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Holcombe House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 September 2019

About the service

Holcombe House is a domiciliary care agency that supports people who have learning disabilities and/or autistic spectrum disorder and are living in their own homes.

Not everyone who used the service received personal care support. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection, the service supported seven people with their personal care.

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. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The systems to check the quality and safety of the service, had not always been effective in identifying areas for development. Actions following checks had not always been completed in a timely manner. Some elements of the safeguarding process had not been robust.

Staff had not consistently had their competency assessed or completed training on topics such as safeguarding, moving and handling practical and infection control.

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 did not always support this practice. We made a recommendation about the completion of mental capacity assessments.

People received their medicines as required. Some people had managed to reduce or stop taking medicines for periods of anxiety and distress, with the support of the staff team. People received support from a consistent team of staff, which enabled positive relationships.

People and their relatives praised staff’s approach in how they cared for people. Staff knew the needs of the people they supported and were keen to continually find ways to promote their independence. People were encouraged and supported to make their own decisions wherever possible.

People engaged in a wide variety of activities according to their own interests. Information was available to guide staff about the support people needed and wanted. People and their relatives were encouraged to be involved in writing their care plans. Support was continually reviewed to ensure it was meeting the person’s needs and outcomes.

The provider and registered manager wanted people to receive good, person-centred care; a value they shared with the staff team. The management team were approachable and ‘hands on’ in the support they provided. Staff felt supported and valued in their role.

The service applied the principles and values 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.

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's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 26 October 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to the governanc

Inspection areas

Safe

Requires improvement

Updated 11 September 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 11 September 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 11 September 2019

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 11 September 2019

The service was responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 11 September 2019

The service was not always well-led.

Details are in our well-led findings below.