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Inspection Summary


Overall summary & rating

Good

Updated 12 September 2017

We inspected this service on 25 July 2017. This was an unannounced inspection.

The service is registered to provide accommodation and personal care for up to six people. People who use the service have learning and physical disabilities. At the time of our inspection five people were using the service. The service is owned and managed by Community Integrated Care [CIC], which is a non-profit making organisation. Staff members are on duty twenty-four hours a day. The people who live in the home have resided there for many years.

At our previous inspection in February 2017, we rated the service as 'Inadequate’ and placed it into special measures. This was because there were a number of regulatory breaches. Risks to people's health, safety and wellbeing were not always assessed and planned for. People did not always receive their prescribed medicines in a safe way. People's health needs were not always effectively monitored and advice from healthcare professionals was not always followed to promote people's wellbeing. Staffing levels were not consistently maintained to ensure people received their care in a timely and responsive manner and there were some gaps in staff training. The requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards were not always followed, which meant some people were potentially being unlawfully deprived of their liberty. The information staff needed to provide people with consistent care was not always available. People were not always enabled to be involved in making choices about their everyday care. Effective systems were not in place to assess, monitor and improve the quality of care. The registered manager and provider did not always notify us of reportable incidents and events that occurred at the service and the service's inspection rating was not being displayed as required by law.

At this inspection, we identified significant improvements had been made to ensure people received care that was safe, effective, caring, responsive and well-led. We have taken the service out of special measures.

The service has a registered manager. 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.

Most people living in the home were unable to converse with us, but we observed staff providing support to people throughout our inspection visit. We saw they were kind and patient and showed affection towards the people in their care. We saw that people who lived at the home were clean and well dressed and they looked relaxed and comfortable in the care of staff supporting them.

There were good systems in place to protect people from harm. Risks were assessed and planned for. Staff had a good knowledge of people’s individual needs and of what people liked or disliked and of how they wished to live their life. Care plans were person-centred and people were consulted in areas such as who supported them, what they did with their day and making decisions about their lives.

People's nutritional needs were met. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

People had access to healthcare professionals and their advice and guidance was followed to ensure people’s healthcare needs were addressed. People were given their prescribed medicines at the right times.

The registered provider understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

The service had a complaints procedure which was made available to people and their relatives.

We found staff had been recruited safely and were appropriately trained and supported. They had the skills, knowledge and experience required to support people with their care and social needs. Staffing levels were sufficient to meet the needs of people who lived at the home and enable them to play an active part in the local community. Discussions with staff members identified that they now felt happy and supported and worked well as a team.

The provider had now implemented a robust quality assurance system which used various checks and audit tools to monitor and review the practices within the home. These included seeking the views of people who used the service and their families or representatives, seeking the views of staff and a regular programme of audits carried out by the registered manager, the regional manager and their Quality Excellence team.

The home’s inspection rating was displayed and the registered provider had notified us of reportable incidents and events since the last inspection.

The local authority who commissioned care for people who lived at Holmdale told us that they thought it was now a good service.

Inspection areas

Safe

Good

Updated 12 September 2017

The service was safe.

Risks to people's health, safety and wellbeing were assessed, planned for and managed in a manner that promoted safety.

Effective systems were in place to ensure that people's prescribed medicines were administered.

There were enough staff to ensure that people were supported to receive their care in a timely manner.

Staff knew how to identify and report potential abuse.

Effective

Good

Updated 12 September 2017

The service was effective.

Staff understood that it was important that people consented to their care and complied with the Mental Capacity Act 2000 if people did not have the capacity to consent to certain aspects of their care.

People's health was monitored effectively to ensure changes in their health or wellbeing were identified and acted upon.

People were supported to eat and drink.

The staff were well-trained and supported.

Caring

Good

Updated 12 September 2017

The service was caring.

Staff knew people well, which enabled them to have meaningful interactions with people.

Staff took time to make sure that people’s privacy and dignity was respected.

People had choices about how they spent their time and making decisions about their lives.

Records were kept securely and people could be reassured that information about them was kept confidential.

Responsive

Good

Updated 12 September 2017

The service was responsive.

Information about people's care preferences and needs was recorded in a care plan for staff to follow.

People and their representatives were involved in reviewing their care needs.

The home had a complaints policy and processes were in place to record any complaints received and to address them in accordance with the policy guidelines.

Well-led

Good

Updated 12 September 2017

The service was well led.

There were effective systems in place to assess, monitor and improve the quality of care. These included seeking the views of people who use the service, their representatives and staff.

The provider notified us of reportable incidents and events that occurred at the service and the inspection rating was displayed as required by law.