Derby

Updated 13 July 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was undertaken by one inspector, a specialist nurse advisor and one expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Heathcotes Derby is a ‘care home’. 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small, and people are often out, and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account to plan our inspection and made the judgements in this report.

We reviewed information we received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and two relatives about their experience of the care provided. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with three members of support staff and the registered manager. We spoke with a paid person’s representative (PPR), an independent advocate who supports a person to make decisions about their care. We reviewed a range of records. This included three people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the registered manager provider to validate evidence found. We looked at training information and the analysed quality assurance records. We spoke with two relatives and commissioner who works with the service.

Updated 13 July 2019

About the service

Heathcotes Derby is a residential care home. The service was a large home, bigger than most domestic style properties. It is registered to support up to eight young people from the age of 13 years and over. There were seven people in residence.

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. There were deliberately no identifying signs, intercom, cameras 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 with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes.

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

The service needed to strengthen the quality monitoring systems to ensure checks and audits were completed in a timely way. The registered manager assured us these issues would be addressed with staff training and increased monitoring.

People continued to be cared for safely. Risks to people’s health, safety and welfare were assessed, managed and monitored on an ongoing basis. Staff encouraged positive risk taking and promoted people’s independence.

Staff continued to support people to maintain good health. People were involved in meal preparation and healthy eating was promoted. People were supported with their medicines and had prompt access to healthcare support when needed. Health action plans were in place, so people’s wishes as to unplanned medical treatment were identified. Procedures were in place for people to express their wishes in relation to end of life care.

Effective systems and policies were in place to ensure staff were appropriately recruited. Staff continued to be trained to the appropriate level to provide effective care and support. There were enough staff to meet people’s needs. Staff worked flexibly and had a consistent approach to promote people’s wellbeing and independence.

The service applied the principles and values consistently of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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.

Staff were caring and treated people with kindness, dignity and respect. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. Staff encouraged people to follow their interests and people were supported to access many varied activities and interests. People’s care plans and information was available in formats people could understand.

People felt staff and management were approachable, acted on concerns and their views were sought to develop the service.

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 22 February 2018).

Why we inspected

The inspection was prompted in part due to concerns received about people’s safety. A decision was made for us to inspect and examine those risks.

Follow up

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