HF Trust - Hollycroft

Updated 26 November 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

Two inspectors carried out the inspection.

Service and service type

HF Trust-Hollycroft 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

During the inspection-

We spoke with four people who used the service about their experience of the care provided. We spoke with five members of staff including the provider’s regional manager, registered manager and care workers. We also spoke to one professional involved with the service.

We reviewed a range of records. This included two people’s care records and two medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and audits were reviewed.

After the inspection –

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two relatives to gain feedback of their experience of the service.

Updated 26 November 2019

About the service

HF Trust- Hollycroft is a residential care home providing accommodation and personal care for 7 people with learning disabilities and/ or autism aged 18 and over at the time of the inspection. The service can support up to 8 people.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 8 people. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

The provider had not ensured that there were always adequate staffing levels to ensure people were safe and their needs were met. During weekends there was often only one staff supporting up to seven people one of who required one to one support.

Staff did not always ensure food safety processes were followed, we found that food was not stored safely in communal fridges and food labels did not display when food had to be used by.

Incident records were unclear and staff were not aware of any policy to follow in relation to recording and reporting incidents and accidents. Incident and accidents were not clearly analysed and assessed to reduce risk and improve care for people.

People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The provider was not following guidance in relation to making decisions for people who were unable to make decisions for themselves. Where people were found to lack capacity to make a decision regarding the care they received, best interest discussions or meetings did not take place to ensure decisions made for people were in their best interests.

Audit systems within the home were not effective in identifying areas of concern and where areas had been identified action was not taken in a timely manner to improve the service of care for people. Care people received was not outcome based and their care was not effectively reviewed to improve where necessary.

People had care records in place for staff to follow however it was unclear when records had been reviewed and updated and many staff had not read people’s care plans since they started working for the service up to 5 years ago. This meant that the provider was not ensuring staff were following consistent approaches and keeping up to date with peoples needs, wishes and preferences.

People were positive about their care. One person told us, “I love it here, my favourite thing is the staff.”

People were supported with kindness, respect and compassion by a staff team who knew and treated people as individuals. There was a focus on people making choices about their support and the staff team promoted people to be as independent as possible. People received personalised care and were communicated with in their preferred communication methods.

People were supported to take part in community-based activities and to take part in daily living skills in the home. Staff members encouraged people to try new things and to be involved in choosing how they spent their time.

People were protected from harm and abuse, by systems put in place at the service. People had assessments in place which enabled them to take positive risks.

People's care was based on an assessment of their needs and their choices. Staff had access to training and support. People were supported to regularly access health care services to maintain their wellbeing.

People were positive about the way they were supported with food and drink, and how they were involved in cooking and preparing meals. People were supported to see health care professionals where this support was needed.

People and their relatives were encouraged to feed back about their care and support and were involved in the service delivery. The registered manager and the staff team worked with other organisations to ensure good outcomes for people using the service. People were positive about the management of the service.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 27 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the governance of the service and in the way that staffing levels are being managed at this inspection

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.