Holmbury Dene (Respite)

Updated 1 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 5 and 19 October 2018. The first day of the inspection was unannounced and the second day of the inspection was agreed to by the registered manager. The inspection team consisted of one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience’s area of expertise is in services for people with learning disabilities.

We gathered and reviewed information before the inspection. We received a completed Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed notifications sent to us.

During the inspection we spoke with two people using the service and two relatives. We also spoke with the registered manager, three care workers and the regional manager. We contacted health care professionals, for their opinions of the service. However, we did not receive any responses.

We looked at three care records, medicine administration records (MARs) for three people, five staff records and other documents relating to the management of the service.

Updated 1 January 2019

This unannounced inspection took place on 5 and 19 October 2018. Holmbury Dene (Respite) provides accommodation, personal care and support for up to 10 people. Since the last inspection the service provision had changed. The service offers interim respite care and permanent placements for people living with a learning disability. Within the service there are individual bedrooms and two self-contained flats. Each flat has a private bedroom, bathroom, and living area. One of the flats is currently occupied on a permanent basis.

At the time of the inspection there were four people living at the service and one person on respite. Holmbury Dene (Respite) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service has a registered manager in post at the time of the inspection. This manager was newly registered with the Care Quality Commission. 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.

People were supported to remain safe at the service. Staff used the provider’s safeguarding policy and guidance to continue to protect people from harm and abuse. Staff completed training in safeguarding and had gained the knowledge to identify and report to the local authority an allegation of abuse.

Risks to people were identified. Staff reviewed people’s needs and risks associated with them. Risk management plans were developed which provided staff guidance on how to care for people in a safe way. The registered provider’s infection control policy was followed by staff. Staff maintained the cleanliness of the service which helped to reduce the risk of infection.

People were supported by enough staff each day. There were sufficient staff available to meet people’s individual needs. Safer recruitment procedures were followed to ensure suitable skilled staff were employed to work with people.

People’s medicines were managed safely. There was an established system in place for the administration, ordering, storage and disposal of people’s medicines.

Staff received support through training, induction, supervision and appraisal.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People consented to care and treatment before staff supported them.

Health, social care services and specialist support was sought when people’s needs changed. Healthcare professional’s recommendations and guidance for people was followed by staff.

Staff carried out people’s care and support in privacy while protecting their dignity. Staff knew people well and understood their individual needs and the support required to meet them.

People had an assessment of their needs. Each person’s care plan identified their individual care needs and the specific support needed to ensure these were met. People were a part of their local community and attended various outdoor activities. At the time of the inspection, there were no people receiving palliative care support or end of life care.

There was an established complaints procedure at the service. Complaints were managed well and each complaint was investigated and a response provided to the complainant.

Staff gave mixed views on the overall management of the service. The registered manager completed audits of the quality of care provided to people on a regular basis. The registered manager sent suitable notifications to the Care Quality Commission of events that occurred. The registered manager had developed joint working relationships with health and social care services.