Solden Hill House

Updated 7 May 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was conducted by two inspectors.

Service and service type

Solden Hill 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.

This service also provides care and support to people living in two ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

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

We gave the service a short period of notice to ensure all risks relating to COVID-19 could be managed safely.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with six people who used the service and two relatives about their experience of the care provided. We spoke with 15 members of staff including the nominated individual/ general manager, registered manager, house managers, senior care workers, care workers, training and development coach and the lifelong skills coach.

The nominated individual is responsible for supervising the management of the service on behalf of the provider. In this case, the nominated individual was also the general manager of the service.

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

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 7 May 2021

About the service

Solden Hill House is a residential care home for adults with learning disabilities, providing personal and support for up to 21 people in two separate buildings on the Solden Hill House site. The two homes were called Apps House and Solden Hill House. There were 21 people using the service at the time of the inspection. Solden Hill House are also registered to provide personal care to people who live in a supported living service on the site. The two supported living services are called Giles House and The Lodges. The service was supporting 9 people at the time of the inspection.

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

Staff received safeguarding training and understood their responsibilities. People were supported to take positive risks. The service had enough staff and deployed them flexibly. Medicines were administered safely. We were assured measures were in place to prevent the spread of infection to both staff and people. Following incidents, the provider had a robust system to review information.

Staff were trained and skilled to support people effectively. People were supported to maintain a well-balanced diet. Staff worked with each other collaboratively and external organisations. People had access to on-going health care services. People were encouraged to have active input into the development of their environment, which was adapted to meet people's needs and promote person centred care.

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.

Staff showed kindness and respect towards people living in the service. People's views were valued, and their feedback was sought. People's dignity and privacy was respected, and people were encouraged

to have as much independence as possible.

People received personalised care which was responsive to their needs. People had care and support records in place. Relatives and staff were listened to and felt they could raise any concerns they had with the registered or general manager. People with diverse cultural needs were supported to ensure equality within the service.

There was a positive, open culture in the service, where staff were empowered to deliver a high quality of care and support to people. The registered and general manager understood their responsibilities

and closely monitored quality. People, staff and relatives were encouraged to engage in the service and their care. The registered and general manager continually looked for ways they could improve the service and ensure sustainability. The service worked in partnership with other agencies.

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.

The service was developed prior to the values that underpin Right support, right care, right culture was published and therefore, were not meeting the best practice guidance relating to the number of people being supported in both Solden Hill House and Apps House. The services were larger than a domestic style property, however, there was no negative impact on people living there.

The service was also in a rural setting with limited access to an immediate community. However, people were supported to access the community on a regular basis by multiple methods of transport, this included people having their own bus pass. Staff supported people to seek and obtain work opportunities and maintain personal relationships.

The service was able to demonstrate how they were underpinning other values of Right support, right care and right culture, and other best practice guidance. These values include choice, promotion of independence and inclusion.

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 22 March 2018).

Why we inspected

The inspection was prompted in part by notification of a previous specific incident, which preceded the current management of the service. Following which a person using the service sustained a harm. This incident is subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident.

The information CQC received about the incident indicated previous concerns about the management of safeguarding concerns. This inspection examined those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe section of this full report.

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.