Heatherdene provides accommodation and support for up 23 people who were living with mental health conditions. People required a range of support to enable them to live independent lives. There were 19 people living at the home at the time of the inspection.

There is a registered manager at the home. 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.

This was an unannounced inspection which meant the provider and staff did not know we were coming. It took place on 31st July and 1st August 2017.

At the time of the inspection there were changes taking place at the home with part of the service being changed to supported living. Some people living at Heatherdene were going to move into the supported living part of the service. Everybody had been involved in discussions about these changes and being supported by staff and social care professionals to make the changes.

We last carried out an inspection at Heatherdene in June 2016 where we rated the service ‘requires improvement’ however there were no breaches of regulations. This was because we found some areas of practice that needed to improve. At this inspection we found that improvements had been made and the provider had addressed these concerns.

People received support from staff who knew them well. They had a good understanding of people’s individual needs, choices and preferences. They understood how people liked to receive their support and worked with people to ensure they received the support they required. Staff were kind and patient; they treated each person as an individual and supported them to maintain their dignity.

Staff were aware of the risks associated with supporting people and knew what steps to take to ensure people remained safe, but retained and improved their independence. There was guidance in place for staff to follow. There were enough staff to support people safely; they received the training and supervision they needed to help them meet people’s needs. Staff had been appropriately recruited and were suitable to work at the home. There were systems in place to ensure people received their medicines as prescribed.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and people were supported to make their own decisions. People had a choice of what to eat and drink throughout the day. They were encouraged to maintain a healthy diet. People were supported to maintain good health and they had access to relevant healthcare professionals when required.

The registered manager was well thought of by people and staff. There was an open and positive culture at the home which was focussed on ensuring people received good person-centred support and developing their independence.

A quality assurance system was in place to monitor the service and the quality of support people received. This meant areas for improvement were promptly identified and addressed.

Heatherdene provides accommodation and support for up 23 people who were living with mental health conditions. People required a range of support to enable them to live independent lives. There were 19 people living at the home at the time of the inspection.

There is a registered manager at the home. 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.

This was an unannounced inspection which meant the provider and staff did not know we were coming. It took place on 31st July and 1st August 2017.

At the time of the inspection there were changes taking place at the home with part of the service being changed to supported living. Some people living at Heatherdene were going to move into the supported living part of the service. Everybody had been involved in discussions about these changes and being supported by staff and social care professionals to make the changes.

We last carried out an inspection at Heatherdene in June 2016 where we rated the service ‘requires improvement’ however there were no breaches of regulations. This was because we found some areas of practice that needed to improve. At this inspection we found that improvements had been made and the provider had addressed these concerns.

People received support from staff who knew them well. They had a good understanding of people’s individual needs, choices and preferences. They understood how people liked to receive their support and worked with people to ensure they received the support they required. Staff were kind and patient; they treated each person as an individual and supported them to maintain their dignity.

Staff were aware of the risks associated with supporting people and knew what steps to take to ensure people remained safe, but retained and improved their independence. There was guidance in place for staff to follow. There were enough staff to support people safely; they received the training and supervision they needed to help them meet people’s needs. Staff had been appropriately recruited and were suitable to work at the home. There were systems in place to ensure people received their medicines as prescribed.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and people were supported to make their own decisions. People had a choice of what to eat and drink throughout the day. They were encouraged to maintain a healthy diet. People were supported to maintain good health and they had access to relevant healthcare professionals when required.

The registered manager was well thought of by people and staff. There was an open and positive culture at the home which was focussed on ensuring people received good person-centred support and developing their independence.

A quality assurance system was in place to monitor the service and the quality of support people received. This meant areas for improvement were promptly identified and addressed.

We carried out this inspection following safeguarding concerns raised about the home. We found that people who used the service were protected from the risk of abuse.

People we spoke with told us they were happy living at the home. One person said, “This is the best place I have lived.” Other people told us they were able to do what they liked during the day and were supported by staff.

We observed staff knew people well and interacted with people in a relaxed, supportive and respectful way.

