We inspected the service on 18 December 2017. The inspection was announced.

Heathcotes (Mapperley Lodge) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Heathcotes (Mapperley Lodge) accommodates seven people living with mental health needs and or learning disabilities and an autistic spectrum disorder. On the day of our inspection seven people were living at the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection in November 2015, the service was rated 'Good'. At this inspection we found the service remained 'Good’.

The service had a registered manager in place at the time of our inspection. 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.

People remained safe because they were supported by staff who knew how to recognise abuse and understood their role and responsibility in protecting them from avoidable harm. Risks in relation to people's needs including the environment were assessed, planned and monitored. There were sufficient staff employed to support people. People received their prescribed medicines safely. People lived in a clean, hygienic service. Staff supported people effectively during periods of anxiety that affected their mood and behaviour. Accidents and incidents were reported, monitored and reviewed to consider the action required to reduce further reoccurrence.

People continued to receive an effective service because their needs were assessed and understood by staff. Staff received an appropriate induction, ongoing training and supervision that supported them to meet people’s needs effectively. People’s dietary needs had been assessed and planned for and they received a choice of meals and drinks. Some improvements were required to ensure there was sufficient food stocks at all times. Systems were in place to share relevant information with other organisations to ensure people’s needs were known and understood. People were supported to access healthcare services and their health needs had been assessed and were monitored. The premise met people’s needs. 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 support this practice. Applications had been made when required to the Deprivation of Liberty Safeguards supervisory body.

People continued to receive good care. Staff were kind, caring and showed empathy and respect. Independence was promoted and staff had a good understanding of people’s diverse needs, preferences, routines and personal histories. People were supported to access independent advocacy service when required.

People continued to receive a responsive service. People who used the service were involved as fully as possible in their care and support. People’s received opportunities to be supported with activities, interests and hobbies of their choice. Support plans focussed on their individual needs. People’s communication needs had been assessed and planned for. People had access to the registered provider’s complaints procedure. People’s end of life wishes had been discussed with them.

The service continued to be well-led. There was an open and transparent culture in the s

We carried out an announced inspection of the service on 17 November 2015.

At our last inspection 4 April 2014 we found the provider was in breach of Regulation 18 HSCA 2008 (Regulated Activities) Regulations 2010. This Regulation corresponds to Regulation 11 HSCA 2008 (Regulated Activities) Regulations 2014. Following this inspection we received an action plan in which the provider told us about the actions they would take to meet the relevant legal requirements. During this inspection we found that the provider had met this breach in regulation.

Heathcotes (Mapperley Lodge) provides accommodation and personal care for up to 7 people with mental health needs, physical needs and people living with a learning disability. Accommodation is provided over three floors and a passenger lift is in place. Seven people were living at the service at the time of the inspection.

Heathcotes (Mapperley Lodge) is required to have a 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 2008 and associated Regulations about how the service is run. At the time of the inspection a registered manager was in post. There was also a home manager who was training to become the registered manager for the service.

Staff were aware of the safeguarding procedures in place to protect people from avoidable harm and abuse. The provider had a safe recruitment procedure in place that ensured people were cared for by suitable staff. Medicines were stored and administered safely and the premises were well maintained to keep people safe.

Accidents and incidents were recorded and appropriate action was taken to reduce further risks. The service worked with health and social care professionals for advice and support in meeting people’s needs.

CQC is required by law to monitor the operation of the Mental capacity Act 2005 (MCA.) This is legislation that protects people who are unable to make specific decisions about their care and treatment. It ensures best interest decisions are made correctly and a person’s liberty and freedom is not unlawfully restricted. We found people’s human right were protected because the MCA were understood by the home manager and staff.

People received sufficient to eat and drink and were offered food choices that met people’s preferences and cultural and religious needs.

Staff were knowledgeable about people’s healthcare needs and people were supported to access healthcare services to maintain their health. Staff spoke positively about working at the service. They were knowledgeable about people’s needs, preferences and life experiences. Staff respected people’s privacy and dignity.

Staff received formal and regular support to discuss and review their learning and development needs. Staff received an induction and ongoing training that reflected the needs of the people that they cared for.

People, relatives and health and social care professionals we spoke with were positive about the care and approach of staff. Staff were found to be caring and compassionate towards people they supported.

People’s preferences, routines and what was important to them had been assessed. Support was provided to enable people to pursue their interests and hobbies. People were involved in the development and review of the care and support they received.

The provider had a complaints procedure that was available for people in an appropriate format to meet their communication needs. People were supported to access independent advocacy services.

The provider had effective checks and audits in place that monitored the quality and safety of the service. People that used the service received opportunities to give their feedback about the service they received.