Lutterworth View

About the service

Heathcotes Lutterworth View accommodates 8 people in one adapted building. At the time of our inspection there were eight people using the service.

People’s experience of using this service and what we found

Risks to people had not been fully assessed to protect them from harm. People’s sensory needs had not always been assessed. Staff were not able to clearly describe how and when ‘as required medicines would be administered. There was no mechanism to review the protocols for these medicines.

Staff were recruited safely and received induction and training for their role. Staff understood how to support people. Staff knew how to protect people from the risk of abuse and how to report any concerns.

People, staff and most relatives told us, and records showed the registered manager was making improvements in the service. Further action was needed to strengthen the governance system to ensure records were completed fully in relation to people’s care and incidents and concerns.

Most people felt safe with the staff and the support provided. However, we received concerns about risks to people’s safety and made several safeguarding referrals to the local authority for further investigations.

Support plans were personalised and focused on all aspects of people’s lives including their individual needs, preferences, aspirations and equality and diverse needs. Staff understood their role and how to support people to meet their needs. People could take their medicines in private when appropriate and safe.

People and most relatives told us they knew how to complain if they were unhappy about any aspect of the care and support provided. Concerns received from a relative and professionals had been shared with their registered manager.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right Support

People were supported by enough staff to meet their care needs. People had a choice about their living environment and were able to personalise their rooms. The service had enough staff, including for one-to-one support for people to take part in activities. People were supported to continue to with their education and work on a regular basis.

People were supported to maintain contact with their relatives and staff encouraged people to take part in community-based activities and hobbies. However, at times people could not go on outings and visits when they wanted to if the care home’s vehicle was already being used to support another person. Alternative transport had been considered but it was not always safe or suitable.

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.

Right Care

People told us they liked the staff who supported them. Staff protected and respected people’s rights and choices. People’s communication needs were identified. Staff ensured information was available in a suitable format so people could understand. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture

The registered manager and staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. The registered manager had the skills, knowledge and experience to perform their role and was improving the culture where people were at the heart of everything they did.

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 2019).

Why we inspected

We received concerns about the service from health and social care professionals in relation to the management of risks to people and the use of restraint, promoting social engagement and activities and, staffing and oversight of the service. As a result, we undertook a focused inspection to review the key questions of Safe, Responsive and Well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Enforcement and recommendations

We have identified a breach of regulation because risks to people’s health, safety and welfare had not been adequately assessed, mitigated and kept under review, at this inspection. Please see the Safe, section of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heathcotes Lutterworth View on our website at www.cqc.org.uk

Enforcement and Recommendations

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.

We found the following examples of good practice.

Information produced in easy read format about Covid-19 and infection prevention and control practices was displayed throughout the home, this included the use of personal protective equipment (PPE) and hand washing guidance.

Staff were trained in infection prevention and control, they had supervisions and meetings to support their wellbeing and keep them up to date with the IPC guidance. Staff engaged in a programme of regular Covid-19 testing. Communication between the management team, people and families was good.

Safe visiting arrangements were in place. Staff and visiting professionals were asked to provide evidence of their vaccination status against COVID-19 prior to entering the home. People were supported by staff to keep in touch with those important to them. Visitors were required to complete a COVID-19 test, had their temperature checked and wore PPE.

Safe admission processes were in place to support people being admitted to the service. Risks to people had been assessed which considered the impact of Covid-19. People were risk assessed regarding the testing and vaccinations, and best interest procedures were followed. People continued to receive one-to-one hours of support from staff as per their package of care.

The premises were well-ventilated, clean and hygienic. Cleaning checklists were in use and cleanliness was monitored. Staff frequently cleaned high touch surfaces to reduce the risk of spreading any infections. A designated lounge had been created to support people who were unable to isolate in their bedroom so they could remain safe, feel less isolated and could be monitored by staff.

Heathcotes Lutterworth View is a residential care home. The service was a large home, bigger than most domestic style properties. It is registered to support up to eight young people from the age of 13 years and over. There were eight young people in residence.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people. People with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes.

People’s experience of using this service and what we found

People felt safe at the service. The provider had effective safeguarding systems and policies in place and staff were trained on topics related to health and safety, and safeguarding procedures.

Potential risks to people’s health, safety and welfare were assessed, managed and monitored on an ongoing basis. Staff encouraged positive risk taking tailored to people’s individual needs to promote their independence.

People were supported to maintain good health. People had enough to eat and drink and were involved in meal preparation and healthy eating. People were supported to take their medicines in a safe way and accessed health care services as needed. Health action plans were in place, so people’s wishes as to unplanned medical treatment were identified. Procedures were in place for people to express their wishes in relation to end of life care.

Systems and processes were in place to ensure staff recruitment practices were followed and staff were trained to support young people using the service. People were cared for by consistent staff team who worked flexibly to meet people’s needs.

The service applied the principles and values consistently of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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’s family and relevant health care professionals were consulted as part of best interest decisions.

People lived in a purpose-built environment that met the needs of people with a learning disability and/or autism. Individual rooms with full en-suite facilities, choice of communal rooms and outdoor garden area promoted people’s privacy and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People were involved in planning and reviewing their care which took account of their cultural and religious needs. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. People’s care plans and information was available in formats people could understand.

People were at the heart of the service as staff and the registered manager were committed to improving and providing person-centred, high quality care. Staff were creative and provided support to enable people to achieve their aspirations, skills and pursue their interests. Nationally recognised best practice guidance was used effectively to promote people’s quality of life. People developed and maintained relationships with family and friends.

The registered manager had systems in place to monitor the quality of the service and were aware of their duties. People felt staff and management were approachable, acted on concerns and their views were sought to develop the service.

This service was registered with us on 13 February 2018 and this is the first inspection.

Why we inspected

This was a planned inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.