Wolsey House

Heathcotes Wolsey House is a residential care home providing accommodation and personal care for up to a maximum of six people in one adapted building. The service provides support to people with a learning disability and autistic people . At the time of our inspection there were six people using the service.

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

People were protected from the risks of abuse and harm and people said they trusted staff to keep them safe. Staff had received training in safeguarding people. Staff we spoke with were confident to report concerns and satisfied that action would be taken to investigate the concerns.

People's care needs were risk assessed and care plans provided staff with the information they needed to manage the identified risk. Accidents and incidents were recorded and analysed. Risk assessments were reviewed following incidents to ensure the service was meeting the needs of people appropriately. Medicines were managed safely. People’s medicine needs were risk assessed and they were supported to manage their medicines independently where appropriate. Staff were trained to administer medicines. Appropriate infection prevention and control measures were in place.

Recruitment checks were robust to ensure staff were suitable to work with vulnerable adults. During the inspection we observed appropriate levels of staffing to support the people who used the service.

The registered manager and staff demonstrated a commitment to people and they displayed strong person-centred values. Staff praised the registered manager and wider management team, they felt supported in their roles. The service worked in partnership with other health and social care organisations and the community to achieve better outcomes for people using the service.

People’s views and decisions about support were incorporated in their care plans. This helped staff to support people in a way that allowed people to have control over their lives. There was a good culture within the service which had a positive impact on people.

Staff, people and their relative's views had been sought through regular contact, surveys and quality monitoring. Regular management and staff meetings were held. Regular meetings with people also took place where people had the opportunity to express what they thought about the service and whether anything could be improved.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people .

Based on our review of key questions safe and well-led, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. Care plans were detailed and person-centred. The care plans provided guidance for staff about how best to support people's needs and preferences; encouraging people’s choice, control and independence.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 13 January 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 31 October 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

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. This included checking the provider was meeting COVID-19 vaccination requirements.

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 requires improvement to good. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Heathcotes Wolsey House is a care home providing accommodation and personal care to four people at the time of the inspection. The service accommodates up to six people living with learning disabilities and autism in one building. This is one of many locations that the provider operates nationally.

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.

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

Overall, people's medicines were managed safely. We found improvement was required with record keeping. Although daily records showed people had received their medicines, we found gaps in the signing of medication administration records (MARs). We found the hand written MARs did not follow National Institute for Health and Care Excellence (NICE) guidelines and were not robust enough to accurately document administration of medicines.

The provider had systems or processes in place that were operating ineffectively as they failed to enable the registered person to ensure accurate, complete and contemporaneous records were being maintained securely in respect of each person.

People told us they felt safe. Staff had a good understanding of how to safeguard people from abuse.

Person-centred care was promoted and people told us the staff knew them well and responded to their needs in a person-centred way.

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.

The service applied the principles and values 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.

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.

The staff and people at the service had prepared a buffet for their Halloween party. People were encouraged to take part in the preparation of the food and had a choice in what they ate. There was a joyous atmosphere.

People told us staff were kind and sensitive. A relative added, “Everybody [management and staff] have gone out their way to make sure [name of person] is well looked after.”

Staff knew people's preferences, likes and dislikes. They provided support in line with legislation, standards and guidance to achieve effective outcomes.

Staff said they were happy working at the service and spoke positively about the management team. Comments included, “We have a good team and [name of manager] is good” and “The atmosphere is good in the home and residents are happy here. I would recommend this home to a family member.”

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

Rating at last inspection

This service was registered with us on 09/11/2018 and this is the first inspection.

Why we inspected

This was a planned inspection based on when the service was registered.

Enforcement

We have identified one breach in relation to regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The registered person had systems or processes in place that were operating ineffectively as they failed to enable the registered person to ensure accurate, complete and contemporaneous records were being maintained securely.

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