2 November 2021
During an inspection looking at part of the service
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.