appropriate measures were in place to manage identified risks. People received their medication safely and the systems to receive, store and administer medicines were appropriately maintained.

Staff knew how to protect people who lacked the capacity to make decisions. There were policies and procedures in place in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People’s nutritional needs had been assessed and they were supported to make choices about their food and drink. Their physical and mental health was closely monitored and appropriate referrals to health professionals were made.

Staff showed care and compassion when supporting people and ensured that privacy and dignity was respected at all times.

People using the service and their representatives were involved in making choices about their care, which was based upon their individual needs and wishes. The care plans reflected people’s current needs and they were regularly reviewed and updated. Staff supported people to follow their choice of leisure, educational and recreational activities and people had regular access to the local and wider community to reduce the risk of social isolation.

09 June 2015

During a routine inspection

This inspection took place on 09 June 2015 and was unannounced.

Heath Rise is a residential care home for four adults living with autism. The home is situated in the suburbs of Wellingborough in Northamptonshire. There were four people using the service when we visited.

The service did not have a registered manager. There was an interim manager working at the service at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Prior to this inspection we received information of concern in relation to care practices at the home. This involved people not having access to snacks and drinks when they required, people being left unsupported for long periods, staff speaking to people in a derogatory manner and often shouting and people being made to leave certain areas of the home. In addition, concerns had been raised about a lack of consistent staffing at the home and a lack of management and leadership.

During this inspection we found the service relied on bank and agency staff to cover a large proportion of care hours. This did not always ensure consistency of staff at the service.

This was in breach of Regulation 18 HSCA (RA) Regulations 2014.

Information about how to make a complaint was not available at the service and a record of complaints received could not be found.

This was in breach of Regulation 16 HSCA (RA) Regulations 2014.

The provider had internal systems in place to monitor the quality and safety of the service, but these had not been used effectively to drive improvement. Records management was not robust and did not ensure records were accurate, accessible and stored securely.

This was in breach of Regulation 17 HSCA (RA) Regulations 2014.

Our observations of staff actions demonstrated that staff were knowledgeable about the people they provided care for. However, records did not show that all staff who worked at the service had received training in core subjects, including an induction.

People felt safe and were protected from abuse. Staff had a good understanding of how to identify abuse, and knew how to respond appropriately to any concerns to keep people safe. Risks to people’s safety had been assessed and were detailed clearly within people’s care plans. Staff had been recruited using a robust recruitment process.

Systems were in place to ensure that medicines were administered and handled safely.

There were policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make decisions for themselves were protected. We observed that staff sought and obtained people’s consent before they helped them. When people declined, their wishes were respected.

People were provided with enough to eat and drink to ensure their dietary needs were met. People were supported to choose, prepare and cook their own meals. People had access to snacks and drinks throughout the day and night.

Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required.

People were looked after by staff that were caring, compassionate and treated them with dignity.

Staff had a good understanding of people’s needs and preferences and we observed positive reactions from people when they were being supported.

Staff supported people to access the community and this reduced the risk of people becoming socially isolated. People were supported to take part in meaningful activities and pursue hobbies and interests.

9 April 2013

During a routine inspection

The persons who used the service that were present at the home when we visited had difficulty in communicating verbally. They used gestures and body language to express their views.

One person used body language to indicate they were happy and that they liked living at Heath Rise. Another person indicated that they liked the staff and the activities that were planned for them.

The people we met were complimentary about the premises, indicating by the used of body language that they felt safe living there.

We found that National Autistic Society (NAS) - Heath Rise was a safe and caring service, the provider may wish to note that the care plans had no been updated for over a year therefore the information contained may be outdated as regards the person who used the service and their current needs.

13 June 2012

During a routine inspection

The persons who used the service that were present at the home when we visited had difficulty in communicating verbally using gestures and body language to express the views.

One person used body language to indicate they were happy at the home. They showed us their room which they had personally chosen the colour scheme for.

People told us they liked living at Heath Rise. One person indicated that they liked the staff and the activities that were planned for them.

The people we met who live at Heath Rise were complimentary about the premises, indicating by the used of body language that they felt safe living there.