Heronsmede

Updated 6 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection which took place on 18 September 2018. The inspection was unannounced and carried out by one inspector.

Before the inspection we reviewed the information we held about the service which included notifications they had sent us. Notifications are sent to the Care Quality Commission (CQC) to inform us of events relating to the service which they must inform us of by law. We also looked at previous inspection reports. We reviewed the Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

The people who lived at Heronsmede were unable to speak with us and express their views on living at the service. However, we spoke with a relative during the inspection to understand their experience of the service and contacted two more following the inspection visit. We spoke with five members of staff including the registered manager, the deputy manager, two support staff and an assistant regional director. In addition, we spoke with a visiting professional and received feedback from another.

We observed care and support being provided in the communal areas of the service, we saw people having lunch during the inspection and we watched the administration of medicines. We looked at records relating to the management of the service including four people’s support plans and associated records. We reviewed the medicine administration records for eight people and inspected three staff files including recruitment records. We reviewed records of accidents and incidents. We looked at a selection of handover and communication documentation, minutes of meetings, service audits and health and safety records.

Updated 6 November 2018

Heronsmede is a 'care home'. It is a detached property, providing accommodation over two floors and has a secure rear garden. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service is registered to provide accommodation and support to eight people with a learning disability or autistic spectrum disorder. At the time of the inspection, there were eight people using the service.

There was 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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service was last inspected in January 2016. At that inspection, the service was rated good overall but requires improvement in the safe domain. At this inspection we found improvements had been made and sustained, therefore the safe domain is now rated good. We also found examples of outstanding care and support in both the effective and responsive domains which have been rated accordingly.

The provider kept staffing levels under review and people benefitted from being cared for by an established and experienced team of staff. There were sufficient numbers of skilled staff deployed appropriately to provide safe support for people. Robust recruitment practices helped to ensure suitable people were employed to work at the service.

People were protected from the risk of abuse by staff who were trained and had the knowledge and skills to identify safeguarding concerns and act on them. Risks to people's health and well-being were assessed and appropriate plans were in place to minimise risks. Regular checks were made regarding the safety of the premises and the provider had plans in place to manage foreseeable emergencies. Medicines were managed and administered safely.

People received extremely effective support from a staff team who were regularly supervised and had their personal performance evaluated at an annual appraisal. Staff were trained in the skills necessary to fulfil their role and had received extensive training in areas relating to the specific needs of people.

The strong person-centred approach focussed on individuals. The consistency of approach used by the staff team enabled people to make changes to affect positive outcomes in their lives. Staff worked with health and social care professionals to meet people’s complex health needs. They adopted a 'can do' attitude to supporting people to live life to the full in spite of those needs.

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’s nutrition and hydration was monitored and staff supported them to have a varied diet.

The interactions between people and the staff were positive. Staff showed a genuine interest in the wellbeing of those they supported and demonstrated kindness and understanding toward people. Staff involved people in choices around their daily living and people's independence was encouraged.

People were relaxed and comfortable in the company of staff, they did not hesitate to seek support and assistance when required. People were spoken to and about in a respectful manner; their privacy and dignity were maintained.

Staff recognised the importance of maintaining relationships with family and friends. They had completed some detailed work to help redevelop and maintain relationships with people's families and achieved very positive outcomes. Relatives told us they were always made welcome whenever they visited.

People were involved in all aspects of the service. Staff had worked very hard and found creative ways to help people communicate and understand information that was presented to them. They had developed easy read documents and social stories to engage people. They used skilled observation to interpret people’s responses to ensure their view was known.

People's support plans were very comprehensive and reflected the extremely person-centred approach taken by the service. They showed how people were supported to achieve positive outcomes to enhance their lives. The detailed information included people's likes, dislikes, cultural and spiritual preferences. People had opportunities to take part in activities of their choice and were encouraged to try new and different things.

The provider made people and their relatives aware of how a complaint may be raised and used their policy to investigate and respond to any concerns.

The provider and registered manager had systems in place to monitor the quality of the service provided and plan improvements. People, their relatives and staff had opportunities to feedback their views on the quality of the service.

Further information is in the detailed findings below