48 Heath Road

48 Heath Road is a residential care home providing accommodation to people who require personal care to up to 8 people. The service provides support to people with a learning disability and autistic people. At the time of our inspection there were 8 people using the service. People are accommodated over 2 floors, with their own individual bedrooms and individual quiet lounges as well as communal lounges and dining areas. The service is located in a village with good community access, close to local shops and transport links.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

People were supported to have the maximum possible choice, control and independence be independent and they had control over their own lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff supported people with their medicines in a safe way that promoted their independence and achieved the best possible health outcome.

Right Care

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. Risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

Staff knew and understood people well, supporting their aspirations to live a quality life of their choosing.

Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 29 November 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The accommodation at 48 Heath Road of several lounge areas for each person to have their own personal space. There was also a communal dining area. Each person had their own room with an ensuite facility. There was a communal bathroom and another room in process of being developed into a sensory room. The service has a vehicle people can use and there are good links to public transport and local community facilities.

48 Heath Road 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. 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 our last inspection in April 2016, we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There were sufficient staff to support people’s needs and this was arranged flexibly to support activities and health care appointments. When staff were recruited the necessary checks were completed to ensure they were suitable to work with people. All the staff received training in safeguarding and this enabled people to be protected from the risk of harm.

Risk assessments had been completed to ensure when a risk had been identified measures were in place to reduce the risk. When guidance was provided we saw this was followed. All the people required support with medicine and this was done safely and in accordance with guidance for all the medicine which was dispensed

People were 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. Best practice guidance was used to support people’s needs and this included training to support these methods. All the staff received training for their role and an induction when they commenced their employment.

People had a choice of meals and their dietary needs were supported. All aspects of people’s health care were considered and we saw how the support and guidance enhanced people’s wellbeing and ongoing health needs. The environment had been adapted to meet individual needs.

Staff had established positive relationships with people and this ensured care was kind and compassionate. People felt their dignity was respected when they received care. Relatives were welcome to visit at any time.

The care plans were detailed and included every aspect of the persons care needs and preferences. We saw how these were updated with any new information as necessary. Consideration of how people communicate was included and developed along with any cultural needs.

When people had lost a loved one there were support systems in place to enable people to understand this difficult time. People were able to engage in activities and areas of interest.

There was a complaints policy and a process to follow. The registered manager understood their role in relation to their registration. Audits and methods to drive improvement were in place and these were used to make improvements to systems and the lifestyles of those living at the home.

People’s views were considered and changes made to reflect these. Partnerships had been developed to enhance the care available to people.

Further information is in the detailed findings below

The inspection took place on 6 February 2016, it was unannounced. The home was last inspected on 13 August 2013 when it was compliant in all areas and no concerns were identified.

The home is located in the Holmewood area on the outskirts of Chesterfield, Derbyshire and provides care and support for up to eight adults with a learning disability o autistic spectrum disorder. Some people have associated conditions that included sensory disability, epilepsy and behaviour that can put themselves or others at risk. At the time of our inspection eight people were living at 48 Heath Road.

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 were happy, comfortable and relaxed with staff and we saw, they indicated with facial expressions and body language they were happy living in the home. They received care and support from staff who were appropriately trained and confident to meet individual needs. Formal supervision and appraisal sessions were in place. Safe recruitment procedures were followed and appropriate pre-employment checks carried out, including evidence of identity and satisfactory written references. Staff were supported by the registered manager who worked with them to assist their continued professional development. There were sufficient staff on duty to meet people's needs and to keep them safe.

People's nutritional needs were assessed and records were accurately maintained to ensure people were protected from risks associated with eating and drinking. Where people required special diets these were followed, people were still able to choose what they ate within these restrictions.

Medicines were managed safely in accordance with current regulations and guidance by staff who had received appropriate training to help ensure safe practise. There were systems in place to ensure medicines had been stored, administered, audited and reviewed appropriately. People were able to access health and social care as required.

People were encouraged to make their own life choices and were being supported to make decisions in their best interests. They were then supported to undertake those life choices and activities. The registered manager and staff had an understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

There was a formal complaints process in place. People were encouraged and supported to express their views about their care and staff responded to their concerns and wishes. Relatives and stakeholders were able to influence what happened to people who lived in the home.

One person told us how they went out regularly and how they liked the staff at the home.

There were systems in place to offer choices to people and involve them as far as possible in decisions about their lives. Where people lacked capacity to make decisions there were processes in place to ensure decisions were being made in people's best interests.

Care records were sufficiently detailed and kept up to date. The care plans we viewed considered people's routines, likes and preferences. This ensured staff had access on how to deliver care to people in a personalised manner.

There were systems in place to safeguard peoples and appropriately handle any allegations of abuse. One relative told us that they would have the confidence to raise any concerns they had.

We observed that records were suitably stored and kept up to date.

Another relative told us they thought things were improving. There had previously been an incident where a breakdown in communication between staff at the home and staff at the learning disability service had had an adverse impact on their son. Improvements to communications were recommended in the subsequent investigation. The relative told us that he believed things had improved.