Archived: Livability Holly Close

Holly Close accommodates three people in one adapted residential house on a residential estate; two people were living there at the time of the 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.

This inspection took place on the 22, 23 and 27 February 2018 and was announced. 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. We had previously inspected this service in March 2016, at that inspection the service was rated ‘Good’. We found that at this inspection the service had remained ‘Good’.

The was a registered manager in post. 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 continued to receive safe care. Staff were appropriately recruited and there were enough staff to provide care and support to people to meet their needs. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision, training and on-going professional development that they required to work effectively in their roles. People were supported to maintain good health and nutrition.

People developed positive relationships with the staff who were caring and treated people with respect, kindness, dignity and compassion. People had detailed personalised plans of care in place to enable staff to provide consistent care and support in line with people’s personal preferences.

People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints that they may receive. Information was available in various formats to meet the communication needs of the individuals.

The service had a positive ethos and an open culture. The registered manager was approachable, understood the needs of the people in the home, and listened to staff. There were effective systems in place to monitor the quality of the service and drive improvements.

There was a registered manager in post at the time of our inspection. 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 felt safe in the home. Staff understood the need to protect people from harm and abuse and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required at the times they needed. There were sufficient staff to meet the needs of the people and recruitment procedures protected people from receiving unsafe care from care staff unsuited to the job.

People received care from staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person.

Care records contained risk assessments and risk management plans to protect people from identified risks and helped to keep them safe but also enabled positive risk taking. They gave information for staff on the identified risk and informed staff on the measures to take to minimise any risks.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.

People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Care plans were written in a person centred approach and focussed on empowering people; personal choice, ownership for decisions and people being in control of their life. They detailed how people wished to be supported and people were fully involved in making decisions about their care. People participated in a range of activities both in the home and in the community and received the support they needed to help them do this. People were able to choose where they spent their time and what they did.

People had caring relationships with the staff that supported them. Complaints were appropriately investigated and action was taken to make improvements to the service when this was found to be necessary. Staff and people were confident that issues would be addressed and that any concerns they had would be listened to. There was a stable management team and effective systems in place to assess the quality of service provided.

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well lead?

This is a summary of what we found-

Is the service safe?

People had been cared for in an environment that was hygienic,safe and clean. There were enough staff on duty to meet the needs of the people living there and a member of the management team was available on call in case of emergencies. People's medication was managed by trained staff and stored safely.

Is the service effective?

We observed that people were happy and confident in their environment. Staff knew them well and were able to offer support and reassurance to manage changes. People's needs were recorded and evaluated each month and changes were made if necessary. One person told us "I like it here. I like my room."

Is the service caring?

People were treated with respect by staff who were attentive to their needs whilst respecting their individuality. Staff approached people in a caring way and encouraged people to do the things they wanted to do. One person was enjoying their music whilst still chatting with everyone. The atmosphere was relaxed and family orientated.

Is the service responsive to people's needs?

We saw that care plans had been updated when people's needs had changed and that referrals had been made to health and social care professionals when needed. One person was preparing to visit their family and the staff had made sure that all the arrangements had been made.

Is the service well-led?

Staff had a good understanding of the ethos of the service and quality assurance processes were in place. In the absence of a registered manager an interim manager had been supporting the staff. People were supported by staff who received training to carry out their job role well. Staff performance was assessed annually.

We spoke with a relative of a person that used the service who told us they were happy with the care their relative received. They told us 'the carers know her very well and she is very content'.

We spoke with a member of care staff that worked at the service who had a good understanding and detailed knowledge of people's needs.

We saw people needs were assessed and care and support plans were put in place to ensure their needs were met. We found that checks were carried out on equipment to ensure it was safe and appropriate checks were undertaken before staff began work. We saw there was a detailed complaints procedure in place and people were asked if they were happy with the service.

However, we identified some concerns with the recording of medication at the service.

We saw that there had been a satisfaction survey sent out to people that used the service, their relatives, friends and health professionals to obtain feedback service.

We spoke to two staff members who told us "I feel well supported" and "we all work well together as a team".

We found that were detailed care plans and assessments for people who used the service in easy read formats. This made it easier for people who used the service to understand them. People who used the service were supported to take part in activities that they liked and enjoyed.

We found that although staff told us that they had completed training we were unable to evidence certificates and dates on the training matrix provided were inconsistent. We found that the quality of the service was not regularly assessed.