Wigston

Updated 23 June 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two Inspectors carried out the inspection.

Service and service type

Heathcotes (Wigston) is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced on 9 May 2022. We gave a short notice period of inspection for the 16 May 2022 to enable the registered manager to make arrangements to minimise disruption for people living at Heathcotes (Wigston).

We visited the service on 9 May 2022 and 16 May 2022 and made telephone calls to relatives and staff between these dates.

What we did before inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We contacted two Local Authorities. We used all of this information to plan our inspection.

During the inspection

We communicated with five people who used the service and received personal care. These people used different ways of communicating including using Makaton, pictures, photos, objects and their body language. We spoke for a short period with two people that did not receive personal care during the inspection, they shared their experiences of living at the service. We spoke with three relatives about their experience of the care provided.

We spoke with 11 members of staff including the registered manager, regional manager, compliance officer, team leaders and care staff.

We reviewed a range of records. This included four people’s care records, and three people’s medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, training data, cleaning schedules and environmental checks and policies and procedures were reviewed.

Updated 23 June 2022

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 assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Heathcotes (Wigston) is a residential care home providing personal care. It is registered to support up to eight people with a learning disability or autistic spectrum disorder. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection there were seven people using the service, five of these people received personal care.

People’s experience of using this service and what we found

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right Support

We made a recommendation about clarifying reporting arrangements for Deprivation of Liberty Safeguards (DoLS) conditions. However, staff supported people to have the maximum possible choice and control over their own lives and to be independent. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff supported people to make decisions following best practice in decision-making.

Improvements were needed to record keeping in relation to lessons learned following accidents and incidents. The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative. Staff did everything they could to avoid using restrictions on people’s freedom. The service recorded when restrictive practices were used, and staff learned from those incidents and how they might be avoided or reduced.

People had health action plans in place, these did not always contain up to date information about their health appointments. Annual health checks were overdue but were booked during the inspection.

People had a choice about their living environment and were able to personalise their rooms. Staff supported people to take part in activities and pursue their interests in their local area.

Staff communicated with people in ways that met their needs. They supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Right Care

There was no system in place for staff to request support if they were unable to ‘breakaway’ in an unsafe situation. During the inspection the provider ordered radio-controlled devices for staff to use. Improvements were needed to record keeping systems relating to accidents and incidents, restrictive practice interventions and debriefs to record in detail lessons learned.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe. There had been a high use of agency staffing during the beginning of the year. However, staffing had improved, and no further agency staff usage was planned, following the inspection. There were enough staff that had been safely recruited to meet people’s needs.

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

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.

People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), pictures and symbols could interact comfortably with staff and others involved in their care and support because staff understood their individual communication needs.

People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities. Where appropriate, staff encouraged and enabled people to take positive risks.

Right culture

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.

Staff turnover had been high resulting in a number of staff vacancies at the beginning of the year. This had improved, which meant the consistency of care people received had improved and they were supported by staff that knew them well.

The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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 December 2018).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

The inspection was prompted in part due to concerns received about people’s safety. A decision was made to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.