Archived: Holland Road

People’s experience of using this service:

People at the service were kept safe, staff understood their safeguarding responsibilities and knew how to identify abuse. Relevant risk assessments had been completed. Medicines were well managed and people received their medicines as prescribed. People lived in an environment that was maintained well and health and safety checks were completed on a regular basis. Systems and processes were in place to report and review incidents and complaints.

The care service was being developed 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.

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 were supported with dietary needs and were involved in menu planning. People’s health was monitored and people had access to health services

People were supported effectively by knowledgeable staff who had been well trained.. Staff were also supported by a management team who were experienced and knowledgeable. A complaints procedure was in place.

People were treated with dignity and respect by caring staff. People were supported to communicate in a way that helped them as the service provided information in easy read format.

Whilst there was nobody at the end of their lives at the time of inspection. We have made a recommendation about end of life planning.

The service was effectively managed by a registered manager with support from a house manager. The service was currently being sold to a new provider, staff reported communication about these changes had been excellent.

More information is in the detailed findings below.

Rating at last inspection: Good (report published 15 September 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The home is a detached house over two floors with access to the first floor via stairs. All people had their own single room. Communal space consisted of two lounge areas and a kitchen/dining room. There was a private garden at the rear and front of the property.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 safe because staff understood their responsibilities in managing risk and identifying abuse. People received safe care that met their assessed needs. There were sufficient staff to provide people with the support they needed to live as full life as possible. Staff had been recruited safely and had the skills and knowledge to provide care and support in ways that people preferred. The provider had systems in place to manage medicines and people were supported to take their prescribed medicines safely.

People who were able to communicate with us gave us positive feedback about the home and the caring nature of staff. Other people were able to demonstrate in other ways that they felt safe and cared for at the home, for example through their interaction with staff.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. Three people at the service were subject to the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and had a good understanding of the requirements of the Mental Capacity Act 2005 and (DoLS).

Staff had developed positive, respectful relationships with people and were kind and caring in their approach. People were given choices in their daily routines and their privacy and dignity was respected. People were supported and enabled to be as independent as possible in all aspects of their lives. People were offered choices, supported to feel involved and staff knew how to communicate effectively with each individual according to their needs. People were relaxed and comfortable in the company of staff. Staff supported people in a way which was kind, caring, and respectful.

Staff knew people well and were trained, skilled and competent in meeting people’s needs. Staff were supported and supervised in their roles. People, where able, were involved in the planning and reviewing of their care and support.

People’s health needs were managed appropriately with input from relevant health care professionals. Staff supported people to have sufficient food and drink that met their individual needs. People were treated with kindness and respect by staff who knew them well.

People were supported to maintain relationships with friends and family so that they were not socially isolated. There was an open culture and staff were supported to provide care that was centred on the individual. The manager was open and approachable and enabled people who used the service to express their views.

The provider had systems in place to check the quality of the service and take the views and concerns of people and their relatives into account to make improvements to the service.

This is a summary of what we found

Is the service safe?

People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard people they cared for. Systems were in place to make sure that managers and staff learnt from events such as accidents, incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The home had policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had been trained to understand when an application should be made, and in how to submit one.

Staff knew about risk management plans and showed us examples where they had followed them. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

The provider had safe and effective recruitment and selection procedures in place. Where staff had been subject to disciplinary action, appropriate procedures had been followed. Policies and procedures were in place to make sure that unsafe working practice was identified and people were protected.

Is the service effective?

People's health and care needs were assessed with them. Specialist dietary, personal care and psychological needs had been identified in care plans where required. People told us that they had been involved in writing them and that they reflected their current needs.

One person had an advocate whom we spoke with. This showed us that when required people could access additional support.

Is the service caring?

People were treated with respect and dignity by the staff. People were supported by kind and attentive staff. We saw that support workers showed patience and gave encouragement when supporting people. People we spoke with told us: 'The staff are very good here and do as much as they can for us. Most importantly for me they really respect my independence and help me to do what I want to do. I really like my individual time I have each day with staff."

People who used the service, their relatives, friends and other professionals involved with the service completed a twice yearly satisfaction survey. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People knew how to raise a concern or complain if they were unhappy.

The service worked well with other agencies and services to make sure people received care in a joined up way.

People completed a range of activities in and outside of the service regularly. The home has its own car, which helped to keep people involved with their local community.

Is the service well-led?

The service had a quality assurance system. Records seen by us showed that identified shortfalls were addressed promptly. We were therefore assured that the provider had taken steps to continually improve the service.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

During our inspection on 31 May 2013 we talked to the manager and three staff. We saw that staff were knowledgeable about the people who lived at Holland Road and promoted people's independence and choices.

During our discussions with staff we found that they had a good understanding and awareness of people's care needs and preferences. One relative told us: 'The care they give X is excellent.'

We saw evidence from our observations made during our inspection and the records we looked at that people received the support they needed to maintain their independence.

There were policies and procedures, records, and monitoring systems in place for the protection of people who used the service. Staff told us about the training they had received to enable them to carry out their roles in supporting people. Staff told us they felt well supported by the manager.

We found that the provider had systems in place to monitor and respond to any complaints received by the home.