21 October 2019
During a routine inspection
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.