This was an unannounced inspection carried out on 13 and 14 February 2017. 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 at the front of the home. Accommodation is in single occupancy bedrooms which have 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 lounge and dining room for people to use and a small garden for people to sit in and enjoy.

At the time of inspection there was a registered manager in post. They had been in post approximately six months on the day of our visit. 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.’

The registered manager reported directly to the general manager. The general manager supervised the registered manager in the day to day management of the home. The general manager had also been in post for approximately six months prior to our visit.

During our visit, we looked at the care files belonging to four people. We found that some of the information in relation to people’s individual risks was generic. This meant for some people, staff had general guidance about their care as opposed to specific information on how to manage their individual risks. This aspect of risk management required improvement. We saw however that staff did routinely mitigate risks in the delivery of care for example, by ensuring people had the mobility equipment they needed and responding promptly to people’s needs when they needed help.

The home was clean and well maintained. We saw that the majority of the home’s utilities had been regularly serviced and inspected as safe. The home’s emergency lighting required improvement as identified improvements had not been completed. Some of the home’s emergency lights had been identified as faulty but had not been fixed. We drew this to the registered manager’s attention. Some improvements to the fire safety arrangements were also required and we were told by the general manager that this was in progress.

The registered manager told us that at times some people’s medication had not been given to them by as prescribed by their doctor and we saw from people’s care records that several incidences of this nature had occurred. The registered manager told us, in response to this, all staff administering medication had completed refresher training in medication administration, had their competency checked by the registered manager and been supervised with regard to safe medication practices. Improvements in the way medication was administered however still needed to be evidenced. On the day of our inspection, the medications we checked were all accounted for and correct.

People we spoke with were happy with the care they received. They told us the staff were kind, caring and looked after them very well. They said they felt safe at the home and they had no worries or concerns.

Staff spoken with, were knowledgeable about types of abuse and what to do if they suspected abuse had occurred. They spoke about the people they cared for warmly. They were knowledgeable about people’s needs and the care they required. It was obvious from our conversations and our observations of the service, that staff knew people well. The atmosphere at the home was homely and relaxed and it was clear that people who lived at the home had positive relationships with th

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.

We spoke to three people who lived at the home and three relatives. People said “Its first class, excellent, staff are wonderful [I feel at home with them]”, “staff are very good” and “there is nothing to complain about”. They told us consent was always sought prior to any care being given and they were able to choose how they lived their life at the home. Relatives said they were “thrilled to bits [couldn’t be happier with the care], “absolutely delighted” and “very happy with the home”.

We found the costs associated with living at the home and the services provided were fully explained to people prior to admission and specified clearly in a written statement of terms and conditions.

We saw people’s needs were assessed and regularly reviewed. Care records contained information about a person’s individual needs and preferences and promoted the person’s independence where possible. We observed people were well cared for and treated kindly.

We saw staff had an annual appraisal, regular supervision and training in relation to their job role. This meant the provider had suitable systems in place to ensure staff had the right skills and competencies to care for people at the home.

The complaints policy was displayed within the home for people to refer to. People/relatives said they had no complaints but would know how to make a complaint. We saw systems were in place to record and monitor complaints. At the time of our visit no complaints had been made.

People who used the service and their relatives whom we spoke with told us they were happy living at the home, were well cared for and treated with dignity and respect. They told us:

“It’s fantastic here”,

“It can’t be any better”,

“They are fully aware of my relatives needs and treat her as an individual”.

People told us they were involved in their care and treatment and were able to make choices in every day living activities such as food choices and level of assistance needed with personal care.

We observed that people were well cared for and treated with dignity and respect. People’s needs were assessed, planned and reviewed. We found that the provider monitored the service and gained views on the service from staff and people who used the service.

Staff were appropriately and safely recruited to care for people’s needs. They demonstrated knowledge and understanding of how to protect people from abuse.

The people using the service said they receive the care and support they need and they

have never been treated or spoken to badly. They said staff are friendly and caring and

always respect their privacy and dignity. They said they know who to speak to if they were

unhappy and want to make a complaint. Some comments made were:

"The staff are very good, they are always on hand and will do anything for you."

"The staff are very good when they help with my personal care such as having a bath."

"The staff are just lovely, nothing is ever a problem."

"I am very happy living is Heathermount, the staff work very hard, they are lovely girls."

"The staff are very kind."

"The staff are all very good, you couldn't get better."

The relatives of the people using the service spoke highly of the standard of care

provided. They said the staff are aware of their relative's care needs and they are always

kept informed about their welfare. They said they are invited to the care plan reviews and

know who to speak to if they want to make a complaint. Relatives said they have never

seen any signs of abuse or neglect. Some comments made were:

"The staff are wonderful."

for the essential standards of quality and safety

Summary of our findings

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"The staff are very kind and caring, they are very good indeed."

"I haven't been invited to the care plan reviews, but I do see the staff regularly and they

always tell me what's going on."

"The manager is very good."

"The staff are very good and very attentive to my relative."

"The home is well run."

" My friend couldn't be in a better place."

" The staff are very patient and kind."

"The staff are very professional and aware of my friend's care needs."

Health care professionals spoken to said they are very happy with the care provided.

They had never seen any signs of neglect. Some comments made were:

"I have absolutely no concerns about my patients' welfare, they are extremely well looked

after."