You are here

Heathcotes (Taylor View and Gilbert Lodge) Good

Reports


Inspection carried out on 28 January 2020

During a routine inspection

About the service

Heathcotes (Taylor View and Gilbert Lodge) 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 (Taylor View and Gilbert Lodge) provides support for up to 10 people with a learning disability and those with autistic spectrum disorder. At the time of our visit there were five people using the service.

The home is located in two houses which are located either side of a tarmac drive. Heathcotes (Taylor View and Gilbert Lodge) is registered as one location, at our last inspection the two buildings operated as separate services. However, this had been addressed by the new registered manager who had made improvements to the service and managed both homes in the same way. Documents used in care planning were replicated throughout the service and staff supported people across the service when required to do so.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s rights to make their own decisions was respected. People were supported to access healthcare services if needed. Staff had appropriate skills and knowledge to deliver care and support in a person-centred way. People were supported to have enough to eat and drink.

People received personalised support based on assessed needs and preferences. Staff knew how to support people in the way that they preferred. People knew how to complain if they needed to.

People received support to take their medicines safely. Risks to people’s well-being and their home environment were recorded and updated when their circumstances changed.

The service was managed by a registered manager who had a clear vision about the quality of care they wanted to provide. Staff were aware of their roles and responsibilities. A range of quality assurance checks were carried out to monitor and improve standards. We received positive feedback regarding the leadership and management of the service.

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

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: The rating at the last inspection was Inadequate. The last inspection was a focussed inspection and only covered the Safe and Well Led domains (Report published 4 June 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since the last inspection. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Inspection carried out on 4 June 2019

During an inspection looking at part of the service

Heathcotes (Taylor View and Gilbert Lodge) 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 (Taylor View and Gilbert Lodge) provides support for up to 10 people with a learning disability and those with autistic spectrum disorder. At the time of our first visit on 4 June 2019 there were nine people using the service. On our second visit on 13 June 2019 there were eight people.

The home is located in two houses which are located either side of a tarmac drive. Heathcotes Taylor View and Gilbert Lodge is registered as one location, but the two homes operate separately.

We carried out an unannounced comprehensive inspection of this service in May 2018 and the service was rated as Good.

Since our May 2018 inspection we received concerns in relation to the safety of care provided at Heathcotes (Taylor View and Gilbert Lodge). As a result, we undertook this focused inspection to investigate those concerns. This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Heathcotes (Taylor View and Gilbert Lodge) on our website at www.cqc.org.uk.

During our inspection we found the service was not consistently safe. Comprehensive assessments had not taken place prior to people being offered a place at Heathcotes (Taylor View and Gilbert Lodge). This meant that staff and management could not assess if all support needs could be met or if there was appropriate staff training in place to ensure that staff could best support people.

We saw that people were being restrained frequently, this should only be as a last resort and if other interventions had failed. Staff were unable to recognise different techniques for de-escalation or fully understand triggers to challenging behaviour.

The service was not using the values and principals of Registering the Right Support and good practise guidance. This would ensure that people using the service can live as full a life as possible and achieve the best possible outcomes. The principals reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. People using the service did not receive co-ordinated person-centred support which was appropriate and exclusive for them.

Heathcotes (Taylor View and Gilbert Lodge) was not consistently well led. Auditing systems were not fully effective in addressing areas for development because actions planned to address areas of concern had not always been completed. Records of people’s care and support were not always accurate and up to date. In addition, incident records had not always been fully completed to show what action had been taken in response to adverse events. We found staff did not all have sufficient knowledge or training to enable the provider to deliver the specialist aspects of the service.

Enforcement: You can see what action we told the provider to take at the back of the full version of the report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within s

Inspection carried out on 24 May 2018

During a routine inspection

A registered manager was in place but not available at the time of our inspection. A manager was covering the registered manager until their return and was present at 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. The provider and registered manager had met their registration requirements had had notified CQC of any event they were required to do.

People told us they were happy with the service they received. Relatives were positive that the provider and staff, provided a service that met their family member’s individual needs. A relative said, “The manager is definitely approachable.” Another relative said, “Staff seem open and friendly, this indicates they get support. All the staff are very amenable. Pass messages on.”

The service had an open and transparent culture where the management team had clear expectations of staff to provide person centred care and support. People were supported to achieve good outcomes.

