The inspection was carried out on 24 October 2017. The inspection was announced.

The service is registered to provide accommodation and personal care for up to eight people living with learning disabilities. Accommodation is provided in an adapted detached house in a residential area of Oadby in Leicestershire. Facilities at the service include eight ensuite bedrooms, a communal lounge, a sensory room and a garden with recreational facilities. At the time of our inspection seven people were living in the service.

The previous Care Quality Commission (CQC) inspection was in January 2017. This was a focused inspection to check whether improvements we required the provider to make following an inspection in May 2016 had been made. We found then that people’s nutritional needs were not met and that CQC were not always notified of incidents that had occurred at the service. We found in January 2017 that improvements had been made; and at this inspection we found that the improvements had been sustained. At this inspection we rated the service as Good.

The service had a registered manager until they left their employment two weeks before our inspection. The provider was in the process of recruiting a manager who would apply to be registered manager. 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 continued to be safe. People were protected against the risk of harm. People felt safe in the service. Staff recognised the signs of abuse or neglect and knew how to raise safeguarding concerns using the provider’s procedures.

Staff followed appropriate guidance to minimise identified risks to people's health, safety and welfare. There were enough staff who were suitably experienced and knowledgeable to keep people safe. The provider had effective recruitment arrangements in place to check the suitability and fitness of new staff to work at the service.

Medicines were managed safely and people received them as prescribed.

Staff received regular training and supervision to help them to meet people's needs effectively.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The provider's policies and systems in the service supported this practice.

People were supported to have a healthy balanced diet and were supported to access health services when they needed them.

Staff were caring and treated people with dignity and respect and ensured people's privacy was maintained.

Each person had an up to date, personalised support plan. These plans were detailed and included information that staff needed in order to know how to support people.

Staff encouraged people to actively participate in activities, pursue their interests and to maintain relationships with people that mattered to them.

Staff ensured the complaints procedure was made available to people to enable them to make a complaint if they needed to.

Regular checks and reviews of the service continued to be made to ensure people experienced good quality safe care and support. The provider’s quality assurance procedures identified and addressed areas requiring improvement.

People and staff were encouraged to provide feedback about how the service could be improved. This was used to make changes and improvements that people wanted.

Further information is in the detailed findings below.

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We carried out our inspection on 31 January 2017. The inspection was unannounced..

Heathcotes (Oadby) provides accommodation for up to eight adults who require personal care and support. There were seven people using the service at the time of our visit. People who use the service live with autistic spectrum disorder and/or a learning disability.

People were safe at Heathcotes (Oadby). They were safe from harm and avoidable harm. People told us that staff looked after them and that their possessions were safe in their home. Staff were supported to recognise and report abuse or any concerns they may have about people’s welfare.

There was sufficient numbers of staff to meet people’s assessed needs. The registered manager increased the staffing levels when people’s needs changed.

The provider had safe recruitment practices. They completed relevant pre-employment checks which assured them that staff were safe to work with people that used care services.

People received their medicines as prescribed by their doctor because staff followed safe practices when they stored and administered medicines to people.

People were not unlawfully deprived of their liberty. The support people received was provided in accordance with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were supported to access training. People felt that staff were skilled to deliver support to them.

People’s dietary needs were met. They had access to a choice of meals. Staff supported people to maintain their health and well-being. They liaised with other professionals to meet people’s health needs.

The service had a registered manager. 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 were positive about the leadership of the home. They told us that the registered manager had improved the home and created a culture of open communication. People has easy access to the registered manager.

Staff felt that they were clearer about the standards expected of them. There was a clear management structure at the service. Staff had access to guidance and support from a manager including during out-of-hours.

The provider had systems in place to monitor the quality of the service. We saw that they worked with the local authority and used their own systems to make the required improvements required at the service.

We carried out our inspection on 5 and 6 May 2016. The inspection was unannounced on the first day, we returned announced on the second day.

Heathcotes (Oadby) provides accommodation for up to eight adults who require personal care and support. People who use the service live with autistic spectrum disorder and/or a learning disability.

The manager had applied to the Care Quality Commission to become the registered manager. 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 were safe at Heathcotes (Oadby). Staff had a good understanding of the provider’s procedure to keep people safe from harm and abuse.

People had the appropriate level of staff support to meet their assessed needs. The provider completed relevant pre-employment checks which assured them that staff were safe to work with people.

People received their medicines as prescribed by their doctor. However staff had not followed guidelines to assure them that people’s medicines remained safe when they administered them.

Staff received the training they required to provide support that met people’s individual needs. They had a good awareness of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) and how they would apply them in their role.

People did not always receive the support they required to have meals that met their needs. The needs of people who required special diets were not always met. Staff did not creatively support people to be involved in planning their own meal. People were not always offered suitable choices of meals that they preferred.

People had prompt access to healthcare services when they needed them.

Staff treated people with kindness and compassion. They respected their dignity and privacy and promoted their independence where possible.

People had access to a variety of activities. They were supported to maintain regular contact with people that mattered to them.

People and their relatives had various opportunities to raise any concerns they had about the service they received.

Management was not open and transparent. They did not share information with staff in a timely manner.

The provider had systems in place to monitor the quality of service. However they did not consistently use the system or other feedback they received to effectively improve the service.

We identified that the provider was in breach of Regulations 9 of the Health and Social Care Act 2008 (regulated activities) Regulations 2014 and Regulations 18 of the Care Quality Commissions (Registration) Regulations 2009. You can see at the end of this report the action we have asked them to take.

We were not able to speak to most people using the service because they had complex needs which meant they were not able to tell us their experiences. We gathered evidence of people’s experiences of the service by speaking with one person who was able to communicate their views to us verbally and we made contact by telephone with two relatives of people who used the service.

The provider had arrangements in place to assess whether people had the ability to make specific decisions. They used a checklist to assess people’s mental capacity and put plans in place if a person lacked the ability to make a specific decision.

People had choices about the food they ate. One of the relatives we spoke with told us, “If they don’t like the meal on the menu the staff will offer alternatives. They always have a choice.”

There was a choice of communal areas so people could choose where they spent their time and whether they wanted to join in with others or sit quietly. The home was clean, tidy and well maintained.

Care staff participated in regular training and those we spoke with told us that they received the support they needed to help them fulfil their roles.

People using the service met with their keyworker every four weeks to discuss their views on the service and to establish if any changes were needed. Easy read notes were made of these meetings to record the important aspects of the meeting and the decisions that had been made.

During our inspection we spoke with three of the people using the service. They were happy with the support they received at Heathcotes Oadby and they felt that staff supported them well. One of those we spoke with told us, “I like it here. It is all good.”

We reviewed care plan documents and these showed that people's individual needs had been assessed and support plans put in place to explain, in detail, how people's care and support needs were to be met. Risk assessments had been used to identify any possible risks to people's safety and welfare with plans in place to explain how these risks were to be managed.

People's personal records were up to date, well organised and stored securely to help ensure that infomation remained confidential.

People told us they were happy living at Oadby Heathcotes. They felt they got on well with the staff and they were available to help them when needed. People enjoyed the activities they took part in and enjoyed spending time together.