Heaton House Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Care was provided in line with people’s wishes, although we did identify some incorrect and contradictory information within people’s care plans. The complaints process was not robust, as not all concerns received had been documented in line with the provider’s policy. Further work was needed with ensuring people and relatives were fully involved in their care. Surveys had started being circulated in resident meetings, although only 2 meetings had taken place since March 2024. Care plans explained people’s communication needs and how staff should meet these. Greater consideration was needed with ensuring information on display and information given to people was accessible to all. People received enough to eat and drink, and any modified dietary needs were met. People’s wishes regarding end of life care were sought and listed within their care records.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People received care in line with their assessed needs. People’s care records explained how they wanted to be supported and any preferences which staff needed to be aware of. People and relatives knew what a care plan was. However, all but one person told us they had not seen or been involved in the care planning process. Comments included, “No I haven’t seen it [care plan],”and, “I know I have one, everyone does. I have never seen it, but I think they [staff] review it,” and, “Yes, they read my care plan to me.” People also told us staff made daily notes and completed ongoing monitoring. One person stated, “They [staff] watch what you eat every day and record what you have eaten. They record what you do and what they do for you.”

Overall, care records were detailed, though due to the electronic system used by the provider, they were not always easy to read or navigate. We also identified some incorrect and contradictory information within the care plans were reviewed. This included information about what room people resided in, the DoLS process, whether a person had a diagnosis of dementia; with some sections stating they did, and others stating they didn’t. For one person we noted conflicting information about what type of diet they required. One section of their care plan stated a normal diet, another stated a controlled diet, whereas the chef told us they received a diabetic diet, which was in line with their needs. We reviewed people’s daily notes and supplementary charts, used to document things such as food and fluid intake, repositioning, personal hygiene and continence care. We found these had largely been completed consistently.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Care records explained people’s specific communication needs and whether they needed to wear glasses or hearing aids to support the communication process. For example, 1 person’s communication care plan stated they should be wearing their prescription glasses each day. We observed them wearing these during both assessment visits. Another person’s care plan stated they preferred to be given information verbally. They confirmed staff respected this wish.

We checked whether the provider was meeting the requirements of the Accessible Information Standard (AIS). The Accessible Information Standard tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their carers, get information in a way they can understand it. It also says that people should get the support they need in relation to communication. An up to date AIS policy was in place. However, we found further work or consideration was needed to ensure documentation was accessible for all people reading or using it. For example, posters advertising policy & procedures, such as the complaints or safeguarding process, survey’s and questionnaires, were lengthy, quite wordy and complicated to work through. Although the provider told us information could be made available in alterative formats, we saw no examples on display or within the home, such as larger font or easy read versions, which some people may have found useful.

People and relatives told us they would speak to staff or management if they had any issues or concerns. One person stated, “I would go to the manager’s office which is near my bedroom.” Whilst another person said, “I would talk to the senior and if needed she would talk to the manager.” We received mixed feedback about whether people and/or their relatives had been asked for their views or opinions about the home and care provided. Comments included, “No, but I’ve noticed there’s a suggestion box on the windowsill,” and, “I think they did once, but you would be better speaking to [relative],” and, “Yes, they come and have paper with questions on and they ask me to be quite open. I feel able to tell them what I am feeling.”

We found the provider’s complaints process was not robust. The complaints folder contained only 1 complaint. Prior to the assessment, the provider had submitted some information to CQC about the home and had referenced receiving on a number of concerns from relatives, as well as a family not being happy after their relative had fallen in the home, and requesting information and feedback. None of these had been captured within the complaints file, so we were unable to confirm whether action had been taken and if the complaints had been resolved. We checked whether resident, relative and staff meetings had been held since the last assessment. For all meetings we identified a gap in completion from the date of the last assessment in March up to August 2024. Since our last assessment, 2 resident meetings had been held, 1 in August and 1 in September 2024, 1 family meeting had taken place in August 2024 and 2 staff meetings, again in August and September 2024. As we were not provided with meeting schedules for each of these meetings, it was not clear how often meetings should take place, or how they were advertised, so people and relatives could make plans to attend. A new process for gathering feedback via written surveys was being rolled out. Each survey covered a specific area, such as complaints and compliments. The deputy manager told us a different survey would be circulated at each resident meeting. People would be asked to complete these independently, although for anyone unable to do so, staff would ask the person the questions and record their responses. We asked the deputy manager what happens with the results of the surveys, and how was information fed back to people, including actions taken and outcomes. They told us there was not a current system in place for dealing with this, though they intended to build an action plan and speak to people, to see what they would like and how they wanted this information to be communicated, then would trial the outcomes.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People and relatives reported no concerns with the support provided with hydration and nutrition. We were told enough food and drink was provided, people’s needs were met, with the only concern being the temperature of food at times when it was served. Comments included, “The food is good, we get plenty of it. If I don’t like the choices, I can have something else.” [Relative] can eat without assistance, they have never made any complaints to me about the food,” and, “The food is sometimes cold, as it has to come a long way from the kitchen via the dumb waiter.” People received support to stay well, with ongoing input being provided by a local GP surgery and referrals being made to other medical professionals as required. One person stated, “The doctor comes in once a week. If I needed a doctor at another time, the staff would ring for me, or they would ring for an ambulance.” People’s oral hygiene needs were also supported, which is important as poor oral health can impact on people’s wider general health. People told us they either managed this aspect of care themselves or received support from staff.

Care records explained people’s modified dietary requirements. Information in the kitchen was up to date and accurate, and ensured people received their meals in line with their assessed needs. Information about professional involvement was kept within people’s care records, this included who the person had been seen by and why. We noted a weekly meeting was held with a local GP surgery. The provider explained how they ensured they worked effectively across teams and services to support people, this included when people were transitioning between services or moving elsewhere. They told us the key thing was communication. Prior to admission, they would carry out an assessment of the person, speak to them and/or family members. Similarly, if a person was transitioning from the home, they would ensure any relevant information about the person and their needs was shared, prior to a move taking place. The provider had an up to date equality, diversity and human rights policy. The registered manager told us they employed a diverse staff team, which helped accommodate the needs of the residents, whether this be dietary, communication or cultural needs. They also stated the home celebrated a range of cultural and religious events such as Diwali, Eid and Christmas, to ensure everyone’s needs were met.

Where people had chosen to discuss this information, their care records contained information about their last wishes and end of life preferences. This also included whether they wished to be resuscitated in the event of a medical emergency.

Training in end of life care was being provided to care staff, although some still needed to complete the course. The home received support from district nurses and the person’s GP with any medical aspects of end of life care, such as the administration of certain end of life medications.