Holt Mill House

Holt Mill House is a residential care home providing personal care to up to 3 people. The service provides support to people with a physical disability, sensory impairment, learning disability or autistic spectrum disorder. At the time of our inspection there were 3 people using the service, who resided in 1 building which had 2 floors.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support

Staff were not up to date with all necessary training. 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. Appropriate staffing levels and recruitment practices were in place. People's rooms and communal areas was clean and tidy. People were supported with their healthcare needs and staff supported people to eat, drink and prepare food in line with their abilities. People took part in activities and spoke positively about this and were supported to maintain relationships with loved ones.

Right Care

Various risks had not been appropriately addressed/assessed. People received person centred care and records reflected this. Medicines were being safely administered. People's needs were assessed and details of this was recorded in people’s care plans. People's equality and diversity needs were respected, and people were supported to be as independent as possible. People's records were securely stored, and staff were kind and considerate. People were able to express their views and could access advocacy services should they need or want to. No one in the service was end of life, though some work was required to improve paperwork and staff training in this area. The registered manager had previously supported LeDer (Learning Disabilities Mortality Review) following a death in the service, and complied with their request for information.

Right Culture

Quality assurance systems needed to be more robust. There were limited examples of lessons learned and the registered manager told us how they would improve this. The registered manager knew about their responsibility to be open and honest and were supportive of our inspection. Staff meetings were taking place and relatives were kept up to date during visits or over the telephone. Some surveys for people had been conducted. The service had a positive and open culture and staff told us they enjoyed their roles. Feedback about the management was positive. Staff worked in partnership with various agencies and health professionals to ensure people received the required support. Processes were in place to safeguard people. People's communication needs were being met and a complaints process was in place, though there had been no recent complaints relating to care.

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 this service was Good (published 11 January 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We have identified breaches in relation to risk (including staff training) and governance. Please see the action we have told the provider to take at the end of this report.

Follow Up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Holt Mill House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Holt Mill House provides care and accommodation accommodates for three adults with a learning disability or autistic spectrum disorder. The home is a terraced property located on a quiet road in the town of Whitworth, Rochdale. Holt Mill House is part of a wider service provision which includes a day care facility and evening activities which are accessible to the local community. At the time of this inspection there were three people living at the home.

The service was managed by a registered manager. 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.

At our last inspection in March 2015, the service was rated Good. At this inspection we found the service remained Good.

During this inspection we observed people were treated with kindness, care and respect. Staff understood their responsibilities to safeguard people from abuse. There were appropriate arrangements in place in relation to the safe storage, receipt, administration and disposal of medicines and new staff were recruited safely. Risks to people’s health, welfare and safety were managed well.

The service was safe, clean and well maintained and suited to the needs of the people living there. People enjoyed a varied and healthy diet and changes in their health were monitored and acted on.

Each person had a support plan which provided clear guidance on how their needs and preferences would be met. Care and support was focused on people's wishes and preferences and people were supported to be as independent as possible in all aspects of their lives. People’s rights to privacy, dignity, independence and freedom of choice were firmly embedded into the culture of the home and staff embraced people's diversity.

Communication between people using the service, relatives and staff was good. People who had difficulty using words or expressing their needs were well supported by the use of other methods of communication which were known to staff.

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 to live full and active lives and use local services and facilities. Activities were provided both inside and outside the wider service and were meaningful, varied and personal to people’s requirements and in line with their wishes and aspirations. People were supported to keep in contact with friends and family.

There were sufficient numbers of staff to ensure people’s care and support was provided flexibly. The staff team at Holt Mill House was stable and happy and were committed to providing quality care; they felt valued, supported, well trained and respected by the management team.

Systems were in place to monitor the quality of the service provided and ensure people received safe and effective care. People’s views and opinions were sought and acted on.

Further information is in the detailed findings below.