Archived: The Hollies

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

On the day of the inspection there was a relaxed and friendly atmosphere at the service. People and staff welcomed us into the service and were happy talk to us about their views of living and working there. People told us they were happy with the care they received and believed it was a safe environment. Comments from people and visitors included, “Very homely, relaxed and happy atmosphere”, “Open approach to any issues raised” and “I’m very happy here, it was my choice to come.”

Many people living at the service had lived in the local area before moving into the service and most staff also lived locally. This meant the people and staff had shared knowledge and interests which had helped people to develop meaningful relationships with staff. We saw that staff interacted with people in a caring and compassionate manner. Comments from people included, “I’ve always lived in Roche and lots of the people who work here live in the village, so I know a lot of the carers here”, “I have no faults with anyone, they are all very good" and “My key worker is lovely, we have a joke.”

Staff supported people to keep in touch with family and friends. People told us, “Lots of friends from the village and family visit me; they can come whenever, it’s like having your own flat; I can Skype all my family in America, the carers set it all up for me each time” and “Family come to visit me; they come when they want, one comes to see me every day.” Relatives told us they were always made welcome and were able to visit at any time. One relative said, “No restrictions at all, we come a lot, around 3-4 times a week.”

People received care and support that was responsive to their needs because staff were aware of the needs of people who lived at The Hollies. Safe arrangements were in place for the storing and administration of medicines. Staff supported people to access healthcare services such as occupational therapists, GPs, chiropodists, district nurses, opticians and audiologists.

People were supported to eat a healthy and varied diet. Where people needed assistance with eating and drinking staff provided support appropriate to meet each individual person’s assessed needs. Comments from people about their meals included, “It’s good food”, “It’s pancake day today and we are going to have pancakes at teatime” and “I enjoy all the food and if you don’t like anything they’ll always get you something else.’

Care plans were well organised and contained personalised information about the individual person’s needs and wishes. Care planning was reviewed regularly and whenever people’s needs changed. People’s care plans gave direction and guidance for staff to follow to help ensure people received their care and support in the way they wanted.

People were able to take part in a range of group and individual activities. An activity coordinator was employed for two days a week and arranged regular events for people. These included baking, craft work, exercises and board games as well as external entertainers and religious services.

Management and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). Where people did not have the capacity to make certain decisions the service acted in accordance with legal requirements. Applications for DoLS authorisations had been made to the local authority appropriately.

There were sufficient numbers of suitably qualified staff on duty to meet people’s needs in a timely manner. Staff knew how to recognise and report the signs of abuse. Staff were supported through a system of induction, training, supervision and staff meetings. This meant they developed the necessary skills to carry out their roles. There were opportunities for staff to raise any concerns or ideas about how the service could be developed.

Staff had a positive attitude and told us the management team provided strong leadership. Staff told us they felt supported by the management commenting, “I would be happy for a relative of mine to live here”, “We are a good team, we have low sickness levels because we don’t want to let our colleagues down”, “I love it here, wouldn’t want to work anywhere else” and “The owners are good to us.”

People and relatives all described the management of the home as open and approachable. Comments included, “Yes, I would definitely recommend the home, I chose here because it is central for my visitors”, “The owners sometimes come around and when they do they talk to everyone individually to see if we are all ok”, “I would recommend it here, they are very good” and “The managers are often around the home.”

People and their families were given information about how to complain. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.

Further information is in the detailed findings below.

The Hollies is a care home that provides personal care for up to 20 older people, some of whom had a diagnosis of dementia. At the time of our inspection there were 17 people living in the service.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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.

Relatives told us they were happy with the care and support their family member received and believed it was a safe environment. One relative said, “[person’s name] has settled in really well, staff are very kind to her.”

With met with several people living in the service but most were unable to tell us their views about the care and support they received. However, we observed people were relaxed and at ease with staff, and when they needed help or support they turned to staff without hesitation.

On the day of our inspection there was a calm and relaxed atmosphere in the service. We observed people had a good relationship with staff and staff interacted with people in a caring and respectful manner. Staff were clearly passionate about their work and told us they thought people were well cared for. Staff told us, “I treat people like they are my own family” and “We [staff] fit around the people who live here, it’s their home and it’s about what they want.”

People were able to take part in a range of activities of their choice. There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes.

Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.

Health professionals told us staff had good knowledge of the people they cared for and made appropriate referrals to them when people needed it. People and visitors told us they were confident that a doctor or other health professional would be called if necessary. One visitor said, “[Person’s name] looks really well, much better than when she first moved in.”

