Lutterworth View

Updated 29 November 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and a specialist advisor, who had experience of working and supporting people with a learning disability and autism.

Service and service type

Heathcotes Lutterworth View is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement dependent on their registration with us. Heathcotes Lutterworth View is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 30 minutes notice of the inspection on 28 September 2022 and announced on 29 and 30 September 2022. 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. We returned unannounced on 12 October 2022, to complete the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people and observed staff interactions with 3 people who could not talk with us to further help us understand their experience of the care they received. We spoke with 4 relatives, social workers, local authority finance officer and a teacher at the college. We spoke with 10 members of staff including support workers, care team leaders, the registered manager, and regional manager. We also spoke with the regional manager and 2 staff from the positive behaviour support team.

We used the Quality of Life Tool which is designed to support the corroboration of all sources of evidence gathered during inspection. We reviewed a range of records. This included seven people's care records and a sample of medication records. We looked at other records relating to the management of the service, including three staff recruitment records, supervisions and training information.

After the inspection

We continued to seek clarification from the provider to validate evidence found. A variety of records relating to the management of the service, including policies and procedures and quality assurance records.

Updated 29 November 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities which most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Heathcotes Lutterworth View accommodates 8 people in one adapted building. At the time of our inspection there were eight people using the service.

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

Risks to people had not been fully assessed to protect them from harm. People’s sensory needs had not always been assessed. Staff were not able to clearly describe how and when ‘as required medicines would be administered. There was no mechanism to review the protocols for these medicines.

Staff were recruited safely and received induction and training for their role. Staff understood how to support people. Staff knew how to protect people from the risk of abuse and how to report any concerns.

People, staff and most relatives told us, and records showed the registered manager was making improvements in the service. Further action was needed to strengthen the governance system to ensure records were completed fully in relation to people’s care and incidents and concerns.

Most people felt safe with the staff and the support provided. However, we received concerns about risks to people’s safety and made several safeguarding referrals to the local authority for further investigations.

Support plans were personalised and focused on all aspects of people’s lives including their individual needs, preferences, aspirations and equality and diverse needs. Staff understood their role and how to support people to meet their needs. People could take their medicines in private when appropriate and safe.

People and most relatives told us they knew how to complain if they were unhappy about any aspect of the care and support provided. Concerns received from a relative and professionals had been shared with their registered manager.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right Support

People were supported by enough staff to meet their care needs. People had a choice about their living environment and were able to personalise their rooms. The service had enough staff, including for one-to-one support for people to take part in activities. People were supported to continue to with their education and work on a regular basis.

People were supported to maintain contact with their relatives and staff encouraged people to take part in community-based activities and hobbies. However, at times people could not go on outings and visits when they wanted to if the care home’s vehicle was already being used to support another person. Alternative transport had been considered but it was not always safe or suitable.

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.

Right Care

People told us they liked the staff who supported them. Staff protected and respected people’s rights and choices. People’s communication needs were identified. Staff ensured information was available in a suitable format so people could understand. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture

The registered manager and staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. The registered manager had the skills, knowledge and experience to perform their role and was improving the culture where people were at the heart of everything they did.

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 2 July 2019).

Why we inspected

We received concerns about the service from health and social care professionals in relation to the management of risks to people and the use of restraint, promoting social engagement and activities and, staffing and oversight of the service. As a result, we undertook a focused inspection to review the key questions of Safe, Responsive and Well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Enforcement and recommendations

We have identified a breach of regulation because risks to people’s health, safety and welfare had not been adequately assessed, mitigated and kept under review, at this inspection. Please see the Safe, section of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heathcotes Lutterworth View on our website at www.cqc.org.uk

Enforcement and Recommendations

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.