This inspection took place on 19 February 2018 and was announced.

Heathcotes (Aylestone) 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.

Heathcotes (Aylestone) is registered to accommodate up to seven people. The service support people with autism and a learning disability. The accommodation includes shared lounge, dining room and kitchen facilities and bedrooms with an ensuite shower and toilet. At the time of our inspection there were seven people in residence.

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.

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.

At our last inspection in December 2015 we rated the service overall as ‘Good’. At this inspection we rated the service overall as ‘Good’.

People continued to feel safe using the service. Risk assessments were completed, managed and reviewed regularly. Staff knew how to keep people safe and understood their responsibility to protect people from the risk of abuse. People received their medicines at the right times. People’s nutritional and cultural dietary needs were met and they had access to a range of specialist health care support that ensured their ongoing health needs were met.

Staff were recruited safely. There were sufficient numbers of staff available who worked flexibly to support people. Staff continued to be supported in their role and received regular training and supervision to meet people’s needs effectively.

People continued to be involved and made decisions about all aspects of their care and were encouraged to take positive risks. They 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.

People continued to receive good care and their privacy and dignity was respected. Staff had developed positive trusting relationships with people. Staff’s skilful interactions promoted people’s wellbeing and independence. The design and homely environment promoted people’s privacy.

People continued to receive care and support that was responsive to their individual needs. Staff promoted and respected people’s cultural diversity and lifestyle choices. People were supported to access the wider community, education and other leisure activities. People maintained relationships with their family and friends. Care plans were personalised and provided staff with clear guidance as to how people wished to be supported. Information was made available in accessible formats to help people understand the care and support agreed.

People knew how to raise a concern or to make a complaint. The provider’s complaint procedure was followed and all complaints were fully investigated. Relatives spoke positively about the staff team, management and the quality of care. Staff were confident to make suggestions to improve the service and enhance people’s quality of life.

The registered manager was aware of their legal responsibilities and provided leadership and supported staff and people who used the service. The registered manager and staff team were committed to providing quality care. They continued to incorporate best practice and worked with outside agencies to continuously look at w

This inspection took place on 16 December 2015 and was unannounced.

Heathcotes (Aylestone) is registered to provide residential care and support for up to seven people who have an autistic spectrum disorder or a learning disability and who may present behaviours that challenge or have complex needs. People live in a home that blends in with other private dwellings in a residential area. The accommodation has three lounges with dining rooms. The bedrooms are over two floors and the upper floor is accessible using the stairs. All the bedrooms have ensuite shower facilities. At the time of our inspection there were seven people using the service.

The service has a manager who was registered with Care Quality Commission (CQC). 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. However, they no longer work for the service and have not yet cancelled their registration. We spoke with the provider representative about this and advised us that the registered manager has been informed to cancel their registration.

A manager has been appointed by the provider and had been in post for two months at the time of our inspection. The manager advised us of their intention to submit an application to the Care Quality Commission to become registered.

Following our inspection visit a registered manager application had been submitted to the Care Quality Commission. The application was successful and confirmed the service has a registered manager in post which ensured that the service is managed well.

People’s relatives told us that their family member’s safety was promoted by the staff that supported them. Staff were trained in safeguarding (protecting people who use care services from abuse) and knew what to do if they were concerned about the welfare of any of the people who used the service. Where people were at risk, staff had the information they needed to help keep them safe.

Staff recruitment practices were robust and appropriate checks were carried out before people started work. People were supported by a dedicated team of staff that provided person centred care and support, which promoted their wellbeing, self-esteem and independence.

Staff provided tailored and individual support to keep people safe and appropriate support when their behaviour became challenging. People were supported to take ‘positive risks’ to promote their independence and personal development.

Medicines were stored safely and people received their medicines at the right time. People’s capacity to make informed decisions about taking some medicines had been assessed and best interest decisions had been made. This was to ensure people’s needs were met when they themselves were not able to promote their own safety and welfare by making an informed decision.

People were supported by knowledgeable staff who understood people’s individual and diverse needs. Staff were well trained and had the knowledge and skills to care for people effectively. There was a culture of continual learning and personal development for staff which brought about improvements to people’s quality of life.

People received effective care that was centred on their individual care and support needs. People using the service and their relatives were involved in the development of their support plans to ensure care provided was tailored and took account of people’s diverse needs. Support plans provided staff with clear guidance about people’s needs which were monitored and reviewed regularly.

We found the requirements to protect people under the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) had been followed. Staff had received training on the MCA and DoLS. Capacity assessments had been carr

We recently undertook an inspection visit to Heathcotes (Aylestone). We were unable to speak with people using the service because they had limited verbal communication skills. We observed people using the service and how staff supported and interacted with them. We reviewed three people’s care records. We spoke with four relatives to gather their views about the service. We spoke with the manager, three staff and reviewed their recruitment and training records. We also reviewed the records in relation to the management of the service. We considered all the evidence we had gathered under the outcomes we inspected.

Is the service safe?

