The inspection of Heathcotes (Whitley House) took place on 6 July 2017 and was unannounced.

Heathcotes (Whitley House) is a residential care home for up to six people living with autism, learning disabilities and mental health needs. The service was newly registered in May 2015. People who live at the service have complex needs and associated communication difficulties, which increases their vulnerability. The property is situated in a rural location on the outskirts of the village of Whitley and accommodation is provided across a five bedroom house and a one bedroom independent living flat on the same site.

At the last inspection on 23 May (and 03 June) 2016 the service did not meet all of the regulations we assessed under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service was rated ‘Requires Improvement’, because the provider was in breach of two regulations. These related to ‘safe care and treatment’ and ‘records’. We also recommended that improvements be made with support plans.

At this inspection we found the overall rating for the service to be Good. The rating is based on an aggregation of the ratings awarded for all five key questions. Improvements were made in the provision of safe care and treatment and in maintaining records, so that all requirements made against breaches in regulations were now met. A recommendation made about support plans was also met.

The provider was required to have a registered manager in post and on the day of the inspection we found that the manager had only been registered for ten days, though in post as the manager for the past five weeks. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Systems in place to detect, monitor and report potential or actual safeguarding concerns, protected people from the risk of harm or abuse. Staff were appropriately trained in safeguarding adults from abuse and understood their responsibilities in respect of managing potential and actual safeguarding concerns. Risks were also managed and reduced so that people avoided injury of harm wherever possible. The premises were safely maintained. Staffing numbers were sufficient to meet people’s needs. Recruitment policies, procedures and practices were carefully followed to ensure staff were suitable to support vulnerable people. The management of medicines was safely carried out.

People were supported by qualified and competent staff that were regularly supervised and appraised regarding their personal performance. People’s mental capacity was assessed and their rights were protected. Support workers had knowledge and understanding of their roles and responsibilities in respect of the Mental Capacity Act (MCA) 2005 and enabled people to make decisions for themselves. The registered manager explained how the service worked with other health and social care professionals and family members to ensure decisions were made in people’s best interests where they lacked capacity. People received adequate nutrition and hydration to maintain their levels of health and wellbeing. The premises were suitable for providing support to people with a learning disability or mental health needs.

Support workers were kind and caring and knew about people’s needs and preferences. People were supplied with the information they needed at the right time, involved in all aspects of their care and were asked for their consent before any support was provided to them. People’s wellbeing, privacy, dignity and independence were monitored and respected.

We saw that people were supported according to their person-centred care plans, which reflected their needs and were regularly revi

Heathcotes (Whitley House) is a residential care home for people living with autism, a learning disability and/or mental health needs. The home is situated in a rural location on the outskirts of the village of Whitley and is registered to provide care for up to six adults. Accommodation is provided across a five bedroom house and a one bedroom independent living flat on the same site.

The home was first registered in May 2015. We inspected this service on 23 May and 3 June 2016. This was our first inspection of this home. The inspection was unannounced. At the time of our inspection, there were three people using the service; two people living in the main house and one person living in the home’s independent living flat.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission (CQC). However, the registered manager was in the process of de-registering and a new manager was in post and applying to become the home’s registered manager. A registered manager is a person who has registered with the CQC 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.

During the inspection we found that risks were identified and assessed, but care and support provided did not always effectively manage these risks. For example, one person using the service had left the home on several occasions. However, new gates installed to manage this risk and prevent the person running into a busy road at the front of the property, were left open when we visited.

This was a breach of Regulation 12 (2) (b) of the Health and Social Care Act 2008 Regulated Activities) Regulations 2014.

We found that the registered provider had not maintained a complete and contemporaneous record in respect of each person using the service or with regards to the management of the regulated activity.

This was a breach of Regulation 17 (2) (c) (d) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the registered provider to take in relation to these breaches of regulation at the back of the full version of this report.

Health and social care professionals told us the care and support provided was not always person centred and responsive to people’s individual needs. Concerns were raised about inconsistencies in the staff team at Heathcotes (Whitley House). We identified concerns about how recommendations from health and social care professionals were recorded and shared with staff and concerns around the support provided to engage in meaningful activities including access to transport. We have made a recommendation about developing person centred care in our report.

Staff we spoke with understood their role and responsibilities with regards to safeguarding vulnerable adults.

There were sufficient staff on duty to meet people’s needs and medicines were managed safely and in line with guidance on best practice.

Staff received an induction, on-going training, supervision and yearly appraisals to support them to develop in their role.

Due to people’s complex needs, people using the service did not always have a varied and nutritious diet. However, staff encouraged people using the service to eat and drink regularly. People’s food and fluid intake were monitored.

People were visited by health and social care professionals, however, records of their visits and the outcomes or any recommendations made needed to be more clearly recorded to ensure more effective collaborative working.

Staff were described as kind and caring and we observed that people using the service were treated with dignity and respect. People were encouraged to make decisions and be involved in planning their care and support.

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