Derby

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.

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.

Heathcotes Derby accommodates up to eight people. The accommodation includes shared bathrooms, toilets, lounge, dining room and kitchen facilities. At the time of our inspection there were seven people in residence.

Heathcotes Derby 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.

This was our first inspection of the service since they registered with us on 12 October 2016.

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 told us they felt safe using the service. A range of risk assessments were completed, managed and reviewed regularly. People were involved and made decisions about all aspects of their support and were encouraged to take positive risks.

Staff knew how to keep people safe and understood their responsibility to protect people from the risk of abuse. Staff were safely recruited and there were sufficient numbers of staff to provide the care and support people needed.

People received their medicines at the right times. People were involved in planning and the preparation of meals. Cultural dietary needs were met. People had access to a range of specialist health care support. The registered manager and staff worked closely with relevant health care professionals to ensure people’s ongoing health needs and goals to live independently were met.

Staff received comprehensive induction and ongoing training which helped them to understand the needs of the people they were supporting. Staff worked closely with health care professionals to support people with complex needs. Staff received support and guidance through supervision and meetings to meet people’s needs effectively.

People were involved all aspects of their care and decisions made were documented. They 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 received responsive and personalised care and support that promoted their daily living skills, and enabled them to achieve their aspirations and goals to live independently as possible. Care plans and relevant information was made available in accessible formats to help people understand their care and support plans. Care records were reviewed and kept up to date. These provided staff with clear guidance and information to meet people’s ongoing needs.

People told us they were treated as individuals and their values; cultural diversity and lifestyle choices were respected. People took part in activities that were important to them both at home and the wider community. Staff worked in a flexible way so that they could meet people's needs in a person centred way.

People were supported by kind, respectful and caring staff that knew them well. Staff had developed positive trusting relationships with people who were skilful in their interactions with people and focussed on promoting their independence. Staff treated people with dignity and respect. The design of the environment helped to ensure people’s privacy was promoted.

People knew how to raise a concern or to make a complaint. The provider had a complaint policy and procedure and complaints received were investigated.

Staff spoke positively about the registered manager in relation to the support provided and their leadership. Staff were confident to raise any issues with the registered manager and their views were sought in how to improve the service and the lives of people who used the service.

The registered manager was approachable and people felt confident that any issues or concerns raised would be addressed and appropriate action taken. The registered manager and staff team were committed to providing quality care. The registered manager showed an awareness of their legal responsibilities. They kept their knowledge up to date with legislation and best practice and worked with outside agencies to continuously look at ways to improve the experience for people.

The service had a culture of openness and continues learning and development for the staff team. The service learnt lessons from incidents and made improvements when things went wrong. The provider’s governance system to monitor and assess the quality of the service was used effectively to improve the service and looked at ways in which people were supported to achieve greater independence.