People’s diverse needs were discussed with them and the provider had clear values that promoted and empowered autonomy. This was backed up by the provider’s policies and procedures, these included equality and diversity and cross gender.

People who used the service, relatives, external professionals and staff received opportunities to share their experience about the service. This was by means of meetings, surveys and the management team having an open door policy where they made themselves available.

The provider was able to continually improve the service by completing regular audits and checks on quality and safety. The manager, area manager and the provider’s internal quality monitoring team completed this monitoring. Where shortfalls were identified an action plan was developed, to identify what was required by whom and when. This meant the provider had oversight of the service and there was accountability.

The service worked with external agencies and organisations as a method to improve outcomes for people. This involved attendance at local forum meetings where providers shared and exchanged information and good practice. Staff were supported by community health and social care professionals and engaged well with the support provided. A professional told us, “I found the manager of the service to be knowledgeable in relation to the service users and their needs. She formed a good working relationship with myself and others and attended all necessary meetings. The service was always clean and tidy and service users looked happy and were happy to talk about the activities / day trips they had been out on.”

Inspection carried out on 26 November 2014

During an inspection looking at part of the service

We inspected the service on 26 November 2014. This was an unannounced inspection.

Heathcotes (Hucknall and Watnall) is registered to provide accommodation for up to 12 people with a learning disability, a mental health illness or physical disability. The registration consists of two separate houses. One house is named Hucknall and one named Watnall. There were 10 people using the service when we visited, six people living in one house and four living in the other.

We last inspected this service on 25 April 2014. During the inspection we found that the provider was not meeting 3 of the regulations that we assessed. These were in relation to ensuring that there were sufficient staff on duty, ensuring that people’s nutritional needs had been met and that staff were respecting and involving people. The provider sent us an action plan detailing the actions that they would take to meet these regulations. During this inspection we found that the provider had taken the necessary improvements.

The service had a registered manager in place 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.

Everyone we spoke with told us that they felt safe. Staff told us that they followed plans to ensure people’s ongoing safety. However on one occasion we saw that staff had not followed guidance and as a result a person had been placed at risk of harm.

Staffing levels had been increased since the time of our last inspection and this had impacted positively on the people who used the service. People told us that they had opportunities to go out to pursue activities of their choice and staff told us that people did not have to wait for support. Increased staffing levels meant better opportunities for people to receive individualised support.

We saw there were systems and processes in place to protect people and keep them safe. People were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements for staff to respond appropriately to people whose behaviour may challenge others. Staff told us that they had received training in order to do this safely and everyone we spoke with said they felt confident that they would know what to do in such a situation.

People were supported to take informed risks to ensure they were not restricted. Where people lacked capacity to make decisions, the Mental Capacity Act (MCA) 2005 was being considered, to ensure staff made decisions based on people’s best interests.

People’s medicines’ were managed safely and people received their medication when they should. Staff were recruited through safe recruitment practices.

People who used the service told us that they felt consulted in relation to how they lived their lives. There were processes in place to gain their views. People’s preferences and needs were recorded in their care plans and we saw that staff were following the plans in practice.

We saw that the monitoring of food and drink intake had improved and staff could show that people were receiving a varied and balanced diet. At least one person’s health had improved as a result.

Throughout the inspection we saw staff treat people with dignity and respect. We saw staff were kind and caring when supporting people.

People knew who to speak to if they wanted to raise a concern and there were processes in place for responding to complaints. This meant that people were enabled to make a complaint or share a concern about the care and support they received.

There were effective systems in place to monitor and improve the quality of the service provided. Action plans, in response to audits and incidents, documented continuous improvement. Staff had received training and support in relation to learning disability, autism and mental health awareness. to them a better understanding of people’s needs and behaviours.

Staff also told us how they had received support from the manager to raise their awareness of treating people with respect and recognising individuality.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. The Deprivation of Liberty Safeguards are a code of practice to supplement the main Mental Capacity Act 2005 Code of Practice. We looked at whether the provider was applying the DoLS appropriately. These safeguards protect the rights of adults using services by ensuring that if there are restrictions on their freedom and liberty these were assessed by professionals who are appropriately trained to assess whether the restriction is needed. The registered manager told us there was one person who may be being deprived of their liberty. We saw that they had made an application to check this with the local authority and had notified the CQC. At the time of our inspection no one else living in the home was being deprived of their liberty. We found the provider and the registered manager to be meeting the requirements of the DoLS.

