Bridlington

Heathcotes (Bridlington), is a care home providing personal care for up to twelve people with a learning disability and/or autism, with a specialism in prader willi syndrome. Prader willi syndrome is a rare genetic disorder that results in a number of physical, mental and behavioural problems. A key feature is a constant sense of hunger. At the time of our inspection twelve people lived at the service.

People’s experience of using this service

Without exception, all feedback received about the support provided to people was extremely positive. People who lived at the service received extremely high-quality, personalised support from a passionate and committed staff team. The staff team were partners in an exceptionally well-led service.

Staff were fully committed to providing a truly person-centred service. Staff were very proud to work for the service and said they received superb support from the registered manager. People said staff were undoubtedly caring and knew their needs very well.

People’s health was extremely well managed. People’s life had significantly improved from the support they received with their nutrition. Health outcomes had greatly improved for people living at the service including reduced reliance of medicines to support health conditions. People had clear guidance and consistency regarding food and diet and they responded well to this.

The staff team were extremely skilled in effective communication to ensure people felt supported and relaxed. This impacted on people’s behaviours and ability to build relationships with family and friends.

The registered manager provided strong leadership and constantly considered how they could enhance the service. They were creative and innovative at looking for ways to meet individuals needs and created packages of support to suit them in line with best practice. There was a solid structure of governance embedded in the service and action plans drove forward any areas for improvement. There was excellent team work within the service.

People were fully integrated into the local community. They had access to a variety of activities which enhanced their wellbeing and sense of purpose. Complaints procedures were in place and followed. People’s wishes at the end of life were explored.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Risk was extremely well managed, and the service was creative to look at positive risk taking. Recruitment checks were in place to ensure staff were suitable to work at the service. Staff had received training and support to enable them to carry out their role. Relatives felt staff were excellently trained in their role.

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 received their medicines safely and on time.

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 23 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

At the last inspection, the service was rated overall as Good. At this inspection we found the service remained rated overall as Good, but with an improved Outstanding rating in 'caring'.

Staff were exceptionally caring, paying attention to people’s well-being, privacy, dignity and independence. Staff showed they had provided care over the last few years that was over and above what was expected of them in order to ensure people felt valued.

Staff assisted people in outstanding ways to maintain their well-being, by enabling them to experience excellent self-esteem through structured programmes of care underpinned by clear boundaries for behaviour. Boundaries which everyone, staff and people that used the service, agreed were essential to people’s safety and, in the extreme, saved people's lives.

It was this continued staff approach and attention to detail that enabled people to modify their lifestyles while living with Prader Willi Syndrome. This ensured they lived safe lives where personal development became a way of life. Staff upheld principles of equality and diversity and championed people’s rights when out in the community or receiving healthcare and other services. Care for people that used the service was outstanding.

Systems continued to be in place to ensure people that used the service were safe in respect of safeguarding incidents, the premises, staffing levels, recruitment, management of medicines and infection control.

Staff were skilled to carry out their roles and received induction, training and support, which enabled them to care for people to a high standard. The registered provider maintained an environment that was suitable to meet people’s social and personal care needs.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The service exceeded in its support to people regarding their nutritional needs and lifestyles.

People’s support plans continued to be person-centred and people continued to undertake activities, education and employment wherever possible. People followed the complaint procedures to have their views listened to and their needs met.

The service continued to operate an open and inclusive management style where people fully participated in the running of the care provision. A quality assurance system still operated so that people made their views known and quality audits were completed, with the aim to improve the quality and delivery of the service.

Further information is in the detailed findings below.

People told us that they were consulted about their care and were able to make their own decisions about life in the home. People felt staff respected their privacy and dignity. One person said "Staff talk to us about our care and we can make decisions about what we want to do each day."

We found people were being looked after by friendly, supportive staff within a warm and homely environment. Care was personalised and reflected people’s choices and decisions. Care records were up to date.

There were robust policies and procedure in place with regard to safeguarding of vulnerable adults from abuse. Staff told us who they would contact if they were concerned about abuse of people who used the service.

People we spoke with said they preferred the staff to give them their medication and that they usually received this on time and when they needed it. We found there were safe and effective medicine practices being utilised within the service.

Staff had received appropriate professional development and training to ensure they could meet the needs of the people who used the service.

The provider had an effective quality assurance system in place and people’s views and opinions of the service were listened to and acted on where necessary.