Heathside provides accommodation and personal care for up to 51 older people, some of whom are living with dementia. There were 41 people living at the service at the time of our inspection.

This was an unannounced inspection which took place on 5 April 2017.

There was a manager in post who was going through the process of registering with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run. The manager assisted us with our inspection.

We carried out an inspection to this home on 2 and 11 March 2016. At that inspection we found breaches in the regulations in relation to consent, recruitment, person-centred care and good governance. Following that inspection the registered provider sent us an action plan informing us of how they planned to address our concerns. We found at this inspection all areas had been addressed and things had improved immensely.

People were safe because there were enough staff on duty to meet their needs. Risks to people had been assessed and measures implemented to reduce these risks. Accidents and incidents were monitored and action taken to try to prevent reoccurrence. There were plans in place to ensure that people would continue to receive their care in the event of an emergency. Health and safety checks were carried out regularly and medicines were managed safely. The provider made appropriate checks on staff before they started work, which helped to ensure only suitable applicants were employed. Staff understood safeguarding procedures and were aware of the provider’s whistle-blowing policy.

People were supported by staff that had the skills and experience needed to provide effective care. Staff had induction training when they started work and ongoing refresher training in core areas. They had access to regular supervision, which provided opportunities to discuss their performance and training needs.

People were cared for by kind, attentive staff who clearly had a good relationship with people and the atmosphere in the home was calm and relaxed with staff speaking to people in a respectful yet friendly manner. Although some agency staff were used the manager endeavoured to use the same agency staff for consistency. Staff knew the needs of the people they supported and provided care in a consistent way. People were supported to stay healthy and to obtain medical treatment if they needed it. Relatives told us they felt welcomed into the home.

The manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People’s best interests had been considered when decisions that affected them were made and applications for DoLS authorisations had been submitted where restrictions were imposed upon people to keep them safe.

People enjoyed the food provided and could have alternatives to the menu if they wished. People’s nutritional needs had been assessed when they moved into the home and were kept under review. Staff ensured that people who required assistance to eat and drink received this support.

People had access to a range of activities within their individual unit and in the communal areas. Work was on-going to develop meaningful, creative and individualised activities for people recognising their preferred pastimes.

The manager provided good leadership in the home. Staff told us they felt supported by the manager and he had had a positive impact on Heathside. They felt involved in the running of the home as regular staff meetings were held. Relatives told us the service was well run and that the new manager was open and approachable. They said the he had always resolved any concerns they had. Staff said they wor

Heathside provides care and treatment for up to 51 people, some of whom may be living with dementia. The home is divided into seven units, each with their own lounge and dining areas. There is a communal lounge on the ground floor where the majority of activities are held. On the day of our inspection 46 people were living in the home.

This was an unannounced inspection that took place on 2 March 2016 and 11 March 2016. We carried out the inspection over two days because the home had a bout of illness and as a result we were unable to complete our inspection on the first day.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. The registered manager assisted us with our inspection.

Some elements of correct medicines management were not followed by staff, although we did see staff administer medicines safely to people. Staff had considered individual risks for people but had not always taken action to monitor these risks.

There was a lack of appropriately deployed staff to meet people’s needs and proper recruitment processes had not been followed to help ensure only suitable staff were employed to work in the home.

The home was not always a suitable environment for people to live in. For example, we found areas of the home required a good clean. The registered manager did not always have good management oversight of the home.

Quality assurance checks were carried out by staff as well as the provider and feedback was sought from relatives. However, actions or recommendations from these audits were not always followed up by staff.

Staff did not always follow the legal requirements in relation to consent and where people required a referral to a health care professional this was not always done promptly. Care records for people lacked information which would help ensure people received responsive care and some records were not accurate or up to date.

Staff were kind and caring and showed compassion to relatives who were made to feel welcome in the home. However, on a couple of occasions staff did not provide people with the attention they should have.

People were supported and encouraged to make their own choices and remain independent. However, activities provided for people were not always meaningful or suitable for people who may be living with dementia.

Accidents and incidents were monitored by the registered manager and action taken to mitigate their reoccurrence. Staff were aware of their responsibilities to safeguard people from abuse or able to tell us what they would do in such an event. Staff followed legal requirements in respect of restrictions or decisions made on behalf of people.

People’s care would not be interrupted in the event of an emergency and if people needed to be evacuated from the home as staff had guidance to follow. Complaints about the service were responded to appropriately by the registered manager.

Staff were provided with appropriate training for their role. Staff were given the opportunity to progress professionally and meet with their line manager on a one to one basis.

People were provided with the food they preferred and staff monitored people’s weights to help ensure they kept healthy. People, relatives and staff were involved in the running of the home.

During the inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made some recommendations to the registered provider. You can see what action we told the provider to take at the back of the full version of the report.

On the day of our visit we were met by the regional manager who told us there were currently 45 residents in the home out of a total of 51. She said some of the people had varying degrees of dementia whilst others were elderly frail.

We looked at consent to care and treatment and found that people were always asked for their permission to have care and treatment provide to them, and had the right to refuse care and treatment. We also found that staff had a proper understanding of mental capacity issues.

We looked at the care and welfare of people who used the service and found they were generally happy with the level of care they were receiving. We also found that a proper system of care planning and management was in place.

We looked at how the provider ensured that people were protected from abuse and found that staff were properly trained in safeguarding, and would be able to identify and report any instances of abuse.

We looked at staffing levels and basic care qualifications and found that there were concerns amongst people who used the service and staff about the level of staffing in the home.

We looked at how the provider ensured a high quality of service, and found that they regularly sought feedback from people who used the service and from staff. We also found they conducted regular reviews and audits on all aspects of the service.

During the visit we observed how people spent their time, the support they received from the staff and whether they had positive outcomes. We spoke with 12 people and observed the support other people were receiving from the staff. We found people were treated with respect and interacted well with each other. We also spoke with four relatives, 11 staff and a visiting healthcare professional. Relatives were complimentary about the care and support. They said they were “very happy” with the care and they wanted to stress to us they had “no complaints” about the service people were receiving. A healthcare professional told us people received a high standard of care. The staff were knowledgeable and supportive of people’s needs. They were consulted and staff followed their advice which impacted positively on people. People told us they received care from staff who were “very good and very kind”. Another person said they “could not wish for anything better” and liked living there.

Staff were friendly, respectful and courteous when speaking and attending to people. The care plans were detailed and reflected people’s needs. People were offered a varied diet and balanced meals which they said met their needs.

Appropriate arrangements were in place for the management of people’s medicines. People had access to healthcare professionals and treatment as needed. There was a recruitment process that was followed. There was a system to monitor the quality of the service.