Heatherdene

Heatherdene is a residential care home providing personal care to 7 people at the time of the inspection. The service can support up to 10 people.

People living at Heatherdene were supported with a range of mental health conditions, including schizophrenia and were supported to enable them to live independent lives. Heatherdene provides care and support in one adapted building. At the last inspection, changes were taking place to make the adjacent side of the building into a supported living service where some people were being supported to move into. At this inspection, this work had been completed and Heatherdene operated as a separate entity to the supported living service.

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

People told us that they were happy living at Heatherdene. People were supported by staff who understood their physical, emotional and mental health needs. People were kept safe from harm.

The needs of people living with mental health conditions were well supported. People were cared for by staff who had the right skills and knowledge to meet their needs effectively. The provider carried out appropriate checks to ensure that suitable staff were employed. Risks to people had been assessed and actions put in place to mitigate those risks.

People’s health was properly managed and supported. People were supported to access healthcare services and staff ensured that specialist health support was sought when needed. People lived as independent a life as possible and staff supported them to maintain this independence.

People were supported by kind and caring staff who understood their emotional and physical needs. People were treated with respect and staff supported them to lead as independent life as possible.

People received person centred care that was responsive to their needs. People were supported with occupation and engagement.

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.

People were supported by an open, transparent and approachable registered manager. There was a system of checks and audits in place to ensure that any issues were identified, and so improvements could be made.

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 (last report published 23 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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.

There is a registered manager at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

This was an unannounced inspection which meant the provider and staff did not know we were coming. It took place on 31st July and 1st August 2017.

At the time of the inspection there were changes taking place at the home with part of the service being changed to supported living. Some people living at Heatherdene were going to move into the supported living part of the service. Everybody had been involved in discussions about these changes and being supported by staff and social care professionals to make the changes.

We last carried out an inspection at Heatherdene in June 2016 where we rated the service ‘requires improvement’ however there were no breaches of regulations. This was because we found some areas of practice that needed to improve. At this inspection we found that improvements had been made and the provider had addressed these concerns.

People received support from staff who knew them well. They had a good understanding of people’s individual needs, choices and preferences. They understood how people liked to receive their support and worked with people to ensure they received the support they required. Staff were kind and patient; they treated each person as an individual and supported them to maintain their dignity.

Staff were aware of the risks associated with supporting people and knew what steps to take to ensure people remained safe, but retained and improved their independence. There was guidance in place for staff to follow. There were enough staff to support people safely; they received the training and supervision they needed to help them meet people’s needs. Staff had been appropriately recruited and were suitable to work at the home. There were systems in place to ensure people received their medicines as prescribed.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and people were supported to make their own decisions. People had a choice of what to eat and drink throughout the day. They were encouraged to maintain a healthy diet. People were supported to maintain good health and they had access to relevant healthcare professionals when required.

The registered manager was well thought of by people and staff. There was an open and positive culture at the home which was focussed on ensuring people received good person-centred support and developing their independence.

A quality assurance system was in place to monitor the service and the quality of support people received. This meant areas for improvement were promptly identified and addressed.

There is a registered manager at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

This was an unannounced inspection which meant the provider and staff did not know we were coming. It took place on 7 and 9 June 2016.

Staff were kind and caring and treated them with the respect they deserved. People were listened to, their views were respected and acted on. Staff provided people with the individual and personalised support they required. However, recent changes at the home meant that people’s future needs may not be met.

People were supported by staff who knew them well however their records did not always reflect the support they required and received. There was an audit system in place however; this had not identified some of the shortfalls we found. There was a lack of PRN guidance in relation to people’s medicines and there was no assessment of the potential impact from the smoking room on people who lived and worked at the home.

Staff had a good understanding of the risks associated with the people they supported and knew what actions to take to ensure they remained safe. They had a good understanding of how to safeguard people from the risk of abuse.

There were enough staff, who had been safely recruited working at the home. Staff were well supported and received the appropriate training to enable them to meet people’s individual needs. Staff had an understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards.

People were supported to see the appropriate healthcare professionals when they needed to, to ensure they remained healthy. They were supported to eat food and drink of their choice. They were encouraged to maintain a healthy diet.

Feedback received from people was positive about the support they received, the approach of the staff and atmosphere in the home. There was an open and positive culture which focussed on people. The staff told us they felt supported and listened to by the registered manager.

People we spoke with told us they were happy living at the home. One person said, 'This is the best place I have lived.' Other people told us they were able to do what they liked during the day and were supported by staff.

We observed staff knew people well and interacted with people in a relaxed, supportive and respectful way.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

Is the service safe?

People who used the service were protected from the risk of abuse because the provider had taken steps to identify the possibility of abuse and prevent abuse from happening. There were systems in place to ensure that management and staff learnt from events that adversely affected the people using the service.

Is the service effective?

People received effective care from staff that were trained and supported by the manager. People were involved in assessments of their health and care needs and in writing their plan of care so they understood the information that was written about them. Staff encouraged and supported people to keep healthy and well through regular monitoring of people's general health and making sure they attended scheduled medical and healthcare appointments.

Is the service caring?

There were processes in place that ensured people who used the service were able to contribute to discussions about how they preferred to be cared for and supported. People were supported by attentive and patient staff. We saw staff give encouragement to people and these interactions were caring and compassionate. Staff respected peoples' privacy, dignity and right to be involved in decisions and make choices about their care. People we spoke with told us they were well supported and happy with the care that they received in the home.

Is the service responsive?

There was an effective complaints system available. Comments and complaints people made were responded to appropriately. We found staff continually monitored people's condition and where necessary sought advice and assistance from other community based health and social care professionals.

Is the service well-led?

People who used the service appeared at ease in their surroundings. People who used this service were able to make choices with regard to their daily lives such as what they would like to wear or to eat or whether they would like to join in any activities. Staff helped them in the way that they preferred and they had their wishes, privacy, dignity and independence respected. The provider carried out regular checks to assess and monitor the quality of the service provided. In this way the provider ensured that the quality of the service was maintained.

We examined the home's safeguarding policy and procedures and spoke with staff. Staff were clear about their responsibility in relation to safeguarding vulnerable adults and had a good understanding of what constituted abuse.

We looked at the safety and suitability of the home in terms of the people who lived there. We found that it was suitably designed and maintained to a good standard.

We examined four staff files including the home's most recently recruited staff member. We found that there were robust systems in place in relation to recruitment and selection of staff and all appropriate checks were completed before staff were allowed to work unsupervised at the home.

We examined the home's complaints policy and procedures and found that there was an effective complaints system available and people were supported to have their concerns heard.

People we spoke with were happy to be living at the home. They enjoyed the level of independence and privacy that the way they were supported gave them. People told us they were able to organise their own days. They said that staff support was always available if they wanted. We saw that they were able to make drinks and snacks for themselves when they wanted, subject to risk assessments having been carried out.

The staff we spoke with were well qualified, knowledgeable about people's needs and familiar with the support people needed.

We saw the service ensured that staff were able to deliver care and treatment safely due to the training and audits in place.

The home set out to support people to be as independent as possible. We saw evidence of this in the way people came and went freely and the interaction between staff and people who lived at the home.

The home had quality assurance systems to assess their performance and ensure standards improved. This included canvassing the views of people who lived there, their relatives and staff.