Heatherington House

Heatherington House is a ‘care home’ specialising in supporting people with Prader-Willi syndrome (PWS) and learning disabilities. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. PWS is a condition where people have a chronic feeling of hunger that can lead to excessive eating and sometimes life-threatening illnesses.

The home was a spacious three-story building located near to a small town centre which people could access as they wished.

The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance, with the exception that the home accommodated more than six people. 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 and the staff within this service were exceptional in ensuring this was the case for people living at this home.

There was a registered manager in post. 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.

Without exception, people were supported to achieve their goals. The staff and management team were creative, committed and determined to support people to live independent lives and challenge the barriers around supporting people with PWS.

People were supported to complete major achievements, relevant to each person’s individual wishes. People were supported to manage their weight and food choices with sensible decision making and this had seen huge benefits to people’s health and wellbeing. People were educated about food choices and activity levels and had lots of control and opportunities to be around vast quantities of food.

People had developed strong links with local leisure facilities and other amenities in the community which further helped enable people’s independence and manage their vulnerabilities. People were proud of the progress they had made at Heatherington House and valued the experiences and progress they had made.

People had seen huge benefits to their health and activity levels. People had made significant progress and they, and the staff, were immensely proud of what they had accomplished. People had better lives and were supported to try a variety of new experiences.

People were fully involved in ensuring the home they lived in was safe, taking responsibility for key elements of the running of the home. Staff supported people to learn about safety issues, such as fire risks and how this could be managed safely if unexpected events occurred.

People were encouraged and supported to take risks and grow in confidence and their abilities to manage situations independently. The staff prepared and educated people so they could be as independent as possible for each person whilst out in the community.

People were involved in staffing decisions and of the recruitment of new staff. Staff skills were considered alongside the people that lived at the home to bring out the best in people and encourage them to try new things and take greater responsibility wherever possible.

The registered manager challenged stigma and stereotypes and ensured that people with Prader-Willi Syndrome (PWS) were not disadvantaged or treated differently because of their condition. Staff followed the lead of the registered manager and ensured that people were challenged to achieve what they wanted.

Staff consistently went the extra mile for people to ensure they received all the support they required, when they needed it. People living at the home valued their relationships with staff and the commitment they provided, and this benefitted people immensely.

Heatherington House specialises in providing support for up to eight people living with Prader-Willi Syndrome (PWS). This is a condition where people have a chronic feeling of hunger that can lead to excessive eating and sometimes life threatening obesity. The service is situated in a residential part of Kettering, close to local amenities. On the day of our visit, there were seven people living in the service.

There was a registered manager in post. 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 service provided exceptionally person-centred care which helped people to make remarkable changes to their health and general well- being. People told us numerous stories of just how much difference the care they received had made to them; sometimes even changing their lives for the better, giving them a new lease of life. Devoted staff provided bespoke care and support, tailored to people’s individual needs and based on their likes, dislikes and individual preferences. They worked effortlessly to encourage and stimulate people to consider doing things they might not have done previously, not recognising barriers and making things possible for people.

Staff were passionate in their intentions and supported and encouraged people to access the local community and participate in activities, including voluntary and paid work placements. These opportunities were incredibly important to people as they empowered them to have meaningful and fulfilled lives, becoming fully integrated within the local community. The opportunities they had were provided by skilled staff who worked hard to give people every chance to undertake the things that they wanted to, to be adventurous and achieve independence. This gave people a huge sense of self satisfaction and self-belief, leading them to consider moving on to more independent living opportunities.

People felt safe in the service. There were appropriate systems in place to safeguard people from the risk of harm and staff understood the process of reporting suspected abuse. Risks to people had been assessed and detailed the control measures in place to minimise the potential for future risks to occur and to help keep people safe. They provided information to staff about actions to be taken to minimise any risks whilst allowing people to be as independent as possible. Staff were aware of the importance of their role in reporting incidents that placed people at risk of harm.

