The Hesley Village is registered to provide accommodation and personal care for up to 80 people. The village is on the outskirts of Tickhill, near Doncaster. There are several houses and flats, set in extensive grounds, with shops, a cinema and a café. The village is for people with a learning disability and people on the autistic spectrum. At the time of our inspection there were 75 people using the service.

This inspection took place on 23 January 2019 and was unannounced. At our last inspection in June 2016 we rated the service overall as good. At this inspection we found the evidence continued to support the overall rating of good. There was no evidence or information from our inspection and ongoing monitoring which demonstrated any serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

The service was developed and designed before the guidance, Registering the Right Support came into being. However, the service worked to make sure it was run in line with the values that underpin this and other best practice guidance. These values include choice, promotion of independence and inclusion.

There were enough staff to meet people’s needs. Staff retention had improved and with this, the need to use agency staff had decreased. There were effective systems in place that helped make sure people’s medicines were managed safely.

People were protected from abuse and avoidable harm. Staff had received training and were confident to raise any concerns they had.

Staff had received training and understood their responsibility regarding the Mental Capacity Act 2005 (MCA). People's capacity to make decisions had been assessed when planning care. Staff confirmed they asked for people's consent before providing care and they respected and promoted each person's choices.

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 supported this practice. The principles of the Mental Capacity Act (MCA) were followed.

Care planning was person centred, with detailed records of people’s preferences. People were supported to access the local community. Complaints were responded to appropriately.

Quality and safety management systems were effective. There was evidence of continuous improvement. Systems were in place to gather feedback from people and their relatives. The service worked in partnership with other agencies and followed up-to-date legislation.

This inspection took place on 14 and 15 June 2016 and was unannounced on the first day. The home was previously inspected in November 2015 and the service was in breach of the Health and social care Act 2008 (Regulated Activities) Regulations 2014 in respect of staffing and staff deployment, review of care plans and risk assessments, management of medicine, dealing with complaints, and the monitoring the safety and quality of the service.

As a result the service was rated Requires Improvement. You can read the report from our last inspections, by selecting the 'all reports' link for ‘The Hesley.Village’ on our website at www.cqc.org.uk’

The Hesley Village is registered to provide accommodation for up to 80 people. The village is on the outskirts of Tickhill, near Doncaster. There are several houses and flats, set in extensive grounds, with shops, a cinema and a café. The village is for people with a learning disability and autistic spectrum disorder. Most people who live there have behaviour that can be challenging. At the time of our inspection there were 71 people using the service.

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.

During this inspection we found that improvements had been made since our last inspection in November 2015. A number of new staff had been recruited and had started work. Others were awaiting recruitment checks, or undertaking induction training. There were adequate staff on duty at the time of our inspection. However, there was a need for continued improvement in recruiting and deploying staff to the core teams supporting people, and new staff needed time to settle in, in order to be able to respond well to people’s needs.

The need to use agency staff had decreased, and the provider had taken steps to ensure that where they were used, this was in a more consistent way and they were better equipped to support people who used the service. Relatives we spoke with told us improvements were taking place in staffing and the use of agency staff, but there was still ‘a way to go’ with this. They said that, the service mostly provided good care and support and the staff were caring and kind and respected peoples choices and decisions

Medicines were managed safely and improvements had been made to ensure the management of medicines was of a consistent standard throughout the service.

People’s needs were identified, and improvements had been made in the way people’s plans and assessments were reviewed. This helped to protect people from risk and helped to make sure they received care and support that met their changing needs.

There was a robust recruitment system and all staff completed an induction to the service. The induction had been improved to help equip new staff for their role and to help with staff retention. Staff received formal supervision and annual appraisals of their work performance.

There were systems in place for monitoring the quality and safety of the service. These had been improved, so that they were more effective. Where they identified issues and areas of concern, these had been addressed and followed up to ensure continuous improvement.

The service had received a reduced number of complaints since our last inspection, and these had been dealt with following the company’s procedures, to ensure people were listened to and their complaints acted on.

We saw that staff respected people’s privacy and dignity and spoke to people with understanding, warmth and respect.

