Archived: The Hollies

Updated 17 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 23 November 2017 and was unannounced. The inspection team comprised an inspector 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. The expert by experience at this inspection had experience of people living with a learning disability.

Prior to the inspection we reviewed the information we held about the service. This included information from other agencies and statutory notifications sent to us by the registered manager about events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with five people who lived at the home and three relatives. We spoke with the registered manager and two care staff. We spent time observing the care and support that people received during the time of the inspection. We reviewed a range of records relating to people’s care and how the home was managed. These included four care records and medicines records. We looked at staff training, support and employment records, audits, minutes of meetings with people and staff, complaints, policies and procedures and accident and incident reports.

Updated 17 March 2018

The inspection took place on 23 November 2017 and was unannounced.

The Hollies is registered to provide care and support for up to 14 people living with a learning disability and/or autism, within the 40s to 60s age range. The service comprises two distinct areas with separate entrances known as ‘The Hollies’ and ‘Number 84’. At the time of our inspection, eight people were living at the service, three people at The Hollies and five people at Number 84. Communal areas include a living room, dining room and kitchen in each part of the home. Number 84 has accommodation over two floors and The Hollies is all on ground floor level.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they 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.

At the last inspection, we found areas for improvement in relation to the guidance for ‘as required’ medicines, the drawing up of capacity assessments and staff understanding in relation to mental capacity legislation and that people and/or their relatives were not involved in reviewing their care. At this inspection we found that improvements had been made and the rating in each domain has improved from ‘Requires Improvement‘ to ‘Good’.

Staff had completed training in the administration of medicines. Medicines that were administered on an ‘as required’ basis were done so safely. People understood what their medicines were for and why they had been prescribed. Medicines were managed safely. People were protected from potential abuse and neglect and staff had completed training in safeguarding adults at risk. People felt safe living at the home. People’s risks were identified, assessed and managed safely and risk assessments provided detailed information about people and how staff should support them to mitigate risks. Accidents and incidents were logged and when things went wrong, lessons were learned. Duty of Candour was applied and the provider ensured that staff were open and honest in their communication with people and their relatives. Staffing levels were sufficient to meet people’s needs. Safe recruitment practices were followed. People were protected from the risk of infection and the home was clean and odour free.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff had a good understanding of the Mental Capacity Act 2005 and associated legislation. People were only deprived of their liberty where they were deemed to lack capacity in relation to specific decisions. People’s needs and choices were assessed so their care and treatment was delivered effectively. People were encouraged to be as independent as possible. Areas of good practice were shared between the provider and registered manager and cascaded to staff. Staff had the skills, knowledge and experience they needed to look after people effectively and had completed a range of training. Staff had regular supervisions. People were supported to have sufficient to eat and drink and were encouraged in a healthy diet. The service worked with a variety of organisations to deliver people’s care and support. People had access to a range of healthcare professionals and services. People’s rooms were personalised and decorated in line with their preferences.

People were looked after by kind, caring and friendly staff and positive relationships had been developed. People felt relaxed and at ease with staff who knew them well. Relatives spoke positively about the care staff. People’s communication needs were taken account of so that they were enabled to make decisions relating to their care. People were treated with dignity and respect and their independence was promoted.

People and their relatives were involved in reviewing the care and support provided and review meetings took place. Care was person-centred and responsive to people’s needs. Care plans were provided in an accessible format and people, where possible, had signed their care plans to show their agreement with them. Care plans included people’s personal histories, care and support needs and were detailed in providing guidance for staff, for example, in relation to providing support to people perceived as having challenging behaviour. People pursued activities of their choosing and that were of interest to them. Some people went out independently and could use public transport. Complaints were listened to and acted upon and the provider’s complaints policy was accessible and in an ‘easy read’ format. When people reached the end of their lives, people left behind at the home were supported by staff through the grieving process. People’s end of life wishes were recorded within their care plans when they felt able to discuss these with staff.

People’s rights to a meaningful life were promoted and the registered manager was passionate about this. She supported people and valued staff to do their best. The culture of the home was person-centred, open and inclusive. Staff were positive about working at the home and felt the registered manager was supportive. Staff were asked for their feedback about their employment through annual surveys sent out by the provider. Staff attended staff meetings and were encouraged to make suggestions. People were involved in developing the service and weekly house meetings were held. Relatives were happy with communication at the home from the registered manager and staff. Auditing systems were effective in measuring and monitoring the quality of care and the service overall. Notifications that the provider was required to send to the Commission by law had been sent and the rating awarded at the last inspection was on display. The service worked in partnership with other agencies to provide holistic care.