Holcombe House is a domiciliary care agency owned by Vision Homes Association. It provides supported living services to people in their own homes. At the time of our inspection six people were receiving personal care from the agency.

The inspection of this service took place on 22 August 2016 and was announced

There was a registered manager in post and they were present at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, registered managers 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.

People were supported by staff who knew how to keep them safe and free from harm. They knew how to recognise and report any risks, problems or potential signs of abuse.

People were supported to live full and independent lives. Risks were assessed prior to activities taking place and guidelines were developed to ensure that people could learn new skills safely. Regular reviews ensured that risks were updated as people achieved their goals.

Some people required support to take their medicines. They were protected by safe systems in place for administering, storing and recording medicines. Robust training was in place to enable staff to safely support people to take their medicines when required.

People were supported by sufficient staff to meet their needs safely and effectively. People received flexible and responsive support. Staff were recruited through safe recruitment practices meaning that only people suitable to work in the role were appointed.

People were supported by staff who had the knowledge and skills to provide effective support. They received good training opportunities and training had been developed around the individual needs of the people who used the service. Staff competency was regularly reviewed and knowledge was updated to ensure it continued to reflect current best practices and legislation. Staff felt very well supported by the registered manager and their colleagues.

Staff understood their roles and responsibilities and worked well as a team to ensure people’s needs were met. People’s rights were protected under the Mental Capacity Act 2005 and staff understood how to protect people’s human rights. The registered manager and the staff team were committed to offering a service that was centred on meeting people’s individual needs. People were offered choices as to how they lived their lives and staff recognised the importance of people having the right information and support to enable them to make their own decisions

People received support to ensure they enjoyed a balanced and nutritious diet. Staff worked with healthcare professionals to ensure people’s continued good health and wellbeing.

People were supported by staff who were caring and understood the importance of delivering person centre care that promoted and developed people’s independence. People’s privacy and dignity was respected as was their individuality, which was recognised and celebrated. People were supported to maintain and develop positive relationships with people who were important to them.

People enjoyed living the lives they chose and this involved having active social lives. Activities were developed around individual preferences, likes and hobbies. Staff recognised the importance of social engagement and contact and encouraged it in daily planning. Staff were creative in developing activities designed around people’s abilities, cultures and preferences.

People who used the service, and their friends and relatives, shared information effectively with the registered manager and the staff team to ensure they received a responsive service. People told us they were able to raise concerns and felt these would be acted on by the registered manager. The provider had a system t

Holcombe House is the office from which Vision Homes runs its domiciliary care service for people with learning disabilities. At the time of our visit, the service was providing support for two people twenty four hours a day in their own homes.

We were not able to speak with either of the people who received a service because of their disabilities, but we did speak with the relative of one. They were very pleased with the service. They told us, “It’s as good as it gets”, and that it was, “An absolutely positive experience”.

We found that staff supported people to be as independent as possible. Staff understood the people they cared for very well and respected their decisions and choices.

Care plans were very person centred and had been produced with input from the people concerned and their relatives where appropriate. We saw good evidence of regularly reviewed risk assessments to help keep people safe.

We found that people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent it from happening.

We saw evidence of a good induction programme for new members of staff and a comprehensive package of ongoing training for all staff.

We were satisfied that the provider had appropriate systems in place to monitor and assess the quality of the service it provided.

We visited the office and looked at records about staff and the running of the agency. We looked at records of the three people who used the service. We spoke with their representatives as people were unable to tell us their views. We spoke with three managers, the provider’s human resource department and three staff.

People’s relatives were complimentary about the service and told us that people felt safe with the staff. Relatives were involved in care reviews and meetings to make best interest decisions. They commented, “X leads an active life”, “X's home is always clean”, “The staff have a good attitude and are well trained”, and "Good financial records are kept."

Individual needs were met as people preferred, respecting their lifestyles, interests and beliefs. People’s health and wellbeing was monitored and staff had specialist training to meet people’s health needs. Managers carried out regular spot checks to ensure that people were appropriately cared for and hygiene standards were maintained.

Staff worked in dedicated teams and people helped to choose their staff. The provider made appropriate checks that staff were safe and fit for their roles before they started to work with people. Staff had ongoing training and were confident about reporting concerns of abuse should they arise, to managers and other agencies. Managers acted upon and staff learned from comments or complaints people and their representatives had made.