This comprehensive inspection took place on 8 and 11 December 2017 and was unannounced. This was the first inspection since this location registered with us on 31 October 2016. The service was previously registered with us under a different provider.

Heathcotes, Dawson House, provides 24-hour residential care for adults with learning disabilities, autism and associated challenging behaviour. The service had seven en-suite bedrooms on the ground and first floor. The first floor rooms were accessible by stairs. There was a modern kitchen diner, two communal lounges and a well-maintained garden.

A registered manager was in post at the time of our inspection. 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 indicated they felt safe living at Dawson House and relatives we spoke with confirmed this. There were enough staff on duty to keep people safe and staff knew the systems and processes in place to protect people from harm. People and staff were encouraged to raise concerns and staff told us they felt they were listened to.

Staff protected people from risk while minimising restrictions on people’s choice and control. This gave people the independence and freedom to try and experience new things while still being safe.

People had good continuity of care by a staff team who knew people well. Staff attended training which gave them the knowledge and skills to support people effectively. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

Medicines were managed safely and people received their medicines when they needed it. The service was undergoing a plan of essential maintenance and risks to people during this period were assessed and managed to help ensure people were kept safe.

People were supported to take part in interests and activities they enjoyed.

People were encouraged to make health choices about their food and supported to have sufficient amounts to eat and drink. Risks associated to people’s diet had been identified and staff knew what to do to manage this risk. Staff supported people to access the healthcare services they needed to maintain their health and referred people to specialist support when necessary.

Care records were focused on each person and gave a complete picture of the individual including their physical, mental, emotional and social needs. Staff understood the best ways to communicate with people and used a range of techniques including visual systems to help people communicate their needs. Recognised techniques were used to enable staff to support people as individuals when they became upset or anxious so people experienced positive outcomes in terms of managing behaviour which challenged others.

The provider listened to and acted on complaints. Information was available for people and their relatives to make a complaint and relatives were confident the registered manager would respond appropriately if they raised any concerns.

Leadership was visible across the service and the registered manager, regional manager and staff had a good understanding of their roles and responsibilities. The provider had a range of audits in place to assess, monitor and drive improvement. When things had gone wrong lessons were learned and this was shared across the service.