Heathcotes (Bridlington) is a residential care home for 12 people with a learning disability, including specialist care for people with Prader Willi Syndrome. The care home provides single occupancy accommodation on two floors in the main house and in flats within a separate annexe building, also on two floors. There is a choice of lounge and dining space for people to use in the main house. Some bedrooms have en-suite toilet and/or shower facilities.

At the last inspection, the service was rated overall as Good. At this inspection we found the service remained rated overall as Good, but with an improved Outstanding rating in 'caring'.

Staff were exceptionally caring, paying attention to people’s well-being, privacy, dignity and independence. Staff showed they had provided care over the last few years that was over and above what was expected of them in order to ensure people felt valued.

Staff assisted people in outstanding ways to maintain their well-being, by enabling them to experience excellent self-esteem through structured programmes of care underpinned by clear boundaries for behaviour. Boundaries which everyone, staff and people that used the service, agreed were essential to people’s safety and, in the extreme, saved people's lives.

It was this continued staff approach and attention to detail that enabled people to modify their lifestyles while living with Prader Willi Syndrome. This ensured they lived safe lives where personal development became a way of life. Staff upheld principles of equality and diversity and championed people’s rights when out in the community or receiving healthcare and other services. Care for people that used the service was outstanding.

Systems continued to be in place to ensure people that used the service were safe in respect of safeguarding incidents, the premises, staffing levels, recruitment, management of medicines and infection control.

Staff were skilled to carry out their roles and received induction, training and support, which enabled them to care for people to a high standard. The registered provider maintained an environment that was suitable to meet people’s social and personal care needs.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The service exceeded in its support to people regarding their nutritional needs and lifestyles.

People’s support plans continued to be person-centred and people continued to undertake activities, education and employment wherever possible. People followed the complaint procedures to have their views listened to and their needs met.

The service continued to operate an open and inclusive management style where people fully participated in the running of the care provision. A quality assurance system still operated so that people made their views known and quality audits were completed, with the aim to improve the quality and delivery of the service.

Further information is in the detailed findings below.

All of the people who used the service had Prader Willi Syndrome (PWS). This condition can cause a chronic feeling of hunger that, coupled with a metabolism that utilizes drastically fewer calories than normal, can lead to excessive eating and life threatening obesity. We recognised that certain rules and restrictions around food and diet were necessary to maintain a healthy lifestyle for the people who used the service. This is reflected in our report.

People told us that they were consulted about their care and were able to make their own decisions about life in the home. People felt staff respected their privacy and dignity. One person said "Staff talk to us about our care and we can make decisions about what we want to do each day."

We found people were being looked after by friendly, supportive staff within a warm and homely environment. Care was personalised and reflected people’s choices and decisions. Care records were up to date.

There were robust policies and procedure in place with regard to safeguarding of vulnerable adults from abuse. Staff told us who they would contact if they were concerned about abuse of people who used the service.

People we spoke with said they preferred the staff to give them their medication and that they usually received this on time and when they needed it. We found there were safe and effective medicine practices being utilised within the service.

Staff had received appropriate professional development and training to ensure they could meet the needs of the people who used the service.

The provider had an effective quality assurance system in place and people’s views and opinions of the service were listened to and acted on where necessary.

All of the people who used the service had Prada Willi Syndrome (PWS). This condition can cause a chronic feeling of hunger that, coupled with a metabolism that utilizes drastically fewer calories than normal can lead to excessive eating and life threatening obesity. We recognised that certain rules and restrictions around food and diet were necessary to maintain a healthy lifestyle for the people who used the service. This is reflected in our report.

People told us that their experience was a positive one. They were involved in the decisions about coming into the service and staff discussed their care and treatment with them. They were able to make choices and decisions about their daily lives, and the staff respected their wishes and supported their independence.

People told us that they had a good choice of social activities to take part in and the meals provided at the service offered them lots of choice and variety. People said they enjoyed living in the home and the staff were friendly and supportive.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014. The inspection was unannounced. 

Heathcotes, Bridlington is registered to provide accommodation and personal care for up to 12 people with a learning disability or autistic spectrum condition.  All of the people who use the service have Prader-Willi Syndrome, a condition that can cause a chronic feeling of hunger that, coupled with a metabolism that utilises drastically fewer calories than normal, can lead to excessive eating and life threatening obesity.  Certain rules and restrictions around food and diet are necessary to maintain a healthy lifestyle for the people who use the service. Currently there are ten people residing at the home.  There are three flats to the side of the property, two self-contained and one without a kitchen area.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People told us they felt safe living at the home. Staffing levels meant that people received high levels of 1:1 support.  Most people said that staffing levels were good. However the manager may need to review their contingency arrangements to ensure that staffing levels are consistently maintained.

Staff were trained in safeguarding vulnerable adults and discussions with staff confirmed they were clear about what to do should an allegation be made.

Some staff had received training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Additional training was being considered for staff who had not yet received this training. Staff were also trained in non abusive psychological and physical intervention (NAPPI). Recruitment records viewed contained the required information evidencing that only staff suitable to work with vulnerable people had been employed. This helped to protect people who lived at this home.

People told us the service was effective in helping them manage their Prader-Willi Syndrome.

The home had policies, procedures and systems in place which supported staff to deliver care effectively. People told us they were able to make choices and decisions and were involved in discussions regarding their care records.

Staff received training and supervision to support them in their roles. Staff confirmed the training they received supported them in caring for people appropriately.

We received mixed comments regarding the menu choices available. The manager was trying to access support from a nutritionist and we saw evidence to support this.

People experienced a range of social and leisure opportunities and were involved in independent living tasks.

All of the people we spoke with told us they were well cared for. They were positive about the staff who supported them. They confirmed that they were treated with privacy and dignity by the staff who supported them. People told us they had access to their care records.

People told us that the home was responsive to their needs. People chose how to spend their time and said they were listened to. They said that the manager and staff understood their Prader-Willi Syndrome and supported them  in managing this.

People said they knew how to complain and we saw that complaints were appropriately responded to.  People told us they could express their views and opinions and felt listened to by management. Relatives also confirmed this. There were good quality monitoring systems in place to review and develop the service.