We considered our inspection findings to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

Is the service safe?

People who used the service were protected from the risk of abuse because the provider had taken steps to identify the possibility of abuse and prevent abuse from happening. There were systems in place to ensure that management and staff learnt from events that adversely affected the people using the service.

Is the service effective?

People received effective care from staff that were trained and supported by the manager. People were involved in assessments of their health and care needs and in writing their plan of care so they understood the information that was written about them. Staff encouraged and supported people to keep healthy and well through regular monitoring of people's general health and making sure they attended scheduled medical and healthcare appointments.

Is the service caring?

There were processes in place that ensured people who used the service were able to contribute to discussions about how they preferred to be cared for and supported. People were supported by attentive and patient staff. We saw staff give encouragement to people and these interactions were caring and compassionate. Staff respected peoples' privacy, dignity and right to be involved in decisions and make choices about their care. People we spoke with told us they were well supported and happy with the care that they received in the home.

Is the service responsive?

There was an effective complaints system available. Comments and complaints people made were responded to appropriately. We found staff continually monitored people's condition and where necessary sought advice and assistance from other community based health and social care professionals.

Is the service well-led?

People who used the service appeared at ease in their surroundings. People who used this service were able to make choices with regard to their daily lives such as what they would like to wear or to eat or whether they would like to join in any activities. Staff helped them in the way that they preferred and they had their wishes, privacy, dignity and independence respected. The provider carried out regular checks to assess and monitor the quality of the service provided. In this way the provider ensured that the quality of the service was maintained.

We spoke with people at the home, examined four care plans and observed staff interaction with people during our inspection. One person told us, “I like it here. I’m very happy.” Another told us, “I don’t want to leave.” We found that care was person-centred, in line with individual assessments and reviewed regularly with the person’s involvement.

We examined the home’s safeguarding policy and procedures and spoke with staff. Staff were clear about their responsibility in relation to safeguarding vulnerable adults and had a good understanding of what constituted abuse.

We looked at the safety and suitability of the home in terms of the people who lived there. We found that it was suitably designed and maintained to a good standard.

We examined four staff files including the home’s most recently recruited staff member. We found that there were robust systems in place in relation to recruitment and selection of staff and all appropriate checks were completed before staff were allowed to work unsupervised at the home.

We examined the home’s complaints policy and procedures and found that there was an effective complaints system available and people were supported to have their concerns heard.

During our visit we spoke with three people who lived at the home, and three staff members.

People we spoke with were happy to be living at the home. They enjoyed the level of independence and privacy that the way they were supported gave them. People told us they were able to organise their own days. They said that staff support was always available if they wanted. We saw that they were able to make drinks and snacks for themselves when they wanted, subject to risk assessments having been carried out.

The staff we spoke with were well qualified, knowledgeable about people’s needs and familiar with the support people needed.

We saw the service ensured that staff were able to deliver care and treatment safely due to the training and audits in place.

The home set out to support people to be as independent as possible. We saw evidence of this in the way people came and went freely and the interaction between staff and people who lived at the home.

The home had quality assurance systems to assess their performance and ensure standards improved. This included canvassing the views of people who lived there, their relatives and staff.

The people we spoke with all told us they enjoyed living at Heatherdene and did not want to leave. One person told us ‘ I wouldn’t change anything.’ Another said the ‘home is perfect as it is.’

People felt the staff knew them and their needs well and treated them with respect. One person said ’ I love it here. It’s friendly and the food’s pretty good.’

We met and spoke with eight people during our visit. Only three people however, were willing to engage in the inspection process and talk about their experiences of living in the home.

Those spoken with told us that they liked living at the home. They reported that they had no set daily routines and could make decisions about what they did each day. Staff support was available if they wanted a more structured week. They said they could make drinks and snacks for themselves when they wanted.

They were asked for their views about the food they received and said they were able to make choices about this.

They said that they had opportunities to raise concerns and there were resident meetings. One person said that they did not always attend resident meetings.