Heaton House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

The home delivered effective care and treatment that was consistently aligned with current evidence‑based practice and recognised standards. Staff demonstrated strong teamwork, used effective handover processes, and worked collaboratively with most partners to ensure children received coordinated, timely and appropriate care.

Effective systems supported safe delegation of clinical tasks, with staff trained and competent to undertake delegated responsibilities. Policies and procedures reflected current legislation, including the Mental Capacity Act (MCA) and the Children’s Act, and staff had completed required training. Children were supported to express their views and were given time to make decisions. Processes were in place to minimise restrictive interventions through clear guidance and safe, proportionate practice.

This meant that children’s outcomes were consistently good, and people’s feedback confirmed this.

Inconsistent communication between the home and external partners was reported, which at times affected shared understanding and the oversight of care, although since the inspection the provider has told us they have taken steps to revisit the processes around sharing of information,

The home was led by inclusive leaders who were visible and promoted a culture of openness, honesty and continuous improvement. They maintained a clear focus on improving outcomes for children and demonstrated transparency about risks and challenges within the home, taking proactive steps to address these. Staff reported a supportive working environment with strong relationships between leaders and the wider team. Systems ensured that staff received appropriate supervision, access to development opportunities, and clear processes to raise concerns through an established freedom to speak up framework.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The judgement for Assessing needs is based on the latest evidence we assessed for the Effective key question.

The provider planned and delivered children’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Children benefitted from evidence-based treatment from a multi-disciplinary health team including a physical health nurse, mental health nurse, occupational therapist, assistant psychologist and specialist doctors. Children made good or excellent progress from their starting points. For example, some children who had experienced extended periods of time out of education were now attending school or college regularly and undertaking qualifications to prepare them for adulthood and independence. The children we met had made excellent progress in their ability to manage strong emotions, demonstrated by improved mental health and well-being and a reduction in self-harm incidents.

There was an audit plan in place which was aligned to best practice guidance, including areas such as incident management, infection prevention and control and daily health and safety audits of children’s rooms.

Children did not consistently receive easy read risk management plans and care plans on how best to support them in a format they will understand. Although children's views and wishes were reflected strongly in plans, these were not easily accessible for children in the home. Following the inspection, the provider took immediate steps to develop easy-read care plans for children.

The provider worked well across teams and services to support children. They made sure children only needed to tell their story once by sharing their assessment of needs when children moved between different services.

A robust multi‑disciplinary team (MDT) approach was in place, enabling staff to work collaboratively and consistently to meet children’s individual needs. An established eight‑week care‑planning cycle of reviewing the care plan ensured that support remained structured, purposeful and responsive.

Children’s MDT care plans that we reviewed clearly reflected the child’s overall needs and agreed objectives, which enabled each MDT member to tailor their work to support these shared goals. Care plans were regularly reviewed at MDT meetings attended by health and care professionals involved with the child, with parents and or carers and external stakeholders, such as social workers, invited to attend.

The judgement for Supporting people to live healthier lives is based on the latest evidence we assessed for the Effective key question.

The judgement for Monitoring and improving outcomes is based on the latest evidence we assessed for the Effective key question.

The provider always carefully explained to children what their rights around consent were, made sure they fully understood them and always fully respected these when delivering person-centred care and treatment.

The provider ensured that staff applied the Mental Capacity Act and the Children’s Act in line with legislation and consent was appropriately applied when delivering care and treatment.

Policies and procedures were in place to support staff, reflecting the requirements of relevant legislation and guidance, including the Mental Capacity Act 2005 and the Children’s Act 1989.

Processes were also in place to minimise the need for restrictive interventions. Clear guidance supported staff in the safe and appropriate use of restraint and restrictive practices, ensuring these were only used when absolutely necessary.

Consent documentation was clearly evidenced within the children’s records we reviewed. Appropriate consent was obtained for a range of activities, including independent visitors accessing files, the taking of images, room searches, physical examinations, and agreed interventions. Consent was reviewed monthly with the child, ensuring their understanding and ongoing agreement.

Children's views and wishes were considered. Their voice was captured in care plans; positive behaviour support plans and risk assessment management plans.