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Reports


Inspection carried out on 21 March 2018

During a routine inspection

Holt Road 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.

Holt Road is a care home providing personal care support and accommodation for up to five people with autistic spectrum conditions, complex communication needs and behaviours that challenged the service. At the time of our inspection, five people lived in the home.

At our last inspection on 31 March 2016 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 on-going 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.

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Holt Road had robust system, processes and practices to safeguard people from abuse and avoidable harm. Potential risk to people was assessed and their safety was monitored and managed to ensure people stayed safe and their freedom was respected. Sufficient staff were deployed to meet people’s needs and safe recruitment practices ensured only staff suitable to work people was employed. Medicines were managed safely and people can be confident that they received their medicines as prescribed. Appropriate infection control prevention ensured people lived in a clean home. Lessons were learned from incidences and accidents to minimise the risk of these happening again.

People’s needs were assessed to ensure Holt Road was able to meet their complex needs. Care staff had access to a wide range of training, which also included training specific to people’s needs. People had a choice of a nutritious and well balanced diet, which was freshly prepared by care staff. Holt Road accessed specialist support if needed. People lived in a well maintained and decorated home, which provided space to relax and socialise. 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 did support this practice.

Relatives told us that people were treated with respect and kindness and care staff demonstrated compassion and understanding for people’s complex needs. People who used the service were encouraged and supported to express their views. People’s privacy, dignity and independence was respected and promoted.

Peoples care was personalised and responsive to their needs. Complaints and concerns were taken seriously and responded to appropriately. The service does not provide end of life care.

Relatives and staff spoke positively of the changes in management and practice. Staff were motivated and felt supported by in their role and were on board with the registered manager's vision for the service. Relatives, people and staff were provided with the opportunity to give feedback on the service, which was then acted upon. A variety of audits were in place to assist the registered manager in driving improvement across the service. The registered manager and staff group worked alongside other agencies in order to obtain the appropriate care and support for people.

Further information is in the detailed findings below.

Inspection carried out on 31 March 2016

During a routine inspection

We carried out an announced comprehensive inspection of this service on 31 March 2016. This was the first inspection since the provider changed the registration from Salisbury Autistic Care Limited to Salisbury Support 4 Autism Limited (SS4AL) in December 2015. During our focused inspection of Salisbury Autistic Care Limited in September 2015 we found that the provider was meeting all regulations assessed.

Holt Road is a care home providing personal care support and accommodation for up to five people with autistic spectrum conditions, complex communication needs and behaviours that challenged the service. At the time of our inspection, five people lived in the home.

There was a manager registered with the Care Quality Commission (CQC), however the registered manager was currently on sick leave and an experienced senior support worker was acting on her behalf. 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.

We found people were cared for by suitably qualified, skilled and experienced staff who knew their needs well. People were supported to follow their own chosen routines and to take part in activities they liked, such as trampolining, swimming, going to the gym, walking, and baking cakes and household chores.

People’s care plans contained a good level of information setting out exactly how each person should be supported to ensure their needs were met. Staff followed the care plans and had good relationships with the people living at the home.

Risk assessments and care plans for people using the service were effective, individual and autism specific in capturing the required information. People’s individual care needs were recorded in a timely manner which demonstrated that their needs had been met. There was a strong focus on supporting people in becoming more independent by working together with the family, the person and the day service to achieve the best possible outcome.

People received their medicines in a safe manner and staff recorded and completed Medicine Administration Record (MAR) charts correctly.

The service showed good practice in supporting people with their physical and mental health needs and in making decisions for themselves.

The house was safe and improvements to the environment had been made since our last inspection.

The home was well managed and the registered manager was supported by an experienced senior care worker as well as the Head of Care who was available as and when needed. Care workers were supervised monthly and supported by senior members of staff to ensure they did their job well.

Where things had gone wrong, appropriate action was taken to make sure the same mistakes were not made again. For example, where a mistake had been made in giving somebody the wrong medicines, staff were suspended from giving medicines until they had further training and the manager had assessed their competence.

The manager notified relevant people of any incidents as required.

SS4AL undertook frequent audits to ensure the home was operating to a good standard.