Heathcotes (Sawley) is a residential care home that provides accommodation and personal care support for up to six people between the ages of 18 to 65 with a learning disability and associated conditions. 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. There were six people who used the service at the time of our visit.

At our last inspection on the 20 May 2016 we rated the service good. At this inspection we found the evidence continued to support the overall rating of good but improvements were needed to ensure all recruitment checks were thoroughly explored. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.

The registered manager had overlooked recruitment information received for one staff member. They took immediate action to address this at the time of the inspection. Staff understood how to protect people from harm and their responsibilities to raise concerns and record safety incidents. Risks to people were managed to reduce potential hazards. Enough staff were available to support people. Where people required support to take their medicines; this was provided in a safe way. Staff understood their responsibilities in relation to hygiene and infection control.

People continued to receive effective support. Staff had the knowledge they needed to provide effective care and support was delivered in line with good practice guidance. People’s physical health was monitored and they were supported to access healthcare services. People’s dietary needs and preferences were met. People are 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 continued to receive support that was caring by staff who knew them well. People were involved in making decisions about their care and their privacy, dignity and independence was respected and promoted.

People continued to receive support that was responsive to their individual needs. People were consulted regarding their preferences and interests and these were incorporated into their support plan to ensure they were supported to lead the life they wanted to. People were supported to be as independent as they could be and assistive technology and accessible information was in place to support people in achieving this. The support people received was reviewed with them to ensure it remained relevant. People knew how to raise any concerns or complaints, and these were responded to in a timely manner.

The service continued to be well led. The registered manager understood their roles and responsibilities and the staff worked well as a team to enable people to be supported in their preferred way. People, staff and visiting professionals were encouraged to give feedback, and their views were acted on to develop the service. The provider worked in partnership with other agencies and systems were in place to drive ongoing improvements.

Further information is in the detailed findings below

This inspection visit took place on the 20 May 2016 and was unannounced. At our previous inspection on the 23 May 2013 the service was meeting the regulations that we checked.

Heathcotes (Sawley) provides accommodation and personal care support for up to six people with a learning disability and autistic spectrum disorders between the ages of 18 to 65. There were six people who used the service at the time of our visit.

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.

Staff understood what constituted abuse or poor practice and systems and processes were in place to protect people from the risk of harm. People were protected against the risk of abuse, as checks were made to confirm staff were of good character and suitable to work in a care environment. Staff knew how to respond to incidents if the registered manager was not in the service. People told us and we saw there were sufficient staff available to support them. Medicines were managed safely and people were supported to take their medicine as needed.

People were treated with dignity and respect and had their choices acted on. The staff worked in partnership with people when supporting them. People confirmed that staff supported them in the way they wanted. Staff knew people’s likes and dislikes and care records reflected how people wanted to be supported and how care was provided.

People were enabled by staff to maintain choice and independence and were supported to develop life skills to enable them to live more independently. People were supported to develop and maintain hobbies and interests within the local community to promote equality and integration.

The staff team actively sought and included people and their representatives in the planning of care. There were processes in place for people to raise any complaints and express their views and opinions about the service provided. There were systems in place to monitor the quality of the service to enable the registered manager and provider to drive improvement.

On arrival at the home we saw people were being involved in making decisions about their lives. For some people this involved getting ready to go out with their family members. In this way family relationships were being maintained. For others we saw they were being helped to decide their chosen activity for the day. We saw people were given choices as to how they wished to spend their time. People were assisted to give consent to their care and to their treatment. We spoke with one person who told us they had access to their own records when they, wanted to see them. They told us they regularly kept their own records as part of their right to confidentiality.

During our visit people were seen going out and returning from activities. We saw they looked happy and well cared for.

Two people told us they felt safe living at the home. There were a variety of documents in the foyer to help them if they needed more help or advice.

We spoke with three people who live at Heathcotes Sawley. One person had issues with their communication, which made gaining their views difficult. However there was a great deal of positive body language and the people who were able to express a view told us that they were happy.

The observations we made of staff working with people who lived at the care home showed that people were well cared for, and treated with respect and consideration.

We spoke with four family members who told us staff were helpful. All the family members who spoke with us explained they found their relative to be happy at the home. They told us they thought staff were able to meet their relative’s needs.

Two people told us they were given their medicines when they needed them.

We observed staff taking people out for activities and returning later, we saw that people who needed one to one support were receiving this. We saw that people were free to move around the home when they wanted to.

One relative told us, “I am invited to reviews about my relative and I am given the opportunity to discuss anything about my relatives care. I am involved in the care planning.”

We saw a mixed picture of the care provided. We spoke with two people who used services. They both told us they had care plans and they had discussed their care and support needs with staff.

They told us they went out most days of the week, went out shopping, to cafés and pubs during the week and at the weekend. They told us there were regular tenants’ meetings where they talked about life at the home.

They told us about the activities they took part in, such as going away on mini breaks with staff members, as support, usually their key worker, and taking part in special community events, such as the yearly bonfire night event. A key worker is a staff member allocated to get to know a person who uses services during their stay, and provides one to one activities to carry out with the person using the service.

People who used services told us they received visitors from their family members and were able to speak with them privately in their bedroom.

One person told us, “I prefer to lock my room door when I am not in it.” They showed us their room key.

Two people told us, “Care provided at the home was given by a number of different support staff.” One person explained, “It is better to have the same staff to care for me each time I need help.”

However, we found some visitors were unhappy with the care and with communication from staff.

We saw a mixed picture of the care provided. We spoke with two people who used services. They both told us they had care plans and they had discussed their care and support needs with staff.

They told us they went out most days of the week, went out shopping, to cafés and pubs during the week and at the weekend. They told us there were regular tenants’ meetings where they talked about life at the home.

They told us about the activities they took part in, such as going away on mini breaks with staff members, as support, usually their key worker, and taking part in special community events, such as the yearly bonfire night event. A key worker is a staff member allocated to get to know a person who uses services during their stay, and provides one to one activities to carry out with the person using the service.

People who used services told us they received visitors from their family members and were able to speak with them privately in their bedroom.

One person told us, “I prefer to lock my room door when I am not in it.” They showed us their room key.

Two people told us, “Care provided at the home was given by a number of different support staff.” One person explained, “It is better to have the same staff to care for me each time I need help.”

However, we found some visitors were unhappy with the care and with communication from staff.