This inspection took place on 5 October 2017 and was unannounced. We carried out a comprehensive inspection in June 2015 and the service was rated as good.

Heathvale House provides accommodation, care and support for up to nine men with complex mental health needs. The aim is to help people to live with more independence in the community. There were eight people using the service when we visited.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (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.

People told us they felt safe with the service they received. There were arrangements in place to help safeguard people from the risk of abuse. Staff were aware of the provider’s policies and procedures about how to identify potential abuse and how to report abuse.

We looked at the systems in place for managing and administering medicines and found the systems in place were safe.

People had risk assessments and risk management plans to reduce the likelihood of harm. Staff knew how to use the information to keep people safe and work with them positively to help them be as independent as possible.

The provider ensured there were safe recruitment practices to help protect people from the risks of being cared for by staff assessed as unfit or unsuitable for their roles within the home.

Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure people are only deprived of their liberty in a safe and correct way. There were policies in place in relation to this and appropriate applications were made by the provider to the local authorities for those people who needed them. Staff supported people to make choices and decisions about their care wherever they had the capacity to do so.

People were supported to stay healthy by staff who were aware of people’s healthcare needs and through regular monitoring by health and social care professionals.

People and professionals told us staff were consistently kind and caring and established positive relationships with them. Staff valued people, treated them with respect and promoted their rights, choice and independence.

Comprehensive care plans were in place detailing how people wished to be supported and had been produced jointly with them. People told us they agreed with the information in the care plans and were fully involved in making decisions about their support.

People participated in a wide range of activities within the home and in the community and received the support they needed to help them to do this. There was a complaints procedure in place and people felt confident to raise any concerns either with the staff or the registered manager if they needed to.

People gave positive feedback about the management of the service. The registered manager and the staff were approachable and fully engaged with providing good quality care for people who used the service. The provider had systems in place to continually monitor the quality of the service and people were asked for their opinions via feedback surveys. Action plans were developed where required to address areas that needed improvements.

We carried out an unannounced focused inspection of Heathvale House on 22 November 2016. The inspection was prompted by a notification of a serious incident that happened at the home and was conducted to check if people using the service were safe. This report will focus only on the topic of whether the service is safe and should be read in conjunction with the report we produced after our unannounced inspection in June 2015.

Heathvale House is a residential care service in Thornton Heath. The home supports up to nine male adults experiencing mental health difficulties. At the time of our inspection there were five people living in the home.

The service did not have a registered manager. The previous registered manager had left the service three months before our inspection. A registered manager is a person who has registered with the Care Quality Commission (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. The provider was in the process of recruiting a manager who was deemed suitable to apply for registration with the CQC.

At our previous unannounced comprehensive inspection of Heathvale House in June 2015, the service was rated good. However, we found that at night there was not a sufficient number of staff to help keep people safe and meet their needs. After the comprehensive inspection, we received confirmation that a further member of staff had been employed to work at the home during the night.

During our focused inspection in November 2016, we found there was a sufficient number of suitable staff working during the day and at night to meet people's needs. Appropriate checks were carried out on prospective staff before they began to work with people. This helped to ensure that people were not supported by staff who were unsuitable for their role.

The provider had taken reasonable steps to protect people from abuse by training staff in safeguarding vulnerable adults and ensuring people living in the home and staff knew how to report any concerns.

People had personalised risk assessments which gave staff information on how to manage the risks identified. There were plans in place to keep people safe in the event of an emergency.

There were appropriate arrangements in place for storing, administering, recording and disposing of medicines. Staff received training in administering medicines and knew how to do so safely.

All areas of the home were clean and well maintained. Staff controlled the risk and spread of infection by following the service’s infection control policy.

We inspected Heathvale House on 11 June 2015. The inspection was unannounced. Heathvale House is a care home for people experiencing mental health difficulties.

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. The CQC was in the process of considering an application from the manager to be registered as the registered manager.

People told us they were safe. This was also the view of their relatives. Care was planned and delivered to ensure people were protected against abuse and avoidable harm.

There was a sufficient number of suitable staff to keep people safe and meet their needs during the day but we found there was insufficient staff during the night. Since our inspection we have received confirmation that a further member of staff has been employed to work during the night and that this staff member is required to remain awake.

People’s medicines were appropriately managed so they received them safely. Staff understood their responsibilities in relation to infection control. People were protected from the risk and spread of infection because staff followed the procedures in place. The home was clean and well maintained.

People were satisfied with the quality of care they received. People were cared for by staff who had the necessary experience and knowledge to support them to have a good quality of life. Staff knew how to deal with each person’s behaviour that challenged others. Staff knew people’s routines and preferences and understood what was important to them. They also knew how to recognise the signs that a person’s mental health was deteriorating.

Staff understood the relevant requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) and how it applied to people in their care.

Staff knew what constituted a balanced diet. Staff supported people to do their shopping and to prepare nutritious, well balanced meals. People had enough to eat and drink. People received the help they needed to maintain good health and had access to a variety of healthcare professionals.

Staff enjoyed working with the people in their care. People were treated with respect, compassion and kindness. It was clear that people’s individuality was at the centre of how their care was delivered. They were fully involved in making decisions about their care including what they ate and how they spent their time day-to-day. People were supported to express their views and give feedback on the care they received.

There were procedures in place to regularly check and monitor the quality of care people received which were consistently applied by staff.

People who used the service told us that they liked to be called residents.

We spoke to three residents, three staff and the registered manager.

Residents told us they were treated with respect by staff. They attended regular residents meetings. One resident told us that they enjoyed the things they did in terms of their activities. They said, “I go to college three times a week and I love that”. Another person said, “I do some domestic activities around the home and I enjoy what I do”.

People’s needs and risks were assessed and residents each had individual care plans. We selected and examined three people’s care files. The files included essential information about the person, a personal history, assessment information, records of appointments with health care professionals, records from keyworker meetings, a support plan and risk assessments.

The three residents who we spoke with told us they felt well supported and that Heathvale was a safe place to live. They said that staff were kind to them and treated them with dignity.

All the people we spoke with knew how to make a complaint.

The feedback received had been generally very positive, with favourable comments being made about the home and the support being provided by staff. Views expressed by people using the service indicated that the home provided a safe, pleasant and welcoming environment. People we spoke with told us that staff were "very kind" "and "very pleasant".

Overall, people we met told us that they were happy with the care and support they were receiving. Comments included, “it’s alright here” and “the staff are good” and “I like here”.