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Inspection carried out on 19 September 2017

During a routine inspection

Heathcotes (Knollbeck) is registered to provide accommodation for up to six people who require personal care. The home provides a service for people who have a learning disability. At the time of the inspection there were six people living in the home.

The last inspection took place in July 2015 the service was rated as 'Good'. At this inspection we found the service remained 'Good'.

Systems were in place to manage risks to people living at the home and to keep them safe. All the people, professionals and staff we spoke with said they thought Heathcotes (Knollbeck) was safe. Staff had completed training in how to protect people from harm and abuse and understood the different forms and potential signs of abuse. Staff told us they had confidence in the management team to deal with safeguarding issues promptly and effectively. Medicines were managed safely to ensure people received them in accordance with their health needs and the prescriber's instructions.

There was sufficient numbers of staff on duty to safely assist and support people. The recruitment and selection procedure ensured that only suitable staff were recruited to work with people living at the home. Staff were well supported through a system of induction and training. Staff told us the training was thorough and gave them confidence to carry out their role effectively.

The registered manager and staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have choice and control over their lives as much as possible. Staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice.

People's needs were assessed, so that their care was planned and delivered in a consistent way. The registered manager and care staff were knowledgeable about the people they supported and knew their care needs well. Staff offered people choices and these were respected and actioned by staff.

People were treated with kindness, compassion and respect. Staff demonstrated they had an excellent knowledge of the people they supported and were able to appropriately support people without limiting their independence. Staff consistently spent time speaking with the people they were supporting. We saw many positive interactions and people enjoyed talking to and interacting with staff.

People had regular routine access to health and social care professionals where necessary. People attended health checks with a GP and had access to other medical services to ensure their health needs were met. Professionals told us there was appropriate communication between the service and themselves.

People had a choice of how they spent their time and the activities they undertook. Meals, snacks and drinks were chosen by people, which they enjoyed. People had been included in planning their own menus and their feedback about the meals in the service had been listened to and acted upon. Some people were actively involved in meal preparation.

The service had clear complaint systems and people had regular opportunities to discuss how they felt about the service.

People had individual support plans, detailing the support they needed and how they wanted this to be provided. Staff reviewed plans at least monthly with input from the person who was supported. Professionals told us they were kept informed of changes to people’s support plans and were regularly invited to review meetings.

There was an effective quality assurance system in place to monitor key areas such as medicines, safeguarding concerns, accidents, incidents and staffing issues. People were consulted about how they wished their care to be delivered and their choices had been respected. People, their relatives and staff were provided with the opportunity to give their feedback about the quality of the service provided.

Inspection carried out on 2 July 2015

During a routine inspection

The inspection took place on 2 July 2015 and was unannounced. Our last inspection of this service took place in October 2013 when no breaches of legal requirements were identified.

Heathcotes (Knollbeck) is registered to provide residential accommodation and care for six adults with learning disabilities or autistic spectrum disorder, and other complex needs. At the time of the inspection six men were living in the home.

The registered manager had been promoted within the organisation and, a new home manager was running the home, The new manager had started the process of applying to be registered with CQC. This meant that the service did not have a registered manager running the service on a day to day basis at the time of our inspection. 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.

People told us they felt safe living at the home. People told us that staffing levels were good, and some people received one to one staff support. Staff we spoke with had a clear understanding of safeguarding people from abuse and of what action they would take if they suspected abuse.

People were supported in their individual choices and involvement in life skills and there was a core staff team who had worked with people for some years and knew people well. We saw that staff engaged positively with people and there was a general sense of calm. People were seen to have very busy and fulfilled lives.

The accommodation was comfortable and homely and people were confident, happy and settled. People were observed to be very comfortable with the staff supporting them. Staff recruitment records included the required information showing that only staff suitable to work with vulnerable people had been employed.

We saw risk assessments had been devised to help minimise and monitor the risk, while encouraging people to be as independent as possible.

Staff were provided with appropriate training to help them meet people’s needs and we found the service was meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good knowledge of this.

People told us they took turns to cook the evening meal and were encouraged to eat a healthy diet. People were supported to maintain good health, have access to healthcare services and received on going healthcare support.

People’s needs were assessed and they were involved in creating their individual support plans, which were very individual and reflected their diverse interests. Staff were aware of people’s needs and the best ways to support them, whilst maintaining their independence.

People’s individual plans included information about who was important to them, such as their family and friends. We saw that people had many and varied individual interests that they engaged in and were supported to be involved in work and college and took part in lots of activities.

The service had a complaints procedure and people knew how to raise concerns. The procedure was also available in an ‘easy read’ version. People said they knew how to complain and we saw that complaints were appropriately responded to. People told us they could express their views and opinions and felt listened to. People told us they were able to make choices and decisions and we saw that they were involved in discussions regarding their care records. It was clear that people’s views were central to how the service was run.

There were thorough quality monitoring systems in place to review and develop the service.

The company sent out stakeholder satisfaction surveys to people for them to comment on their experience of the service provided and the outcome was very positive.

Inspection carried out on 29 October 2013

During a routine inspection

We spoke with three people who used the service. They said they were happy and liked living at Heathcotes (Knollbeck). One person said it was nice, another said they were very happy. A third person said the staff were great.

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

People were protected from the risks of inadequate nutrition and dehydration.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

There was an effective complaints system available. One person told us they would speak to staff and managers if they were not happy.

Inspection carried out on 19 December 2012

During a routine inspection

We found that people's views and experiences were taken into account in the way the service was provided in relation to their care. We spoke with two people who used the service. They told us they were treated with respect and were very happy with the care they received. One person said the home was the first place they had ever felt really at home in.

People experienced care, treatment and support that met their needs and protected their rights. Both people said they were happy with their care plans and they talked about things regularly with their key workers.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Both of the people we spoke with told us they felt safe in the home and with the staff.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. People said the staff were helpful, encouraging and understanding.

We found that the provider had an effective system to regularly assess and monitor the quality of service that people received.

Inspection carried out on 16 September 2011

During an inspection in response to concerns

People told us that they liked living in the home and got on well with staff. One person told us, �Everything is all right living here; I get on OK.� Another person said, �They�ve helped me a lot, but I want to leave and get my own place. Staff listen to me!� People spoke about how they were respected. One person told us, �Staff treat me with respect; they treat us like adults.�

People described how they spent their time and told us about the activities they enjoyed. People did things they chose to do in the home. They played pool, did puzzles and built models. People also told us about projects in the home�s garden they were involved in. We observed this in action.

People described their choice of outside activities. People could visit attractions they chose. People spoke about going to college and doing voluntary work.

People said to us that they got to see the doctor, with a member of staff if necessary. People also told us they received the support they needed to visit the dentist and the optician regularly.

People told us they felt safe. A person spoke to us positively about the approach of staff in using restraint and about how he provided reassurance to other people who experienced restraint.

People we spoke to were very complimentary about the staff that worked with them.

People told us about meetings they had attended to discuss improvements. A person told us how he appreciated being asked about how to improve the service.

Reports under our old system of regulation (including those from before CQC was created)