Background to this inspection
Updated
25 December 2019
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.
Inspection team
The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Holehird is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
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. This information helps support our inspections.
We used all of this information to plan our inspection.
During the inspection
We looked around the home, reviewed records relevant to the running and quality monitoring of the service, the recruitment records for all new staff employed in the last year and policies and procedures. We looked at training and supervision records. We looked at care records and the records of medication administration, medicines storage and management.
We spoke with three people who lived at Holehird and four relatives, three more relatives contacted us to share their experience of the service provided. We observed people's daily routines and staff interaction. We spoke with seven staff members on duty, including the registered manager and two members of the clinical team. We also received information from visiting professionals about their experiences of working with this service.
After the inspection
We continued to seek clarification from the registered manager to corroborate what we found. This included recruitment and maintenance records. We obtained more feedback from two health and social care professionals who had been involved with people living at the home.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included five people’s care records and medication records. We looked at five 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.
Updated
25 December 2019
About the service
Holehird provides care and nursing for up to 29 people with physical disabilities. At the time of the inspection there were 25 people living there.
The home is a detached period property that has been suitably adapted. Accommodation is provided over two floors and has accessible outdoor areas with extensive gardens. It is close to the town amenities of Windermere and the Lake District.
People’s experience of using this service and what we found
The service continued to provide exceptional effective treatment and person-centred care which had outstanding results and for some people life changing. The in-house physiotherapy and clinical teams worked exceptionally well with other organisations in helping people achieve positive and life changing outcomes. They built people’s confidence and supported them in regaining their independence sufficiently to leave residential care.
Visiting professionals told us the team at Holehird were extremely effective and totally committed to extending their clinical knowledge for the benefit of people in their care. We were told the team used their extended skills and made a huge effort in enabling people to develop their functional skills and daily activities. The service worked with a variety of external agencies and health professionals to provide appropriate care and support to meet people’s physical and emotional health needs.
The provider had safeguarding systems to protect people from the risk of abuse or unsafe care. Staff were aware of the procedures, had received training on it and knew what action to take. We saw that staff treated people with kindness and respect and made sure their dignity was maintained.
The provider had policies and procedures to support the safe recruitment of staff. The registered manager made sure sufficient numbers of appropriately trained staff were on duty throughout the day and night to make sure people received the support they needed.
Staff gave people the support they needed to take their medicines. People received their medicines safely and as their doctor had prescribed. People received support to maintain good nutrition and hydration in line with their personal choice.
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. People and their families had been fully involved in planning and reviewing the care and support provided.
People's rights were protected. People were treated with respect and their dignity and privacy were actively promoted by the staff supporting them. People were fully supported to maintain their independence. The provider planned people's care to meet their needs and take account of their choices. People could see their families and friends as they wished.
People knew how they could raise concerns about the service provided. The provider and registered manager monitored the quality of the service and identified areas which could be improved. Governance and quality assurance were well-embedded within the service. Staff said they felt valued and respected.
The leadership of the service promoted a positive, open culture. The registered manager and staff team displayed knowledge and understanding around the importance of openness and working closely with other agencies and healthcare professionals to make sure people had excellent effective 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 3 May 2017).
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.