This inspection took place on 1 June 2018 and was announced.

At the last inspection, the service was in breach the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 12, Safe Care and Treatment and Regulation 17, Good Governance.

We asked the provider to complete an action plan to show what they would do and by when to improve the key questions, ‘Effective’ and ‘Well-Led’ to at least good. At this inspection, we found the necessary improvements had been made, this ensured that people’s long-term healthcare conditions were managed and supported and effective systems were in place to oversee and manage the service.

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

Heathcotes (Moulton) accommodates six people in one adapted building. At the time of our inspection, five people received care at the service.

The service supports people with complex learning disability and autism. 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.” Registering the Right Support CQC policy

The service had 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.

People had individualised health plans in place and were supported to access health appointments when necessary. Health professionals were involved with people’s support as and when required.

Quality monitoring systems and processes were in place and comprehensive audits regularly took place to continually drive improvement of the service. Systems were in place to seek feedback from people using the service and their representatives.

Staff understood the importance of safeguarding people and the procedures to follow to report abuse. Risk assessments covered risks that were present within people’s lives, and were managed in a way that was the least restrictive and promoted independence.

The staffing levels met people's assessed needs and the level of support they required. The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service.

Systems were in place to ensure medicines were managed safely and people were supported to self-administer their medicines building upon independence.

All areas of the service were clean and tidy. Staff were trained in infection control and used appropriate personal protective equipment (PPE) to perform their roles safely. Regular cleaning took place, to ensure the prevention of the spread of infection.

Lessons were learned and improvements had been made when things had gone wrong. Staff understood their responsibilities to raise safeguarding concerns, to record safety incidents, accidents and near misses. Reflective practice was used to learn from incidents to mitigate the risks of reoccurrences.

People’s needs and choices were assessed and their care, treatment and support was delivered in line with current legislation, standards and evidence-based guidance to achieve effective outcomes.

Staff had the skills, knowledge and experience to deliver effective care and support. Staff were provided with comprehensive induction training and on-going refresher training. Specific training was provided to meet th

This unannounced inspection took place on 28 February and 1 March 2017. This residential care home is registered to provide accommodation and personal care for up to six people with learning disabilities, and complex needs and challenging behaviour. At the time of our inspection there were five people living at the home.

There was 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.

Improvements were required to the way in which people’s long term healthcare conditions were managed and supported. Guidance was in place to help support people and their conditions however people may benefit from further input from healthcare professionals.

Improvements were required to the quality assurance systems that were in place to ensure the service was providing a good standard of care. Improvements were also required to the records the registered manager completed to show the checks and audits they had completed.

Improvements were required to ensure that actions were followed up in a timely way when improvements had been identified. For example to ensure that staff followed procedures as expected, and people received the support for their care needs without delay.

Improvements were required to the opportunities available to people and their relatives to provide feedback on the care they received. The staffing team communicated updates to people and their relatives however there were limited opportunities for people and their relatives to review the service and the care provided and to give their views.

People were safe in the home. Staff understood the need to protect people from harm and abuse and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required at the times they needed. There were sufficient staff to meet the needs of the people and recruitment procedures protected people from receiving unsafe care from care staff unsuited to the job.

People received care from staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person.

Care records contained risk assessments and risk management plans to protect people from identified risks and helped to keep them safe but also enabled positive risk taking. They gave information for staff on the identified risk and informed staff on the measures to take to minimise any risks.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.

People’s mental capacity needs were reviewed. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Care plans were written in a person centred manner and focussed on empowering people; personal choice, ownership for decisions and people being in control of their life. They detailed how people wished to be supported and people were fully involved in making decisions about their care. People participated in a range of activities and received the support they needed to help them do this. People were able to choose where they spent their time and what they did.

People at the home reacted positively to the registered manager and the culture within the home focussed upon supporting people’s independence and for people to participate in activities that enhanced their quality of life.

We identified that the provider was in breach of