Middleton

Updated 21 February 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 1 inspector, a specialist medicines advisor, and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Heathcotes (Middleton) is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Heathcotes (Middleton) is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was no registered manager in post.

Notice of inspection

The inspection was announced. We gave the service notice of the inspection. This was because it is a small service and, and we wanted to be sure there would be people and staff at home to speak with us.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We looked around the service and observed interactions between people and staff. We spoke with people and observed interactions with staff. We also contacted 4 relatives by telephone so seek their views about the service. We spoke with 5 staff, including operations manager and support staff. Feedback was also received from a healthcare professional, and advocate involved in people’s care and support.

During the inspection visit we looked at the management of people’s medicines and reviewed 2 care plans. We also looked at staff recruitment and health and safety records. Additional evidence, such as audits, meeting records and policies, sent to us electronically, was reviewed remotely.

Updated 21 February 2024

About the service

Heathcotes (Middleton) is registered to provide accommodation and personal care for up to 7 people with a learning disability and/or mental health diagnosis. There were 7 people accommodated at the home on the day of the inspection.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

Improvements were needed to ensure people’s prescribed medicines were managed and administered safely. People were cared for in a way they wanted and needed. Care records needed updating. A new systems was being introduced to help address this. Staff had received relevant training to help support people in a safe and effective way. Sufficient numbers of staff were now provided so people had access to the support they needed, enabling them to maintain their independence. People were able to receive visitors without restrictions in line with best practice guidance. A good standard of accommodation was provided. Plans were in place to further enhance areas of the home.

Right Care

People were safeguarded from abuse and avoidable harm. Staff understood their responsibilities to raise concerns. Risks were assessed and planned for. Any accidents or incidents were reviewed and reflected upon to help learn and improve the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People maintained relationships and followed their interests, taking part in activities of their own choosing. People had access to health care professionals when they needed them. People's privacy, dignity and independence were respected and promoted. Safe recruitment processes were followed.

Right Culture

People’s relatives were not clear about the management of the service. The registered manager had recently left the service, a new appointment was to be made. Staff told us morale within the team was improving. Formal support systems, such as team meetings and supervisions session were to be re-established to help promote teamwork. Whilst a range of audits and checks were completed, these were not always effective. An action plan was in place identifying areas of improvement across the service, helping to further enhance people’s experience. Opportunities for people and their relatives to contribute to the running of the home could also be improved.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good, (published 2 July 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We have identified breaches in relation to the management and administration of people’s medicines and good governance.

Please see the action we have told the provider to take at the end of this report.

Follow Up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.