About the service:

Heathcotes (Mansfield) is residential care home and provides accommodation and personal care for up to five people living with mental health, a learning disability and or autistic spectrum needs.

People’s experience of using this service:

Incidents were acted upon and recorded, but the registered manager could improve the way in which incidents and low-level behaviours, were reviewed and how lessons were learnt. This included a more detailed analysis of behaviours such as themes and patterns to improve understanding and outcomes.

We have made a recommendation about the management of incidents.

Body maps were used to record any injuries a person sustained through accidents or incidents, but the monitoring of injuries was not recorded to confirm what action had taken place. This was discussed with the registered manager and established was a recording issue.

Staff had guidance on managing people’s behaviours that was detailed, but information was repetitive in places meaning information was not easy to follow. People told us they felt safe living at Heathcotes (Mansfield) and staff had received safeguarding training and had policies and procedures to support their practice in keeping people safe.

People received the right level of support to meet their individual needs. Medicines were managed in accordance with national best practice guidance and people received reviews of their prescribed medicines. The prevention and control measures of infections were understood by staff and the service was found to be clean.

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 support this practice.

People were involved in menu planning, food shopping and meal preparation as much as possible and healthy eating was encouraged. People’s healthcare needs and wellbeing had been assessed and was monitored, referrals had been made to external healthcare professionals when required.

Staff received an induction on commencement of their employment and ongoing training, and opportunities to discuss their work and development needs.

Support plans had been developed with people and were regularly reviewed with the person and or their relative or representative. Information supported staff to understand what was important to people, including diverse and cultural or religious needs.

People had access to the provider’s complaint procedure and they were encouraged through one to one meetings, to talk about any concerns or complaints. Discussions and plans had been had with people about end of life wishes.

Staff felt supported by the registered manager and partnerships had been developed with a range of health and social care professionals. Quality assurance processes were in place to help identify good practice and areas for improvement.

More information is in the full report

Rating at last inspection:

Good (report published 29 April 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up:

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

We carried out an announced inspection of the service on 16 March 2016.

Heathcotes (Mansfield) provides accommodation and personal care for up to five people living with mental health, a learning disability and or autistic spectrum needs. Five people were living at the service at the time of the inspection.

Heathcotes (Mansfield) is required to have a registered manager in post. 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 the time of the inspection a registered manager was in post but not present, they had submitted an application to de-register from the service. There was an acting manager who was in the process of submitting their application to become the registered manager. We were monitoring this.

People were safe and protected from harm. Staff were aware of the safeguarding procedures in place to protect people from abuse and had received safeguarding adults training. Any risks to the safety of people including the environment were assessed and reduced as far as possible.

Accidents and incidents were recorded and appropriate action was taken to reduce further risks.

Safe recruitment practices meant as far as possible only people suitable to work for the service were employed. Staff received an induction, training and appropriate support. There were sufficient experienced, skilled and trained staff available to meet people’s needs.

People’s medicines were managed safely and people received their prescribed medicines appropriately.

People received sufficient to eat and drink and their nutritional needs had been assessed and planned for. People received a choice of meals and independence was promoted. People’s healthcare needs had been assessed and were regularly monitored. The service worked well with visiting healthcare professionals to ensure they provided effective care and support.

The manager applied the principles of the Mental Capacity Act 2005 (MCA) and Deprivations of Liberty Safeguards (DoLS), so that people’s rights were protected.

Staff showed kindness and compassion in the way they supported people. People were supported to maintain relationships with family and friends and there were no restrictions on visitors. Staff showed respect for people’s privacy and dignity. They understood the importance of confidentiality, keeping all personal information about people safe and secure.

The service was responsive to people’s individual interests and preferences, and plans of support and care were specific to their individual needs. Staff had a person centred approach and a clear understanding of what was important to people.

The provider asked people, relatives, staff and visiting professionals to share their experience about the service provided. Communication between relatives, external professionals and the service was good.

People were involved as fully as possible in their care and support. There was a complaint policy and procedure available. People had information to inform them of independent advocacy services.

The provider had checks in place that monitored the quality and safety of the service. These included daily, weekly and monthly audits.

Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with one person who used the service and asked them for their views. We also spoke with two support workers, the trainee manager and the regional manager. We also looked at some of the records held in the service including the support files for three people and observed the support people who used the service received from staff.

We found people gave consent to their care, and received care and support that met their needs. We saw people who used the service had signed their support plans to show they had been involved in preparing these and were in agreement with them. A person told us, “I like to go out, I like to go out for meals and have a big burger. We plan my activities each week.”

We found people received their medication safely. People who received medication were assessed to determine if they could self-medicate. A person told us, “They (support workers) give me my medication in my hand and watch me take them.”

We found the staff team was responsive and well led. The provider assessed and monitored the quality of the service. One person showed us a form they had completed in preparation for a residents’ meeting.

We did not speak directly with any people who used the service as two of the three people were not present. The third person said they did not wish to speak to us.

In order to complete our inspection, prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with one care worker, the deputy manager and the regional manager. We also looked at some of the records held in the service including the care files for three people. We carried out a brief tour of the building and observed briefly how staff supported one person, but we saw that the person was unsettled (who was unsettled) so we did not continue.

We found people were involved in the running of the home and they were respected and treated with dignity.

We found people were safeguarded from abuse and the staff team were supported through training. The provider had suitable systems to record information needed for the running of the service.

However, we also found people’s care had not been properly planned for.