Holkham House

Updated 4 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by one inspector.

Service and service type

Holkham House 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We reviewed the Provider Information Return (PIR). This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. This information helps support our inspections. We also reviewed notifications we had been sent. Notifications are specific issues that registered people must tell us about.

We used this information to plan our inspection.

During the inspection

We met all ten people who lived at the service, however, some people had some communication difficulties and where not able to tell us in detail about the care they received. We spoke with four members of staff, the registered manager and one professional. We also received feedback from three relatives after the inspection.

We reviewed a range of records. This included two people’s care records and medicine records. We looked at one staff file in relation to recruitment and at the staff supervision records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 4 March 2020

Holkham House is a residential care home providing personal care for up to 10 people who may have a learning disability and associated condition, for example autism. At the time of the inspection 10 people were living at Holkham House. The service is owned by Elysium Care Partnership No 2 Limited and is on the same site as another 10 bedded residential home owned by the same provider.

Whilst the environment wasn’t developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance, people’s care was. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People at Holkham house lived their life’s as full as possible and had control over what they did and how they were involved in decisions about their care and the service.

People’s experience of using this service and what we found

The ethos of the organisation was to enable people to have as much independence, choice and control as possible. We saw many examples of people leading the life of their choice and being able to influence that on a daily basis. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. Any communication challenges were seen as an opportunity to support someone to have a voice and still have control of their life. We saw staff used a range of innovative methods to communicate with people. For example, videos, audio minutes, pictorial and easy read versions of some procedures.

When we arrived at the service the atmosphere was busy and friendly. We met everyone living at the home, spoke with some and observed care. Staff were supporting people coming in from various outings and planning a visit out to attend a party in the service next door. Staff were encouraging people with meal planning and preparation while some people were doing craft work.

People’s relatives said they felt their loved ones were safe with the staff supporting them. Two people told us they felt safe. Systems were in place to safeguard people. Staff had completed safeguarding training and were confident any concerns would be dealt with. When people were at risk of harm, assessments were in place alongside guidance for staff on how to mitigate the risk.

People received their medicines safely in the way prescribed for them. Infection control measures were in place to prevent cross infection. Staff were suitably recruited. Staffing levels were flexible to enable the service to provide a bespoke service to people to meet their needs.

People were supported by staff who completed an induction, training and were supervised. The support required by people with health and nutritional needs was identified and provided.

Relatives agreed the staff were kind and caring. Their privacy and independence were promoted. Systems were in place to deal with concerns and complaints. This enabled people to raise concerns about their care if they needed to.

People’s care records were detailed and personalised to meet individual needs. Staff understood people’s needs and responded when needed. People were not able to be fully involved with their support plans, therefore family members supported staff to complete and review people’s support plans. People’s preferences were sought and respected.

People had staff support to access activities and holidays. This was flexible and provided in response to people’s choices. People’s communication needs were known by staff. Staff had received training in how to support people with different communication needs.

People were supported by a service that was well managed. Records were accessible and up to date. The service was audited, and action taken to address any areas identified that needed improving. Relatives were complimentary of the management of the service with one commenting; “Always very approachable and seems to have a genuine sense of care for the residents.” Staff were committed to providing good outcomes for people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good. (Report published 28 September 2016)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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