Basford

Heathcotes (Basford) is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Heathcotes (Basford) accommodates six people living with mental health needs and or learning disabilities and or an autistic spectrum disorder. On the day of our inspection six people were living at the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the last inspection, in February 2016 the service was rated overall as ‘Good’. At this inspection we found that the service remained ‘Good’.

Since our last inspection there had been a change of registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.

People were supported by a staff team who understood their role and responsibilities to protect them from abuse and avoidable harm. The registered provider had systems, policies and processes to support staff in safeguarding people. Staff had received appropriate safeguarding training.

Risks to people’s safety, including the environment had been assessed and were monitored and reviewed. Some concerns were identified with staffing levels and action was taken to improve this with immediate effect.

People’s medicines were managed safely. Not all night staff had received medicines training, whilst there was a plan to manage this action was taken to resolve this issue. Following our inspection the registered manager confirmed night staff that had not received medicines training, were enrolled to complete this as a matter of priority. The service was clean and hygienic and staff had received training in the prevention and control of infections and a policy and procedure was available to support staff.

People’s needs had been appropriately assessed and staff had information of the support people required to effectively manage their needs. Staff had received an appropriate induction and support. Some gaps were found in staff training, this had been already identified in some areas and training booked. Immediate action was taken to arrange for staff to receive refresher training where required.

People received a choice of meals and drinks and their dietary needs were known and understood by staff. People were supported to access primary and specialist health services to monitor their health needs. Staff worked with external healthcare professionals to secure good outcomes for people. The internal and external environment was appropriate for people’s individual needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported by a staff team that knew them well; staff were caring and provided a person centred approach. Independence was promoted, dignity and privacy respected and people were involved in their care and support. People had access to independent advocacy information should they have required this support.

Staff supported people with their interests and hobbies and people contributed to planning the care and support they received. People’s communication needs had been assessed and planned for. The provider’s complaints procedure had been made available for people and was presented in an appropriate format. People’s end of life wishes had been discussed with them.

People, relatives and staff were positive about the leadership of the service. People received opportunities to share their experience about the service they received. Systems and processes were in place to monitor the quality and safety of the service people received.

Heathcotes (Basford) provides accommodation and personal care for up to 5 people living with a learning disability and/or autistic spectrum or mental health needs. Five people were living at the service at the time of the inspection.

Heathcotes (Basford) is required to have a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run. At the time of the inspection a registered manager was in place. However, a new acting manager was taking over and had started the process of registering with CQC.

Staff were aware of the safeguarding adult procedures to protect people from abuse and avoidable harm and had received appropriate training. Appropriate action had been taken to respond and investigate safeguarding concerns.

Risks to people had been assessed and risk plans were in place to manage and reduce known risks. Accidents and incidents were recorded and appropriate action had been taken to reduce further risks. These were monitored and analysed for themes, patterns and trends. People received their medicines as prescribed by the GP and these medicines were managed correctly.

Safe recruitment practices meant as far as possible only people suitable to work for the service were employed. Staff received an induction, training and appropriate support. There were sufficient staff available to meet people’s needs, staffing levels were flexible and responsive to people’s needs.

People received sufficient to eat and drink and their nutritional needs had been assessed and planned for. People’s healthcare needs had been assessed and were regularly monitored. Some concerns were identified about the recording of information that informed staff of the support people required with their needs and choices.

The manager applied the principles of the Mental Capacity Act 2005 (MCA) and Deprivations of Liberty Safeguards (Dolls). However, best interest decisions had not always been made in accordance with this legislation.

Staff were kind, caring and respectful towards the people they supported. They had a person centred approach and an understanding of people’s individual needs, preferences and routines. People were involved as fully as possible in decisions and choice about how they lived their life.

There was a complaint policy and procedure available for people, and complaints made had been investigated and appropriate action had been taken to resolve issues if required. People had access to information about an independent advocacy service. There were no restrictions on people visiting the service.

The provider had good systems and processes in place that checked and monitored the quality and safety of the service. These included daily, weekly and monthly audits completed by the manager and staff team, and regular audits completed by the regional manager. Where shortfalls were identified actions plans were developed and improvements were made.