This inspection took place on 15 & 17 November 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, Hollyfield House, is a specialist residential care home providing 24 hour support for adults with a learning disability, autism, epilepsy and associated challenging behaviour. The service has nine en-suite bedrooms over three floors. It has two lounges, two kitchens and a well maintained garden area. At the time of our inspection nine people were using the service. 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.

We met with the manager at this inspection who was in the process of becoming a registered manager with the CQC. Shortly after our inspection we received confirmation that they had successfully registered for the service.

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.

Staff knew how to keep people safe at Heathcotes, Hollyfield House. Systems and processes were in place to protect people from harm and people and staff were encouraged to raise concerns.

People were protected from risk, while minimising restrictions on people’s choice and control. Staff knew how to support people and manage their risks while giving them the independence and freedom to try and experience new things.

There was enough staff to keep people safe and meet people’s individual needs and people were supported by a consistent staff team that gave people continuity of care. 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.

Staff actively encouraged and supported people to be involved in the interests and activities they enjoyed.

Medicines were managed safely and people received their medicine when they needed it. The service was clean and well maintained.

Staff worked hard to ensure people had a choice of food and were able to try and experience different food and flavours if they wanted to and different food choices were also available. 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.