Inspection carried out on 25 April 2014

During Reference: not found

Inspection carried out on 25 April 2014

During a routine inspection

Heathcotes (Hucknall & Watnall) is a care home providing accommodation for up to 12 people. There were 12 people living there when we visited. The service provides care and support to adults who have a learning disability, a mental health illness or physical disability. There is a manager registered at the service. The service consists of two separate houses on the same site. One house is named Hucknall and one is named Watnall. Six people live in each house. There is also an office and activity room on site.

We saw there were systems and processes in place to protect people from the risk of harm. People were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements for staff to respond appropriately to people whose behaviour may challenge others. We saw staff responding appropriately to a person with behaviours that may challenge the service during our inspection.

People were supported to take informed risks to ensure they were not restricted. Where people lacked capacity to make decisions, the Mental Capacity Act (MCA) 2005 was being considered, to ensure staff made decisions based on people’s best interests. However, the service acknowledged that further work was required in this area and new forms and training were being introduced to support staff. The MCA 2005 was an act introduced to protect people who lack capacity to make certain decisions because of illness or disability.

We found that there were systems in place to ensure people received their medicines as prescribed. Staff were recruited through safe recruitment practices.

There were not always enough staff to support people safely and meet their needs. This was a breach of Regulation 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and you can see what action we told the provider to take at the back of the full version of the report.

There were processes in place to gain the views of people in relation to their care and support. People’s preferences and needs were recorded in their care plans and staff were following the plans in practice.

Records and observations showed that the risks around nutrition and hydration were not always monitored and managed by staff to ensure that everyone received adequate food and drink. This was a breach of Regulation 14 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and you can see what action we told the provider to take at the back of the full version of the report.

We observed that most staff treated people with kindness and compassion however, staff were not always respectful to people when they were supporting them. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and you can see what action we told the provider to take at the back of the full version of the report.

People were supported to attend meetings where they could express their views about the home. People knew who to speak to if they wanted to raise a concern and there were processes in place for responding to concerns. The manager told us there had not been any complaints made by people who lived in the home or their relatives or advocates.

There were effective systems in place to monitor and improve the quality of the service provided. Action plans, in response to audits and incidents, and the following up of these ensured continuous improvement. Staff were supported to challenge when they felt there could be improvements and there was an open and transparent culture in the home. However, we found that there was limited evidence of training for all staff in the areas of learning disability, autism and mental health awareness.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. The Deprivation of Liberty Safeguards are a code of practice to supplement the main Mental Capacity Act 2005 Code of Practice.

We looked at whether the service was applying the DoLS appropriately. These safeguards protect the rights of adults using services by ensuring that if there are restrictions on their freedom and liberty these are assessed by professionals who are trained to assess whether the restriction is needed. The manager told us there was one person who may be being deprived of their liberty. We saw that they had made the correct application and notified the CQC of this. We saw no evidence to suggest that anyone else living in the home was being deprived of their liberty. We found the location to be meeting the requirements of the DoLS.

Inspection carried out on 2 September 2013

During an inspection looking at part of the service

We carried out the inspection to check that the provider had met the compliance action that we set at our previous inspection on 30 April 2013.

We spoke with three people using the service. Two people were not happy with the amount of staff on duty. They raised concerns about the behaviour of other people using the service. We discussed this with the manager and other staff and they told us about the actions they were taking to address this issue. The other person we spoke with was happy with the amount of staff on duty.

We found that there were enough qualified, skilled and experienced staff to meet people�s needs at all times.

Inspection carried out on 30 April 2013

During a routine inspection

We spoke with two people using the service. One person said, �Staff are really nice here.�

One person told us they were very happy with their bedroom. The other person showed us where there was damp in the ceiling of their bedroom. They did not raise any other concerns with us.

We found that people using the service, visitors and staff were not fully protected against the risk of unsafe premises. We also found that there were not enough qualified, skilled and experienced staff to meet people�s needs at all times.

We found that people were cared for by staff who were fully supported to deliver care and treatment safely and to an appropriate standard. We also found that records were fit for purpose and kept securely.

Inspection carried out on 17 August 2012

During a routine inspection

We spoke with three people who use the service. One person said, �I like it here. Everything�s ok.� People told us they liked their room and one person told us they liked staff.

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