Archived: Hollybrook House

At the last inspection, in July 2015 the service was rated Good. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Hollybrook House’ on our website at ‘www.cqc.org.uk’.

This inspection took place on 3 August 2017 and was unannounced. At this inspection we found the service remained Good.

The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

The people we spoke with told us they were very happy with the care and support that they were provided with at Hollybrook House and with the staff who supported them.

People’s care and support was planned and delivered in a way that made sure they were safe. The support plans we looked at included risk assessments, which identified any risk associated with people’s care.

Staff had a clear understanding of safeguarding adults and what action they would take if they suspected abuse.

There were enough staff with the right skills, knowledge and experience to meet people’s needs and the recruitment system was designed to ensure staff were suitable to work with vulnerable people.

An ongoing training and support programme ensured staff maintained and developed their knowledge and skills.

People’s needs were assessed and care and support was planned and delivered in line with their individual support plan. The support plans were person centred and some included photographs and pictures to assist the person to understand and be involved in their plan.

We found the service to be meeting the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). 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.

People were involved in planning, shopping for, and preparing their own meals, with appropriate assistance from staff. This ensured that people were supported to maintain a balanced diet.

People were supported to maintain good health, have access to healthcare services and received ongoing healthcare support.

People were supported in a way that helped them to grow in confidence, maturity and skills. Staff understood people’s needs and effectively promoted people’s independence.

People had their own interests and hobbies and took part in the community. People were supported to maintain their family relationships and friendships.

Staff we spoke with felt the service was well led and the registered manager was approachable and listened to them. There was an open and transparent management of the service, with very comprehensive checks and audits to maintain the quality.

There was a complaints policy to guide people on how to raise concerns and this was available in an easy to read version to help people who used the service to understand and engage in the process.

Staff we spoke with felt the service was well led and the registered manager was approachable and listened to them. There were systems in place to enable people to share their opinion of the service.

The registered manager, registered providers and care team demonstrated a commitment to continually improve the service and use lessons learned to take the service forward. We also saw audits and checks were regularly undertaken to make sure company policies had been followed and the premises were safe and well maintained.

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

Care and treatment was planned and delivered in a way that ensured people's safety and welfare. Each person's plan outlined the areas where they needed support. There were risk assessments in place for people, which outlined any risks associated with their care.

Appropriate arrangements were in place in relation to obtaining medicine. The medication was mainly dispensed from a monitored dosage system. Staff used a medication administration record (MAR) to confirm they had given medication as prescribed. Each person had a front sheet which was placed before the MAR. This gave personal details such as the person's name, date of birth and any allergies. The front sheet also contained a photograph of the person.

Is the service effective?

Before people received any care they were asked for their consent and the provider acted in accordance with their wishes. We spoke with people who used the service and they felt involved in their care. One person said, 'The staff understand me and support me in making my choices.'

People who used the service had the opportunity of discussing their care plan and any other issues at a monthly key worker meeting. At this meeting people discussed what they had enjoyed doing that month and what they may like to change for the coming month. They also discussed important dates, for example family birthdays and how they would prepare for them. People who used the service told us they found these meeting valuable.

People were cared for by staff who were supported to deliver care to an appropriate standard. We spoke with staff and they told us they were involved in staff meetings and they told us they felt supported.

Is the service caring?

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We spoke with people who used the service and they told us the standard of care was very good. We looked at assessments and care plans belonging to two people. They were person centred and gave a clear picture of people's needs. We saw that pictures had been used to help the person understand what was written.

Is the service responsive?

We saw that care plans were reviewed regularly and any changes were made to ensure people's needs were met. We observed staff interacting with people who used the service and saw that they were responsive to their needs. Staff knew how to support people and worked in line with their individual care plans.

Is the service well-led?

We saw that audits had been completed and where actions had been identified these were addressed.

People who used the service and their representatives were asked for their views about their care and they were acted on. We spoke with people who used the service and they told us that they were asked their opinion in how the service was run. We spoke with the registered manager who told us a quality assurance questionnaire was sent out on an annual basis and the results were shared with people.

People who used the service had a care plan which was relevant to their individual needs. We spoke with two people who used the service who spoke positively about the care they received. One person said, 'I really enjoy living here and I go on holiday.' Another person said, 'I have been involved in staff interviews and gave my opinion.'

People's safety and welfare was protected when more than one provider was involved in their care and treatment.

People felt safe and enjoyed living at the home. One person said, "The staff are really nice, they are kind and I feel safe here." Staff we spoke with were knowledgeable about the safeguarding procedure and how to report any concerns.

We found that the provider had an effective recruitment procedure in place. Appropriate checks were undertaken before staff began work.

The provider had an effective system in place to regularly assess and monitor the quality of service that people receive.

People had care records which were person centred and reflected the needs of each individual. People had a key worker who spend time talking to them about their care records and reviewing them. People were able to contribute. One person said, 'I like to sit and talk to my key worker about my activity plan.'

People who used the service thought that the food was good. People helped to prepare the food and were offered a course in food hygiene. One person said 'I am doing catering at college so I like to be involved in the kitchen.'

We found that the environment was clean and tidy. Staff supported people to keep the home clean. There was a schedule of weekly tasks. Each person was supported to keep their own room tidy. One person said 'Sometimes I need help to clean my room but staff help me.'

We found that there were enough staff to meet people's needs. Staff were knowledgeable about their role and felt that the training they attended was good.

People knew how to complain if they needed to. The complaints procedure was available in an easy read format. One person said, 'I have never had to complain but if I had a problem I would tell the staff.' Another person said, 'Staff would sort anything out if I needed them to.'