Staff supported people to maintain a balanced diet appropriate to their dietary needs and preferences. People were able to choose where they wanted to eat their meals, in either the lounge, dining room or in their bedroom. People were seen to enjoy their meals on the day of our visit.

Care records were up to date, had been regularly reviewed, and accurately reflected people’s care and support needs. Details of how people wished to be supported were personalised to the individual and provided clear information to enable staff to provide appropriate and effective support. Any risks in relation to people’s care and support were identified and appropriately managed.

Where people did not have the capacity to make certain decisions the service acted in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People and their families were given information about how to complain. There was a management structure in the service which provided clear lines of responsibility and accountability. Staff had a positive attitude and the management team provided strong leadership and led by example. Staff said, “Management are very supportive” and “I very much enjoy working here.”

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. The owners were visible in the service and regularly observed and talked to people to check if they were happy and safe living at The Hollies.

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

If you want to see the evidence to support our summary please read the full report.

Is the service safe?

People were treated with dignity and respect. Care plans were personalised to the individual and gave comprehensive information about how the person wanted their care and support to be provided.

People were protected from unsafe or unsuitable equipment because equipment used in the service was fit for purpose, properly maintained and used correctly.

The Hollies had policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DOLS). There was evidence the home considered the impact of any restrictions put in place for people that might need to be authorised under the Deprivation of Liberty Safeguards

People were cared for by staff who were properly trained, supervised and appraised. A member of the management team was available on call in case of emergencies.

Systems were in place to ensure managers and staff learnt from events such as accidents and incidents, complaints and concerns. This meant the risks to people were reduced and this learning helped to continually improve the service.

Is the service effective?

We looked at five care records and these showed people's choices and preferred routines for assistance with their personal care and daily living. Specialist dietary, mobility and equipment needs had been identified in care plans where required. Staff we spoke with and observed showed they had good knowledge of the people they supported.

People received personalised care through the effective use of equipment suitable for their needs.

Where people were assessed as not having the mental capacity to be involved in writing and developing their care plans these were written in their best interest. We saw records where family members had signed care plans to agree to the content and confirm their involvement in writing them.

Is the service caring?

People's individual care plans recorded their choices and preferred routines for assistance with their personal care and daily living and support had been provided in accordance with people's wishes.

People we spoke with told us they were very happy living in the home and staff looked after them well helping them to make choices about their daily living. One person told us, 'I like living here and staff are very kind'. Staff were seen responding to people respectfully, with good humour and in a caring manner.

Is the service responsive?

The home had two activity co-ordinators who worked a total of 12 hours each week. There were a range of activities on offer, some facilitated by staff in the home and others with external entertainers. These included: bingo, arts and crafts, sing-a-longs sensory days and trips out. We also observed staff spending one-to-one time with people chatting and reading to them.

The Hollies gave clear information to people about how to complain. The home had not received any complaints in the last year. Although we saw that because of the open culture of the home, people were happy to give feedback or raise concerns as soon as situations occurred. This meant that any concerns were dealt with quickly and resolved without the need to formally complain.

Is the service well-led?

The home worked with external health professionals to ensure people's health needs were met. We saw examples where advice had been sought from occupational therapists and community nurses in assessing the right equipment for people such as pressure relieving cushions and hoists.

It was clear from people we spoke with that the managers and owners were visible in the home and involved people in decisions made about the running of the home. Staff we spoke with told us the management team were very approachable and welcomed any ideas or suggestions from staff.

Staff told us they were offered relevant and useful training on a regular basis. Staff also told us they felt supported by the management team and could approach them at any time if they had a concern.

We saw care plans were detailed and gave direction as to the care and support people needed. They had been regularly reviewed.

People had a choice of meals. Drinks were offered to people at regular intervals.

People were protected from abuse and staff were trained and supported to carry out their roles.

We saw staff were able to meet people's care and social needs. People were not rushed and the routines were flexible to meet people's different needs.

People who used the service were protected against the risks of unsafe or inappropriate care and treatment as records were updated and stored securely in order to protect people's confidentiality.

We saw 75% of care plans had been replaced with a new format and style since the last inspection. They were very informative and directed staff as to the care and support people needed. They were regularly reviewed and updated.

We saw some changes had been made to the medicine administration procedures and a regular audit of the systems in place had been established. As a result we saw, for example, creams kept in peoples rooms had a date of opening on them.

During our inspection visit we saw the home was clean and tidy. We saw the communal corridors on the ground floor had been decorated and new lights fitted making the area look much lighter and brighter. We were shown new flooring in place and a new assisted bath that had been provided by a local charity.

We saw the quality of the service was being regularly monitored and were shown evidence of audits that had been introduced since our last inspection visit.