People received the care and support that they needed. They were helped to take part in activities that were of interest to them at home or by using the community amenities. Throughout our visit we saw staff treated people with respect. Staff understood people’s needs and knew how each person communicated because people had limited verbal communication skills. Staff helped people with their daily living skills and to do things that promoted their independence.

Relatives we spoke with had high praise about the care and support provided to their family member. Comments received included: “He’s helped with most things and tends to have a great social life” and “The staff really do care about them because everyone is treated as person.”

We, the Care Quality Commission, monitor the operation of the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Staff training records showed staff had been trained in Mental Capacity Act 2005 and DoLS. This meant that people could be confident that their best interests would be represented and that their wellbeing would be met reliably.

People lived in an environment that had been suitably furnished and well maintained, which made it safe, homely and comfortable. People were able to access all areas of home and garden safely. Individual bedrooms had been personalised to reflect each person’s interests and other things that were important to them. People’s privacy and dignity was promoted because all the bedrooms had an en-suite shower, toilet and washbasin.

The staff at Heathcotes (Aylestone) had been recruited properly. Checks had been carried out on their background to help ensure they were fit and safe to work with people who used the service.

Is the service effective?

We saw staff helped people with their daily needs. Relatives were involved and attended the review meetings to make sure their family member received the appropriate support. The records we reviewed showed that people’s care needs were met reliably and that they had access to a range of health care professionals. From our observations it was evident that staff had a good understanding of people using the service and that they knew them well.

Staff were attentive and responded promptly to ensure people were supported appropriately. Because some people were unable to communicate verbally it was important that staff recognised and responded in a timely manner. This helped to ensure that they were protected from any risks and those that had been identified could be managed.

Is the service caring?

Staff were caring, kind and attentive. People were involved to make decisions about their care needs, lifestyle and aspirations. Each person benefitted from support tailored to their individual needs, which promoted their independence and wellbeing.

Relatives told us they had no concerns about the quality of care and support provided to their family members. They all told us that their family member had ‘a good quality of life’. Comments received included, “The care is very good” “The staff know and understand each person and seem to be really confident in what they do” and “He gets to do things like any other young person.”

Staff were aware of people’s preferred routines and interests. This included support to attend college, day centres and to use other community amenities. Staff encouraged people to be involved in daily living tasks to help promote their independence. We saw one person liked to help staff to prepare meals and they also did their own laundry.

Is this service responsive?

Relatives told us that they had visited the home to make sure it was the right place for their family member. People’s needs had been assessed before they moved to the home. People’s preferences and expectations had been recorded and the care and support had been provided in accordance with their wishes.

Staff were confident to seek the appropriate support if they had any concerns about people’s wellbeing or health. They understood their responsibilities to act quickly in the event a person became unwell or needed medical treatment. Care records we looked confirmed that people had access to health care professionals such as the doctor, as and when required.

Throughout our visit the atmosphere in the home was happy and relaxed. We observed how staff supported each person and also worked well together. It was evident that there were good relationships between them, which had a positive impact on the wellbeing of people who used the service.

Relatives were confident that any concerns or suggestions made to improve the quality of care would be acted on promptly. The home’s complaints procedure was also produced in a suitable format for people to understand and given to them when they moved to the home. Staff told us that they recognised if someone was unhappy and were confident to act on any concerns to protect the person’s wellbeing. All complaints were handled and responded to promptly and in a consistent way.

Is this service well led?

People’s personal care records and other records kept in the home were accurate and up to date. Care plans were produced in an alternative format to help people understand the how their care and supported needs were to be met. People‘s care needs were reviewed regularly with the support of their relative. This helped to make sure any new needs could be met reliably. Records showed the home’s staff worked with other agencies and services to help ensure people received their care and support that was co-ordinated and managed.

The home had a system in place to assure the quality of service they provided and acted on any feedback and comments received. Satisfaction surveys were used to gather the views of people who lived at the home and their relatives. Regular meetings were held with people who used the service and their relatives where they could make comments and give feedback on the quality of service provided. The complaints procedure was used effectively to ensure continued improvements to the quality of service provided.

The provider and manager carried out regular checks to help ensure people’s health, safety and wellbeing were protected. Staff received regular training to ensure people’s needs could be met safely and reliably. Information from incidents and accidents had been analysed and used to identify changes and improvements, and minimise the risk of them happening again. Prompt action had been taken to improve the quality of service provided and put right any shortfalls that were found.

We were unable able to speak with people using the service because they had limited verbal communication skills. We contacted relatives of two of the people using the service to ask them for their views. We spoke with the manager and regional manager, as well as with three of the support workers employed at Heathcotes Aylestone. We also reviewed records, including the care and support plans, for two people.

Staff were familiar with people’s individual needs and preferences. They were able to communicate effectively with people using the service and involved them in making choices and decisions.

Support plans were well detailed and gave relevant and useful information to help ensure that people received the care and support they needed.

Staff understood the potential risks to the safety and wellbeing of the people using the service and would take action if they had any concerns about a person’s safety.

Arrangements for the safekeeping and administration of medication were reliable.

Sufficient staff were available to help provide the support and care people required.

There were arrangements in place to help monitor the quality of the service and to secure improvements, when needed.