Leeds and Morley

Heathcotes (Morley) is a 15 bed specialist residential service for adults with a learning disability, autism spectrum disorder, mental illness and who may have dual diagnoses and associated complex needs. The service is split into two neighbouring homes with 24 hours support; one has seven beds and the other has eight beds.

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.

Thirteen people were using the service. This is larger than current best practice guidance. However. the size of the services having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

Care plans described the support people needed. These were in accessible formats and included information from external healthcare professionals.

Medicines were managed safely. People were supported and encouraged to manage their medication independently.

People's dietary needs and preferences were met and people were involved in shopping for and cooking their meals.

People were supported to have maximum choice and control of their lives.

People were safely supported and protected from harm or abuse. Safeguarding systems in place supported this. Staffing levels were safe and new staff were recruited using robust procedures. Staff learnt lessons after dealing with problems.

People were empowered to live full and active lives. They had jobs if they chose to and took part in a variety

of activities and were supported to maintain relationships with family and friends.

Staff were kind and caring and knew all the people and their diverse needs. Staff understood their roles clearly and knew what was expected of them. People were treated with respect and dignity, they were also supported to maintain their independence.

Staff provided responsive care, adapting this as people’s needs changed. People and relatives felt their feedback was welcomed and were confident any concerns would be acted on appropriately.

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

Rating at last inspection

The last rating for this service was good (published 25 January 2019).

Why we inspected

The inspection was prompted in part due to intelligence that suggested the rating might have deteriorated. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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.

People’s experience of using this service:

People and their relatives gave positive feedback about the care they received, and their experience of the service. Staff showed genuine dedication to deliver care in a person-centred way, based on people's preferences. People were observed to have good relationships with the staff and management team. Relatives told us they believed their family member had a good quality of life at Heathcotes (Morley).

People were protected from abuse and avoidable harm. Staff had completed training in how to safeguard people and risk assessments were completed to identify potential hazards. Risk assessments were in place, which provided staff with guidance on how to maintain people's safety. The provider ensured robust recruitment procedures were in place.

Staff had received appropriate training and support to enable them to carry out their role effectively and safely. There were enough staff to meet people's needs and people's rights, privacy and dignity were maintained at all times. Staff told us they were supported by the management team and found them to be approachable. Staff received supervision and appraisal of their work performance.

Care plans described the support people needed. These were in accessible formats and included information from external healthcare professionals. Medicines were managed safely. People were supported and encouraged to manage their medication independently. People's dietary needs and preferences were met and people were involved in shopping for and cooking their meals.

People were empowered to live full and active lives. They had jobs if they chose to and took part in a variety of activities and were supported to maintain relationships with family and friends.

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.

The provider monitored the safety and quality of the service. Accidents and incidents were analysed so that lessons could be learned. The culture of the service was open and people, relatives and staff felt able to raise concerns. More information of the findings is available within the full report.

Rating at last inspection: Requires Improvement (published 29 December 2017).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated good. If any concerning information is received we may inspect sooner.

Heathcotes (Morley) is a 15 bed specialist residential service for adults with a learning disability and, or autism spectrum disorder, mental illness and who may have dual diagnoses and associated complex needs. The service is split into two neighbouring homes, one seven bed and the other eight bed with 24 hour support.

The home had a registered manager. 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 who used the service were supported by staff who understood the importance of protecting them from harm. Staff had received training in how to identify abuse and report this to the appropriate authorities. Staff had been recruited in a safe way and had appropriate background checks done on them. Staff were provided in enough numbers to meet the needs of the people who used the service. Staff had a good knowledge of people who used the service and their personal preferences.

People were supported in a respectful and dignified way. People and their relatives expressed their comments around how they were supported. People were involved in the care planning process and were aware of their plans.

Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring. Medicines were managed safely with an effective system in place. Staff competencies, around administering medication, were regularly checked.

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.

Staff had not always have an understanding of Mental Capacity Act 2005. We saw documentation that showed people had been referred for a Deprivation of Liberty Safeguards (DoLS) when it was believed they had capacity.

People were able to choose meals of their choice and staff supported people to maintain their health and attend routine health care appointments. The service worked with various health and social care agencies and sought professional advice to ensure individual needs were being met.

People who used the service had access to a wide range of activities and leisure opportunities and were encouraged to participate in activities and hobbies that they had enjoyed prior to accessing the service. A wide range of activities were provided and included involvement and use of the local and wider community based facilities.

The provider used questionnaires to obtain regular feedback from relatives, staff and stakeholders about their experience of the service.

Staff told us they enjoyed working at the service and felt supported by the management team. Quality assurance processes were in place and regularly carried out by both the provider and the registered manager to monitor and improve the quality of the service. However the audit process had not identified issues we raised with the provider during the inspection.

Feedback was sought from people who used the service through regular 'resident meetings'. This information was analysed and action plans produced when needed.