Heathcotes (Kirklands) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Heathcotes (Kirklands) is an adult service providing support for up to six people living with a learning disability or autistic spectrum disorder, mental health and physical disabilities in one adapted building.

This inspection took place on 1 and 8 November 2017 and was unannounced. Our last inspection took place on 23 November 2015 when the service was overall rated as 'Good' but rated ‘Requires Improvement’ in the Well-led domain. At this inspection we found the service remained ‘Good’ overall and was now rated ‘Good’ in all domains.

At the time of our inspection, there was a registered manager in post.

Staff had undergone safeguarding training and had access to policies and guidance to enable them to safeguard people from abuse.

People had detailed and comprehensive risk assessments in place which were actively reviewed with them to ensure they remained up-to-date and relevant. Staff understood how to respond to emergencies when they arose.

A high level of staffing had been maintained for the number of people who used the service. People were safe as they were cared for by staff whose suitability for their role had been assessed by the provider.

People received their medicines safely from trained staff who were provided with relevant guidance about the administration of people's medicines.

Staff received a comprehensive induction to their role. People were supported by staff who were offered a range of training opportunities relevant to their role to ensure they could support people effectively. Staff were well supported within their role through the supervision process.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were encouraged to eat a balanced diet and healthy eating was promoted. People were encouraged where possible to be independent in the kitchen.

Staff we spoke with were knowledgeable about people's healthcare needs and people received professional support when required.

Staff were observed to be respectful of people's wishes. People's needs in relation to their privacy and dignity had been met.

People were provided with a pre-assessment prior to moving into the service. People had support making their personalised plans.

People were able to access a range of activities both on-site and in the community. People were encouraged to retain or develop their levels of independence.

There was a clearly defined management structure and staff understood their roles and responsibilities. There was an open and transparent culture within the service.

People had been involved in quality assurance processes and their feedback had been used to make improvements to the service. People's complaints were investigated, responded to and any required actions taken.

Various aspects of the service were audited regularly. The results of audits had been used to improve the quality of the service people received.

Further information is in the detailed findings below.

This was an unannounced inspection carried out on 28 September 2015. This was the first inspection the home had received.

Heathcotes (Kirkland’s) is registered to provide residential accommodation and care for six adults with learning disabilities or autistic spectrum disorder, and other complex needs. At the time of the inspection six people were living in the home.

At the time of this inspection there was no registered manager in post. 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 and associated Regulations about how the service is run.

People and their relatives told us they or their family member felt safe at the home. There were effective systems in place to ensure people’s safety at the home for people who used the service, whilst also encouraging and promoting their independence. Staff could describe the procedures in place to safeguard people from abuse and unnecessary harm. Recruitment practices were robust and thorough.

People received their prescribed medication when they needed it and appropriate arrangements were in place for the storage and disposal of medicines. Staff were trained in medicines management.

People were cared for by sufficient numbers of suitably trained staff. We saw staff received the training and support required to meet people’s needs well. Staff spoke highly of their training and said this prepared them well for their role.

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs and preferences. People had detailed, individualised support plans in place which described all aspects of their support needs and aspirations.

Staff were trained in the principles of the Mental Capacity Act (2005), and could describe how people were supported to make decisions to enhance their capacity and where people did not have the capacity decisions these were made in their best interests.

Health, care and support needs were assessed and met by regular contact with health professionals. People were supported by staff who treated them with kindness and were respectful of their privacy and dignity. Suitable arrangements were in place and people were supported and provided with a choice of suitable healthy food and drink ensuring their nutritional needs were met.

People participated in a range of activities both in the home and in the community and received the support they needed to help them stay in contact with family and friends. People were able to choose where they spent their time and what they did.

Staff had good relationships with the people living at the home. Staff were aware of how to support people to raise concerns and complaints and we saw the provider learnt from complaints and suggestions and made improvements to the service.

There were effective systems in place to monitor and improve the quality of the service provided.

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