Heaton House

Updated 3 February 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 under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors from the Children’s Services Inspection Team.

Service and service type

Heaton House is a residential children's home that provides care and treatment to children and young people under the age of 18 who are experiencing poor emotional and mental health. Three children were living there and receiving care and treatment at the time of our inspection.

There was no registered manager. There was a new manager who planned to make a registered manager application. We have referred to them throughout this report as the manager. The provider is legally responsible for how the service is run and for the quality and safety of the care and treatment provided. We have referred to them throughout this report as the provider.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection we reviewed all the information we held in our systems about the location and the provider. This included information the provider had sent to us as part of their legal responsibility to notify us of certain types of incidents and events, such as serious incidents and injuries involving the police.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection-

We spoke with two of the three children living there about their experience of their care and treatment. We also spoke with ten members of staff, including residential support workers, managers, members of the mental health team and executive team.

We reviewed a range of records. This included parts of all three children’s records that were relevant to our focus for this inspection. We looked at records in relation to staffing, training and supervision, incident reporting and debriefs following episodes of restraint. We also looked at risk management recording, recording of auditing processes and documents that relate to the management of the service and service issues.

After the inspection –

Following our visit, we spoke with all three of the children’s social workers, the independent mental health advocate and the district nursing team.

We continued to seek clarification from the provider to validate evidence found. We looked at terms of reference and minutes for staff support groups and management monitoring.

Updated 3 February 2022

The published date on this report is the date that the report was republished due to changes that needed to be made. There are no changes to the narrative of the report which still reflects CQCs findings at the time of inspection.

About the service

Heaton House is a residential therapeutic placement for children aged under 18 with emotional and mental health needs. The primary regulator is Ofsted because Heaton House is categorised as a children's home. However, the provider, Nestlings Care Ltd, is also registered with the Care Quality Commission because they carry out the regulated activity 'Treatment of disease disorder or injury' from this location.

Heaton House is a home providing accommodation for up to four children. At the time of our inspection there were three children living at Heaton House.

Children’s experience of using this service and what we found:

Children told us that they felt included in their care. They understood their treatment plans and they felt able to raise concerns when they needed to.

The location had recently undergone some refurbishments. The children spoke positively about the changes that had been made. Children had choices about what they ate and took an active role in choosing daily activities.

Children told us that they didn’t always hear the outcome when they give feedback on their care. This limits their ability to be fully included in their home life. We have made a recommendation to the provider to address this.

We have also recommended that the provider review their complaints process to make it easy to see what complaints have been made and how they have dealt with them.

Children 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.

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 Effective and Well Led key questions, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• The provider used positive behaviour support plans and there was careful transition planning when children moved into the home. Children know what they can ask for help with and this maximised their opportunities for support and independence.

Right care:

• Care planning and communication to all staff promoted people’s dignity, privacy and human rights.

Right culture:

• Leaders and care staff were open and honest. People knew they could raise concerns, and this was important to support inclusion.

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)

At the last inspection of this service (published 17 December 2020) there was one breach of regulation (regulation 10). The provider completed an action plan after the last inspection to show what they would do and by when to improve. We reviewed this breach (published 16 September 2021) and found that the provider had made improvements and were no longer in breach of this regulation.

Why we inspected

We received concerns in relation to staffing and the impact on patient care. As a result, we undertook a focused inspection to review the key questions of effective 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.

We have found evidence that the provider needs to make improvement. Please see the well led sections of this report.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to good governance at this inspection. This was due to a lack of effective systems to assess and monitor improvement at this location.

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 to address the concerns that we have identified at this inspection. 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.