This was an unannounced inspection carried out on 15 July 2015. Heathermount Residential Home provides privately funded personal care and accommodation for up to 17 older adults. Nursing care is not provided.
The home is a detached three storey house situated in Heswall, Wirral. The home is within walking distance of local shops and public transport. A small car park is available within the grounds. Accommodation consists of 17 single bedrooms with ensuite facilities. A passenger lift and stair lift enables access to all floors for people with mobility problems. Specialised bathing facilities are also available. On the ground floor, there is a communal open plan lounge/ dining room for people to use and a small garden for people to sit in and enjoy.
During the inspection we spoke with six people who lived at the home, the registered manager, the home manager, two care staff and the cook. A home manager supervised the day to day running of the service and reported directly to the registered manager who managed the service.
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.’
At the time of our visit, a new home manager had recently commenced in post and was still in their probationary period of employment.
During our inspection we found breaches of Regulation 13 and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
People told us they felt safe at the home and they had no worries or concerns. Staff we spoke with were knowledgeable about types of abuse and what to do if they suspected abuse had occurred.
We found that a record has been made of incidents of a safeguarding nature but some lacked sufficient evidence that an appropriate investigation had been completed and preventative action taken. This was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Some incidents had not been reported to either the Local Authority Safeguarding Team or to the Care Quality Commission. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.and indicated that some aspects of leadership at the service required improvement.
People who lived at the home said they were happy with their care and told us the staff looked after them well. Everyone held the staff in high regard and felt they had the skills and abilities to meet their needs. They told us they had good relations with the staff who supported them.
We saw that people who lived at the home were supported to maintain their independence and were able to choose how they lived their day to day lives. Activities were provided to occupy and interest people and interactions between people and staff were positive. The home had a warm, homely feel and the atmosphere was relaxed.
We observed that staff treated people kindly, with respect and supported them at their own pace. It was clear from our observations that staff knew people well and that people were comfortable and at ease with staff. Interactions between staff and people were warm, jovial and respectful.
People had access to sufficient quantities of nutritious food and drink and people said they were pleased with the choices and standard of the food on offer. We observed a medication round and saw medicines were administered safely but found the way in which medications from one medication cycle to the next were received and accounted for required some improvement.
Staff were recruited safely and there were sufficient staff on duty to meet people’s health and welfare needs. Staff received the training they needed to do their jobs safely and appropriate managerial support to do their jobs effectively.
We reviewed three care records. Care plans and risk assessments provided staff with sufficient information on people’s needs and risks and gave clear guidance to staff on how to meet them. Record showed people received prompt medical assistance in the event of ill health.
The majority of people who lived at the home had capacity to make their own decisions. We saw the beginnings of good practice in terms of obtaining people’s consent in accordance with the Mental Capacity Act 2005. For example, the home had ensured people’s level of capacity had been considered on admission to the home and regularly reviewed. It was evident in that the culture of the home was to support people with their consent and in accordance with their wishes. Further work was required however to make capacity assessments decision specific, where people were thought to lack capacity.
People were given information about the service and life at the home and regular resident meetings were held to keep people informed about issues associated with their care. People we spoke with and staff told us that the home was well led. We saw some evidence of this. For example, people were more than happy with their care, the home was clean and well maintained, staff were trained and knowledgeable about people’s needs and a positive staff culture was evident throughout the home. Managerial improvements were required with regards to how the quality and safety of the service was assessed.
We found that there were a range of quality assurance systems in place, some of which were effective. Safeguarding audits, accident and incident analysis and medication audits required further improvement in order to be used to improve the quality of the service. At the end of our visit, we discussed the areas for improvement with the registered manager. We found that they were receptive and open to our feedback and demonstrated a positive attitude to resolving the issues.