There were sufficient numbers of suitable staff to meet people’s needs and provide them with the individual care and support they required at the times they needed it. Robust recruitment processes, including pre-employment checks, had been followed to ensure that staff were suitable to work with people.

Safe systems were in place to ensure that people received their medication in line with their prescriptions. Staff ensured that medication was administered, recorded and stored in accordance with best practice.

New staff received induction training, which provided them with the essential skills required to support people in accordance with their needs. Staff received regular training and development which provided them with the right knowledge and skills to meet people’s needs in a person centred manner.

Staff complied with the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS.) People were actively involved in decision about their care and support needs. Where required there were formal systems in place to assess people’s capacity for decision making under the MCA DoLS.

People were supported to have a healthy and balanced dietary intake by staff that had a good awareness of the intricacies of PWS and the impact this has upon people’s desire to eat. As a result of this people could access suitable amounts of food and drink that met their individual preferences. Processes were in place to ensure that people’s health and wellbeing needs were closely monitored and any guidance followed to meet individual needs.

High quality care and support was provided to people by staff that were seen as very approachable, flexible and always willing to listen. Staff were compassionate and warm in their relationships with people, happy to show affection and patiently supporting people to do the things they wanted to. Staff understood how people preferred to be supported on a daily basis and worked hard to ensure they had an enjoyable and purposeful life, based on the things they wished to achieve. There was a calm and positive atmosphere within the home; people were very much at the heart of the service delivery which was provided by staff who wanted the best for people. People were encouraged to be as involved as they wanted to in their care planning. Staff worked hard to promote and protect people’s rights and maintain their privacy and dignity, whilst respecting their human rights.

People and their relatives were encouraged to contribute to the development of the service and their feedback was used to help identify areas for development in the future. Staff were aware of the importance of managing complaints promptly and in line with the provider’s policy. People were confident that any concerns they had would be listened to and acted upon to make improvements.

The registered manager was visible and accessible and staff and people had confidence in the way the service was run. The culture within the service was forward thinking, open and positive, with all staff striving to provide the best care and support they could. The registered manager and provider regularly assessed and monitored the quality of care provided to people so that they could drive future improvement and make changes for the better. Staff were encouraged to contribute to the development of the service and understood the provider’s visions and values.

the experience people have in living there.

The expert by experience spoke with seven people. They told us that staff were friendly and were meeting their needs.

We spoke with two relatives of people living in the home. They told us that the care that staff provided was good or generally good. One relative said: ‘’there is excellent care. I am really glad we found this place‘’.

This was largely a positive inspection. People said that they were satisfied, or largely satisfied, with the care they received. We observed this to be the case. Relatives we spoke with people said that care was good, or generally good.

There were a small number of suggestions: holidays need to be reinstated by the company. The previous arrangement was that people were able to afford to go on long holidays without the new requirement for them to pay for staff input: for people to be always provided with meaningful activities: also that more staff need to be available to take people to activities and deal with people's assessed needs.

A person told us that staff members gave support when he needed it. ‘’Staff know what to do. They all give help when we ask them‘’.

We spoke with four relatives. They all told us that the care staff provided was of a high standard and they had no concerns, and that management was very positive and quickly responded to queries raised.

One relative said; “Staff are excellent’’. Another relative said; ‘’The home runs very well. Staff always get in touch if needed’’.

We received some comments about suggested improvements: To move away from having ‘institutional’ set times for meals; to look at changing the layout of the dining room and make it into a dining/lounge, to give a choice of sitting areas. One relative said she was not always informed of medical appointments.

Three people also said that they wanted to be warm at all times, as the heating was on a timer so was switched off at night. The manager said that this was not the case but would introduce a system to ensure warmth was always maintained. We were sent details of this new system.

This was a positive inspection. People living in the home stated that they were satisfied with the care they were given. Their next of kin were also satisfied with the service. All the standards inspected on this inspection were met.