About the service: Heathcotes (Park View) is registered to provide accommodation and personal care for up to five people with learning disabilities and autism. The service is a house with five bedrooms and communal living areas, in a residential area in Wellingborough. At the time of inspection, five people were using the service.

People’s experience of using this service:

The 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.

• A lack of leadership and management in the service had affected the quality and safety of the care provided.

• Audits were not always effective in identifying where improvements were needed.

• Timely action was not always taken to respond to known areas of required improvement.

• Sufficient numbers of staff were not consistently deployed to support people safely.

• People’s safety was not always maintained because staff did not always follow the risk management plans in place to mitigate risks to people.

• People had not been consistently safeguarded from abuse; this was being investigated by the local authority. Action had been taken to ensure that people’s support was provided in a safe appropriate way.

• Improvements were required to medicines record keeping. People received their medicines as prescribed.

• The environment was not consistently maintained to a safe standard. The arrangements in place for infection control required improvement.

• People’s needs had not consistently been met by staff who acted with appropriate knowledge and skills when providing their support. Action was ongoing to improve staff knowledge and skills.

• People’s personal information was not stored securely.

• Staff recruitment procedures ensured that appropriate pre-employment checks were carried out.

• Staff were supervised well and felt supported by the manager.

• People were supported to have a varied diet.

• Healthcare needs were met, and people had access to health professionals as required.

• People's consent was gained before any care was provided.

• Staff treated people with kindness, dignity and respect and spent time getting to know them.

• Systems had been reviewed to ensure that people were supported in the least restrictive way possible.

• Care plans reflected people’s likes, dislikes and preferences.

• People’s access to activities to enhance their emotional wellbeing and independence had been affected by low staffing levels. This had been recognised and action taken to improve people’s access to activity.

• People and their family were involved in their own care planning as much as was possible.

• A complaints system was in place and was used effectively.

• The manager was open and honest, and worked in partnership with outside agencies to improve people’s support where required. People, relatives and staff told us that the manager had made positive improvements at the service.

•The service met the characteristics of ‘requires improvement’ in four key questions we inspected. Therefore, the overall rating for the service after this inspection was ‘requires improvement’.

More information is in the full report.

Rating at last inspection:

Requires Improvement (report published 13 March 2018)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

At the last comprehensive inspection, we found that the service was not always safe or well led. The provider was in breach of regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Premises and equipment. We asked the provider to make improvements in relation to the safety of the service. The provider submitted an action plan detailing the improvements that they had made to comply with the regulations. They stat

This inspection took place on 23 January 2018 and was unannounced.

Heathcotes Parkview 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 Parkview is registered to accommodate up to five people. The service supports people with autism and a learning disability. The service is a bungalow with five bedrooms and communal living areas, in a residential area in Wellingborough. 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 the time of our inspection, 5 people were receiving care.

The service was not always safe. We found that two bedrooms had mould growing on the ceiling and a damp smell. This was caused by water coming in to the building from the outside. Action was not taken promptly to resolve this issue, and make sure people could sleep in completely clean, damp free bedrooms. We found the service to be in breach of one regulation. You can see what action we told the provider to take at the back of the full version of the report.

All other areas of the service were clean and tidy. Staff were trained in infection control, and told us they had the appropriate personal protective equipment to perform their roles safely. Regular cleaning took place to ensure the prevention of the spread of infection.

Quality monitoring systems and processes were in place and comprehensive audits were taking place within the service to identify where improvements could be made. These audits were not always effective, as actions were not always taken to make necessary and prompt improvements.

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 told us they felt safe, and staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse. People had risk assessments in place to cover any risks that were present within their lives, but also enable them to be as independent as possible. All the staff we spoke with were confident that any concerns they raised would be followed up appropriately by the registered manager.

Staffing levels were adequate to meet people's current needs, and rotas showed that staffing was consistent.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. References and security checks were carried out as required.

Staff attended induction training where they completed mandatory training courses and were able to shadow more experienced staff giving care. Staff told us that they were able to update their mandatory training with short refresher courses.

Staff supported people with the administration of medicines, and were trained to do so. The people we spoke with were happy with the support they received.

Staff were well supported by the registered manager and senior team, and had one to one supervisions and observations.

People's consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met. Consent forms were signed and within people’s files.

People were able to choose the food and drink they wanted and staff supported people with this. People could be supported to access health appointments when necessary. Health profes