Holt Mill House

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