Heightlea

Updated 23 June 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 carried out by 2 inspectors.

Service and service type

Heightlea is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the services performance since its registration. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We met and spoke with all 5 of the people living at Heightlea. We also spoke with 4 members of staff, the registered manager and 3 senior managers. We reviewed 3 people’s care plans, as well as medicine records, daily care records, incident reports, staffing rotas and staff recruitment and training records. The provider was asked share various documents relating to the management of the service and this information was reviewed following the site visit. In addition, we spoke or received written feedback from all 5 people’s relatives and received additional feedback from 3 health and social care professionals.

Updated 23 June 2023

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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

About the service

Heightlea is a residential care home providing personal care to 5 people with a learning disability or autistic people. The service is located on the outskirts of Truro and people were able to walk into town from the service.

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

Right Support

Staff ensured people were protected from abuse and understood how to report safeguarding concerns. Risks had been identified and staff understood the action they must take to keep people safe while promoting independence.

People received there medicines as prescribed and infection control risks were appropriately managed.

People were supported to access medical appointments and regular heath checks and advice from health professionals was acted upon.

Staff supported people to gain new skills and engage with new activities. People’s choices were respected and people were able to change their minds in relation to decisions previously made. People engaged in a wide variety of activities both within the service and in the local community.

People were able to communicate effectively with their staff who routinely used appropriate tools and communication aids.

Right Care

Assessments of people’s capacity to make specific decisions had not been reviewed and updated by the new provider. Instead, the service continued to rely on assessments completed by the previous provider that were not sufficiently decision specific. In addition, people’s care plans did not include sufficiently challenging goals to support the development of new skills and improve independence.

People were happy and confident requesting support from staff who they enjoyed spending time with. Staff got on well with the people they supported and had the skills necessary to meet people’s needs.

Visiting was actively encouraged and people were regularly supported to meet up with friends and relatives.

Right Culture:

Staff had been safely recruited and there were enough staff available to meet people’s needs. The new provider was actively recruiting and was working with staff to reduce working hours to an appropriate level.

Quality assurance systems were effective and had identified failings in relation to capacity assessment, goal setting and care planning. The provider had chosen not to immediately address these issues to prevent changes to systems impacting on the quality of care people received. The new provider intended to introduce a new digital care planning system to support the effective resolution of these issues.

The registered manager and staff team were well supported. Relatives were highly complementary of the changes and improvements they had observed since the new provider’s involvement with the service.

The service learned when things went wrong and changes had been made to systems and procedures following incidents to prevent similar events reoccurring.

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

In September 2022 the provider was asked by the Local Authority to take over the operation of this location from another provider. This service was registered with us on 21 November 2022 and this is the first inspection.

The last rating for the service under the previous provider was inadequate, published on 15 October 2022.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We needed to check on the actions taken by the new provider since they took on responsibility for the service.

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.

Enforcement and Recommendations

We have identified breaches of the regulations in relation to the Mental Capacity Act and good governance.

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 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 continue to monitor information we receive about the service, which will help inform when we next inspect.