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Heathcotes Cranbourne House Requires improvement

Reports


Inspection carried out on 10 November 2020

During an inspection looking at part of the service

About the service

Heathcotes Cranbourne House is a residential care home for adults with a learning disability who may have dual diagnoses and associated complex needs. The home accommodates 8 people. At the time of the inspection there were 7 people living at the home.

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

Staff did not always follow the provider’s COVID-19 policy or infection and protection government guidelines. This posed a risk where staff could transfer infection.

Staff understood the importance of safeguarding and the provider worked closely with the local authority. Issues regarding safety and risk were being overseen by the safeguarding team.

Medicines were managed safely. There were close links with health professionals and other agencies to ensure people’s health needs were met and changes responded to promptly. People had detailed person-centred care plans.

Recruitment was managed safely and there were enough trained and experienced staff to meet people’s needs.

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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

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

Cranbourne House looked like a large family home and there were no identifying external signs to indicate the house was a care home. All the bedrooms had en-suite facilities and people had been supported to personalise their rooms. The home was within easy access of local amenities. Staff were discouraged from wearing uniforms. The model of care maximised people’s choice, control and independence. People had access to specialist and mainstream support with their health and social needs.

People received person-centred care which promoted their dignity, privacy and human rights. People were supported to follow their interests and take part in activities in the local community. People were supported to be involved in the day to day running of the home. Accessible information including pictures and symbols was used to support their understanding and engagement.

Staff had completed Non-Abusive Physical Intervention (NAPPI) training. This meant they used positive behaviour support plans and de-escalation techniques to support people and minimise the need for physical interventions. The registered manager and care staff demonstrated the values and attitudes to support people using the service to lead inclusive lives. Some poor practise including staff working in cliques had recently been identified. The provider had responded to this promptly and completed a detailed action plan. This included changing the way rotas operated and increased staff supervision.

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 the service was good (published 27 August 2019).

Why we inspected

We received concerns in relation to the people not being protected from abuse. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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

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 comprehe

Inspection carried out on 24 July 2019

During a routine inspection

About the service

Heathcotes Cranbourne House is a specialist residential service for adults with a learning disability who may have dual diagnoses and associated complex needs. The service has eight en-suite bedrooms and provides twenty-four-hour support. At the time of our inspection, six people were living at this service.

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.

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.

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

People felt safe living at this service as they were supported by staff who had received training in recognising and reporting abuse.

There were sufficient numbers of staff in the home to meet people’s needs. Staff were recruited using safe procedures and on occasions, one person who lived in the home was part of the interviewing process.

Instances when staff needed to use legal forms of restraint had significantly reduced. Low level forms of restraint were occasionally used at the time of inspection. At the same time, people’s dependency levels had reduced. This had been achieved through building relationships between people and staff based on trust, discussion with relevant professionals and careful risk assessing.

Medication was safely managed as people received their medication as prescribed and the systems to support this were effective.

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.

Positive outcomes were seen where people had specific dietary needs. People had been assisted by staff to manage their diet and we saw they had lost or gained weight in line with their health needs. Other specific dietary needs relating to risk and religion were being met.

The registered manager and staff team worked in partnership with a range of professionals. People had health action plans which showed the involvement of health professionals in meeting their needs.

People and one relative told us they liked the staff who provided their care and support. Through our discussions with staff and examples of interactions we observed, we concluded people were supported by staff who knew their needs well. People’s privacy and dignity was respected and they were encouraged to live independent lives.

People had a wide range of risk assessments to support activities of daily living both inside and away from the home.

Care plans were sufficiently detailed and person-centred. They provided essential information for staff to provide effective care. Regular reviews of care plans were taking place. People received social stimulation both within and away from the home.

Complaints were dealt with appropriately. The service was well-led by a registered manager who was motivated and ensured their staff team received formal and informal support. Audits and spot checks showed oversi