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Inspection carried out on 20 March 2018

During a routine inspection

We carried out an announced inspection of Heyhead House on 20 and 21 March 2018.

Heyhead House is registered to provide accommodation and personal care for eight adults who have a Learning Disability. The service does not provide nursing care. 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. These values include choice, promotion of independence and inclusion to ensure people with learning disabilities and autism can live as ordinary a life as any citizen. At the time of the inspection, there were eight people using the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We observed people were treated with kindness, care and respect. Staff understood their responsibilities to safeguard people from abuse. There were appropriate arrangements in place in relation to the safe storage, receipt, administration and disposal of medicines. New staff were recruited safely.

Risks to people's health, welfare and safety were managed well. However, we made a recommendation about assessing and monitoring the risks in relation to older people’s needs. The service was safe, clean and well maintained and suited to the needs of the people living there. People enjoyed a varied and healthy diet and changes in their health were monitored and acted on.

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 to live active lives and use local services and facilities. Activities were provided both inside and outside the home. People were supported to keep in contact with friends and family.

Each person had a support plan, which provided clear guidance on how their needs and preferences would be met. People were supported to be as independent as possible in all aspects of their lives. People's rights to privacy, dignity, independence and choice were respected; communication between people using the service, relatives and staff was good.

There were sufficient numbers of staff to ensure people's care and support was provided flexibly. The staff team received appropriate support and training and felt valued and respected by the registered manager.

Systems were in place to monitor the quality of the service provided. People's views and opinions were sought and acted on.

Inspection carried out on 7 January 2016

During a routine inspection

We carried out an unannounced inspection of Heyhead House on the 7 and 8 January 2016. Heyhead House is registered to provide accommodation and personal care for eight adults who have a Learning Disability. The service is situated in Brierfield, Nelson in Lancashire.

The service was last inspected in July 2013 and was found compliant in all areas inspected.

At the time of this inspection there was a registered manager employed. 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.

Throughout this inspection we received positive feedback from people who used the service, visitors and community professionals. People expressed satisfaction with the service provided and spoke very highly of the staff that supported them. Comments included, “Staff are nice, they are kind to me” and “I love it here. It’s been the best place I have worked in”.

We saw the service had robust processes and procedures in place to maintain a safe environment for people using the service, staff and visitors. Detailed and up to date health and safety checks were in place covering areas such portable electrical equipment, heating and security of the building. Audits of equipment and furnishings were completed on a monthly basis. We saw the service had a robust fire procedure and each person living at the service had a personal evacuation plan.

People indicated they felt safe living at the home. Safeguarding referral procedures were in place and staff had a good understanding around recognising the signs of abuse. All staff had undertaken safeguarding training and demonstrated good knowledge around this subject.

Over the two days of the inspection we found the service had adequate staffing levels. We reviewed staffing rotas and noted very little staff sickness. People indicated their needs were met appropriately. Staff told us they did not feel rushed with their daily routine and this enabled them to spend time conversing with people. We observed regular staff interaction to support this.

We found an overall good recruitment system in place and a thorough induction process for all new staff.

Processes were in place for the appropriate administration of medication. Staff were adequately trained. We saw individual risk assessments in people’s files to support the safe management of medication administration.

We saw the service had created detailed individual risk assessments for all people using the service. These risk assessments included diet and nutrition, mobility and positive risk taking.

We saw detailed care plans which gave clear information about people's needs, wishes, feelings and health conditions. These were reviewed monthly and more often when needed by the registered manager.

We saw evidence of detailed training programmes for staff. All carers had a Level 2 or above NVQ (National Vocational Qualification). People we spoke to indicated that staff had the correct knowledge and skill base to effectively support people with a learning disability.

Staff spoken with were aware of the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). These provide legal safeguards for people who may be unable to make their own decisions. The manager also demonstrated their knowledge about the process to follow should it be necessary to place any restrictions on a person who uses the service in their best interests. At the time of inspection we found that no person using the service was subject to DoLS.

We saw that people's nutritional requirements were being met and choices were offered throughout the day around meals. We observed people making themselves snacks and drinks throughout the day and contributing to the preparation of meals. We saw the food was freshly prepared and served at a suitable temperature. We noted appropriate referrals had been made to dieticians and instructions were strictly followed in cases where people had known dietary requirements.

We saw positive staff interaction and engagement with people using the service. Staff addressed people in a respectful and caring manner. The service had a calm and warm atmosphere. We observed people laughing and conversing. One person told us “The staff are my friends”.

People using the service indicated they were happy with the service. We saw positive feedback from people using the service by means of ‘service user questionnaires’ and feedback at service user meetings. We also noted positive feedback from relatives and staff about the registered manager. People told us they were happy to approach management with any concerns or questions. We saw evidence that an open door policy was followed.

Inspection carried out on 2 July 2013

During a routine inspection

There was clear sensitive communications between the staff and people using the service, with the staff taking time to listen and wait for responses during conversations. Throughout the inspection we saw staff were regularly interacting with people who lived at the home, helping them to go out to appointments and undertake various other personal tasks.

People were not left alone for long periods and were given time to spend quietly, if preferred. We saw that staff treated people with respect and communicated with them regularly.

We reviewed information about two people's care. We found that the staff understood people's care needs and how to protect them from risk and harm. Records we looked at showed people's needs were assessed and care and treatment was planned and delivered in line with the individual care plan. We found that the care plans were accompanied by risk assessments and risk management plans to ensure people were protected from unsafe care practices.

We found that there were effective systems in place for the safe storage and administration of medicines.

We saw that there were effective recruitment procedures in place to ensure that people who used the service were protected from harm through good staff recruitment. processes.

Inspection carried out on 8 January 2013

During a routine inspection

People told us they were satisfied with the quality of care and support they received. We were told the staffing levels were sufficient to meet the needs of people and that the staff were professional, caring and friendly.

One of the people we spoke with made various positive comments about the staff team: "They have always helped me to do the things I need to do and make life better" and "We are a family who really like each other".

People were provided with care plans that are regularly reviewed so that people have the most appropriate support to meet their needs and if these needs change, the support they received is amended to reflect those needs.

People said they felt safe living in the home and were able to discuss concerns or issues with the staff if they wished to. We saw that the people using the service are involved in planning their care and are in control of how their support is provided for them.

Risk assessments were reviewed regularly in respect of the person's needs, the environment and behaviour so that service users and staff are safeguarded.

Inspection carried out on 18 July 2011

During a routine inspection

People told us that that they were provided with a good standard of care. They were involved in the planning of their care and were supported with their medication. They said that they were given choices in many aspects of their daily lives. Their views were respected and staff encouraged them to be part of the local community and to use the local facilities for education and leisure.

The staff along with other professionals assess the needs of the people before they offer a service so that they can be assured their needs can be met by the staff team.

We met the four people living at the house on the day of our visit. All were able to communicate well with us and told us about living at the home

We were told that people who live there like being in the area and enjoy lots of activities, some of which are associated with leisure and others with educational, particularly help with reading and writing. People are able to go on day trips to places of interest, visit their families and friends, go shopping, visit the cinema, and go to the local cafés and other local amenities. The town centre is within walking distance.

We saw that people were able to decorate their own rooms to their liking and to have things with them that they valued. They were also able to take part in decorating the communal areas and choosing fixtures and fittings.

One person told us that he “likes living here” and likes going out to eat and going bowling with members of staff. He told us that he feels safe and that he is well looked after. He said that he gets people coming to visit him too, including his family, which he enjoys.