Archived: Holmside

This inspection visit took place on 27 October 2016 and was announced 24 hours in advance because we wanted to make sure we could meet people who used the service. The inspection was carried out by one inspector.

The service had 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.

There were systems and processes in place to protect people from harm, including how medicines were managed. Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns.

Safe recruitment practices were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people in the home. There were sufficient numbers of experienced staff to meet people’s needs.

Staff were supported to provide appropriate care to people because they were trained. There was an induction, training and development programme, which supported staff to gain relevant knowledge and skills.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which apply to care homes. The providers were aware of their responsibilities and understood when such an application should be made and how to submit one.

People received regular and on-going health checks and support to attend appointments. They were supported to eat and drink enough to meet their needs and to make informed choices about what they ate.

The atmosphere throughout the home was friendly, calm and caring. The staff spoke about people in a respectful manner and demonstrated understanding of their individual needs.

The service was responsive to people’s needs and staff listened to what they said. Staff were prompt to raise issues about people’s health and people were referred to health professionals when needed. People were confident they could raise concerns or complaints and that these would be dealt with.

There was an open and inclusive culture within the service, which encouraged people’s involvement and their feedback was used to identify any improvements that were needed. There were a range of systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support.

During our visit we spoke with seven of the eight people who lived at the home. All of the people we spoke with told us that they were very happy at the home. Comments included: "I am very happy here everyone gets on great'. "Everything is brilliant' and 'I get all the help I need'. We also spoke five relatives, a health and social care professional, the providers and one member of staff.

We used this inspection to answer our five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service and the staff told us.

Is the service safe?

None of the people we spoke with had any concerns about the support they received. People said they were treated kindly and with dignity and respect by staff. People us they were very happy at the home and told us they felt safe.

We saw care and treatment was planned and delivered in a way which ensured people's safety and welfare. All of the care plans we looked at had risk assessments in place to assist staff in minimising any known risks.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Care plan files contained information regarding to consent to care and treatment. The provider was aware of the need to assess capacity where people did not have capacity to consent to care and treatment and for best interests decisions to be made on behalf of these people.

Is the service effective?

Each person had a plan of care and support. We saw that support plans explained what support people needed from staff. Staff told us the care and support plans gave them the information they needed to provide the level of support people required.

We observed staff supporting people and care staff we spoke with were aware of people's needs and preferences in how people wanted care to be delivered. We saw staff offered advice and support as well as enabling people to make their own choices and decisions.

Is the service caring?

We observed staff speaking to people appropriately and they used people's preferred form of address; People told us staff were kind and patient in their approach.

We saw care workers taking time to chat with people. They responded promptly to peoples request for assistance and had a good understanding of people's needs. A health and social care professional told us they found that the staff were professional and caring towards people and showed a good understanding of their individual needs, likes and dislikes,

Is the service responsive?

We saw people had regular reviews of the care and support they received. We saw that care plans showed alterations had been made to people's plans of care as people's needs had changed.

We saw people were able to participate in a range of activities. Staff told us they encouraged and supported people to participate in activities to promote and maintain their well-being.

People who used the service and relatives were asked by the provider for their views about how the home was meeting people's needs and any concerns or ways to improve the service were acted on.

Is the service well led?

The service had a small staff team who worked alongside the providers to provide the care and support people needed. A staff member we spoke with confirmed this and said they were able to discuss issues openly with the providers.

We saw the home had systems to monitor and assess the quality of the service provided by the home. These including a number of audits including health and safety, medicines, cleaning and infection control.

Staff meetings took place every three or four weeks and minutes of these meetings were kept. Staff we spoke with confirmed this and said the staff meetings enabled them to discuss issues openly with the manager and the rest of the staff team.

Comments included: 'I get all the support I need,' and, 'The staff are very good and give you help when you need it.'

One person told us 'This is the best'.

We spoke with the provider and one member of staff. They said that everyone got on well together. Staff said they were well supported and that they were provided with the training and information they needed to support people effectively. They told us that management were supportive and approachable.

People we spoke with told us they were fully consulted about the care and support they received and that they were able to make their own choices. They all said their privacy and dignity was respected and they felt safe at Holmside.

One of the providers told us that staff would always respect people's wishes and involve

them as much as possible.