We found the service to be meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good understanding and knowle

We spoke with seven people who used the service. The people we spoke with said they were happy and liked living at The Hesley Village. One person said it was nice, another said they were satisfied and it was comfortable. A third person, who had recently moved to Hesley Village, said it was fun.

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

People were protected from the risks of inadequate nutrition and dehydration.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

There was an effective complaints system available. One person told us they would speak to staff, managers and at the residents’ council if they were not happy.

We spoke with seven people who used the service. They said they were happy with the care and support provided. When we asked one person if they liked living in the Hesley Village they said, “It’s nice.”

We saw that there were opportunities for people using the service to make choices and have a say in how their treatment or care was delivered. We found that care and treatment was personalised and equality and diversity taken into account. There was evidence that people took part in range of activities in the community.

Staff protected people from any negative effects of other people’s actions or behaviour. People said they thought the Hesley Village was a safe place to live. One person said, “I am happy.”

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Throughout our inspection we observed good interactions and found people who used the service were relaxed and happy in the care of the staff. One person who used the service said they liked the staff. The quality of the services was regularly assessed and monitored to ensure that it was safe and was meeting people’s needs.

We observed people walking around the campus with staff support, and overheard staff chatting to people in an appropriate and respectful manner, and using discreet prompts to ensure people were safe.

One person told us that staff understood their needs and supported them at all times. They also told us they were involved in making decisions and when their decision was not possible it was explained to them why it was not safe. They told us the decisions were recorded in their care plan.

One person told us they were supported to make decisions and given support and information to be able to make a choice.

People told us they were well looked after, the staff were very good and they could talk to people if they had a problem.

We also spoke to a number of relatives as part of this review and they told us;

‘Staff understand my sons’ needs and he is well supported’

‘Really happy with the level of care’

‘Incidents are followed up; staff are extremely patient and so caring’

‘I can sleep at night’

‘I am impressed with Hesley how they have dealt with my son’s problems’

This inspection took place on 16 and 17 November 2015 and was unannounced on the first day. The home was previously inspected in July 2014 and the service was meeting the regulations we looked at.

The Hesley Village is registered to provide accommodation for up to 80 people. The village is on the outskirts of Tickhill, near Doncaster. There are several houses and flats, set in extensive grounds, with shops, a cinema and a café. The village is for people with a learning disability and autistic spectrum disorder. Most people who live there have behaviour that can be challenging. At the time of our inspection there were 75 people living at the service.

The home did not have 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. The provider had appointed a new manager who had submitted an application to register with CQC at the time of our inspection.

Relatives we spoke with told us the service mostly provided good care and support. But had been struggling recently due to staffing issues. They told us the staff were caring, kind and respected peoples choices and decisions. However, staff did not always have the knowledge and skills to support people safely.

Staff respected people’s privacy and dignity and spoke to people with understanding, warmth and respect.

There were adequate staff on duty to be able to meet people’s needs, however, the high use of agency meant staff did not always have the right skills and knowledge to be able to support people appropriately. People who used the service did not consistently have the same group of staff to support them. This was due to the staff shortages, the constant changes in staff support could have a negative impact on people.

Medicines were stored safely and procedures were in place to ensure medicines were administered safely. However, in some areas of the service we found medicines were not administered following company procedures, which put people at risk of not receiving medication as prescribed.

We found the service to be meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good understanding and knowledge of this and people who used the service had been assessed to determine if an application was required.

People’s needs had been identified, and measures were in place to determine how to meet their needs. However, we found these were not reviewed as specified and evaluations seen were not meaningful. This put people at risk of receiving care and support that did not meet their changing needs.

There was a robust recruitment system and all staff had completed an induction to the service. Staff had received formal supervision and annual appraisals of their work performance.

There were systems in place for monitoring quality, however these were not always effective. We identified issues and areas of concern that had not always been addressed or followed up to ensure continuous improvement.

The service had received a number of complaints since our last inspection, however, these had not been dealt with following the company’s procedures to ensure people were listened to and their complaints acted on.

Staff we spoke with told us that all staff worked well as a team, but were that they struggling due to being short staffed and this was affecting the morale of the staff team. They felt supported by their immediate line managers, but felt the higher management team were out of touch with what was happening at their level.

We found 4 breaches of the Health and social care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.