Heanton Nursing Home

This assessment was undertaken in response to concerns in relation to the quality and safety of care people were receiving. We carried out a comprehensive inspection of the service covering all quality statements in all key questions.

The last planned comprehensive inspection report was published 21 September 2018. The service was rated outstanding. The report was published following Care Quality Commissions (CQC) previous inspection approach using Key Lines of Enquiry (KLOEs), prompts and ratings characteristics. This assessment has been completed following the CQC new approach to assessment. We assessed 34 quality statements across the 5 key questions

This inspection was completed by 2 inspectors, 1 medicine inspector, a regulatory officer

and 2 Experts by Experience. We spoke with 6 people who lived at the service and 3 relatives during the site visit. We spoke with 16 staff including the provider, registered manager, registered nurses, care and ancillary staff. Following the visit, we spoke with 18 relatives and 6 professionals who visited the service. We reviewed care and governance records and information from the provider information return (PIR). The PIR asked the provider to submit data and information on how they are ensuring the service is safe, effective, caring, responsive and well-led.

The governance systems in place had not identified all concerns found at this assessment.

The provider did not always ensure care and support was provided to people in a safe, clean, and well-maintained environment. Some risks had not been fully mitigated until identified during the assessment. The environment required maintenance, however, limited action had been taken to address the poor décor and cleanliness issues we found. The provider and management team responded quickly and positively to our feedback and were keen to ensure things were put right for people straight away. We found improvements to safety and cleanliness on the second day of our visit.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. However, they did not always share concerns quickly and appropriately with relatives when things had gone wrong.

People's needs were assessed and regularly reviewed, although some people and those important to them said they were not always involved in decisions about their care. People’s consent was sought, and they were supported to maintain their health and wellbeing. The provider was improving records of assessments relating to the Mental Capacity Act 2005 and best interest decisions.

There were sufficient staff deployed to meet people's needs. Staff were recruited safely and had effective training, support and supervision to ensure they delivered safe and effective care and support. Staff were aware of their safeguarding responsibilities. People were treated with respect and as individuals. They were offered choice, and their independence was supported in a kind and caring manner.

Medicines were administered safely and where incidents occurred learning was applied.