Holt Road

Updated 13 October 2022

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 team consisted of two inspectors.

Service and service type

Holt Road is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced

What we did before the inspection

We looked at information we held about the service. This information included any statutory notifications that the provider had sent to the CQC. Statutory notifications include information about important events which the provider is required to send us by law. This information helps support our inspections. We reviewed the last inspection report. We also reviewed information about the service that we had received from the host local authority.

During the inspection-

We completed a tour of the premises, visited the communal areas and some people’s bedrooms. We spoke with the service manager, operations lead, behaviour technician and three support workers. People living in the care home were not able to express themselves verbally because of complex needs. However, they were able to express themselves by using gestures.

We reviewed a range of care records and information related to the running of the service. These records included four people's care files, medicine administration records and three staff recruitment records. We also looked at policies and procedures, and records of checks and audits.

Updated 13 October 2022

Summary

We expect¿health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right¿support, right care, right culture’ is the guidance Care Quality Commission (CQC)¿follows to make assessments and judgements about services supporting¿people with a learning disability and autistic people and providers must have regard to it.

About the service

Holt Road is a residential care home providing accommodation for persons who require nursing or personal care for up to five people. The service provides support to people with a learning disability and autistic people. At the time of our inspection there were four people using the service.

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

The service demonstrated how they were meeting the underpinning principles of Right support, Right care, Right culture.

Right support:

Staff were aware of and followed best practice and the principles of Right support. People received person centred support. Positive behaviour support plans promoted strategies to enhance independence and demonstrated evidence of planning and consideration of the longer-term aspirations of each person. The service provided care and support in a safe, clean, well-furnished and well-maintained environment that met people’s sensory and physical needs. The service was similar to the other houses in the area. People’s rooms were clean and personalised with their belongings and family photographs.

Right care:

The service had enough appropriately skilled staff to meet people’s needs. Staff received support in the form of continual supervision, appraisal and recognition of good practice. They also benefitted from a system of monitoring, which ensured they received timely feedback from managers. People could take part in activities and pursue interests that were tailored to them. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. There were visual structures, including picture aids and use of gestures.

Right culture:

The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services led confident, inclusive and empowered lives. Leaders had the skills, knowledge and experience to perform their roles and had a clear understanding of people’s needs and oversight of the services they managed. This was demonstrated by the behaviour technician, service manager and the regional manager throughout the inspection. We found them to have the competencies associated with actions necessary for the delivery of positive behaviour support.

There were effective systems and processes in place to minimise risks to people. The assessments provided information about how to support people to ensure risks were reduced.

Positive behaviour support plans included risk assessments that detailed known triggers, early warning signs and de-escalation methods to be used. This insured people received timely intervention if their mental health deteriorated. There were enough staff deployed to keep people safe. Pre-employment checks had been carried out.

There were systems in place to ensure proper and safe use of medicines. We observed from records people received their medicines on time.

People were protected from the risks associated with poor infection control because the service had processes in place to reduce the risk of infection and cross contamination.

There was a process in place to report, monitor and learn from accidents and incidents. Accidents were documented timely in line with the service’s policy and guidance.

There was an effective training system in place. Care staff demonstrated good knowledge and skills necessary for their role.

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

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

Rating at last inspection

The last rating for the service was good, published on 21 March 2018.

Why we inspected

We received concerns in relation to the management of risk relating to hot water temperature, poor management of medicines and staff demonstrating lack of understanding in the management of behaviours people may display when in distress. A decision was made for us to inspect and examine those risks. We found that the service had acted on the concerns.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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.