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Inspection Summary


Overall summary & rating

Good

Updated 22 March 2018

This inspection took place on 25 January 2018 and was unannounced.

This was the second comprehensive inspection carried out at Solden Hill House. The last comprehensive inspection was 24 February 2016 where we rated the service as Good. The overall rating for this inspection was also Good, however, there were areas that required improvement in the Well Led domain.

Solden Hill House is a care home for adults with learning disabilities. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Solden Hill House does not provide nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Solden Hill House accommodates up to 21 people in two buildings on the Solden Hill House site. On the day of our visit, there were 19 people using the service.

Solden Hill House is also regulated to provide personal care to people living in their own homes. On the day of inspection there was one person receiving personal care in sheltered housing on the site of Solden Hill House.

The service had two registered managers for the provision of personal care and one registered manager relating to the residential care. 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 and associated Regulations about how the service is run.

The provider had recognised that the aging and changing needs of people using the service meant that the existing environment, activities and working practices would need to be updated to meet people’s needs. Although this had been discussed at board level actions had not been implemented to accommodate everyone’s future needs.

The provider did not have enough systems in place to monitor the quality of the service.

There was a strong sense of belonging shared by staff and people using the service. All staff believed in the ethos of the service of providing care that was inspired by the principles of Austrian philosopher, Rudolf Steiner.

Staff understood their roles and responsibilities to safeguard people from the risk of harm. Risk assessments were in place and were reviewed regularly; people received their care as planned to mitigate their assessed risks.

Staffing levels ensured that people's care and support needs were safely met. Safe recruitment processes were in place. People received care from staff that had received training and support to carry out their roles. People were supported to have enough to eat and drink to maintain their health and well-being.

People were supported to access relevant health and social care professionals. There were systems in place to manage medicines in a safe way.

Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA). Staff gained people's consent before providing personal care. People were involved in the planning of their care which was person centred and updated regularly.

People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. People had developed positive relationships with staff. Staff had a good understanding of people's needs and preferences.

People were supported to express themselves, their views were acknowledged and acted upon and care and support was delivered in the way that people chose and preferred.

People using the service and their relatives knew how to raise a concern or make a complaint. There was a complaints system in place and people were confident that any complaints would be responded to appropriately.

We made a recommendation that the provider refers to research and guidelines on providing residential and supported living for adults with learning disabilities.

Inspection areas

Safe

Good

Updated 22 March 2018

The service remains safe.

Effective

Good

Updated 22 March 2018

The service remains effective.

Caring

Good

Updated 22 March 2018

The service remains caring.

Responsive

Good

Updated 22 March 2018

The service remains responsive.

Well-led

Requires improvement

Updated 22 March 2018

The service was not always well led.

There were two registered managers who understood their roles and responsibilities.

The provider had not yet implemented a plan of action to update the environment and working practices to accommodate people’s changing needs.

The provider did not always have enough systems in place to monitor the quality of the service.

People and their representatives were involved in developing the service.