HF Trust - Hollycroft

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last inspection we rated this key question Requires improvement. At this inspection the rating has changed to Outstanding. This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

This service scored 95 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Without exception, people and particularly, their relatives spoke incredibly positively about their/ their family members support and the overwhelmingly kind and caring nature of the staff team. One person said, ‘‘[Staff] are fantastic and wonderful.’’ Relatives’ comments included, ‘‘The quality of care and as a result the quality of life they have is amazing. How happy and content they are is just incredible and a massive credit to the staff team. They have lived at the service a long time but have really come out of their shell the last couple of years. So much more conversational and confident. I am absolutely thrilled.’’ And ‘‘Since [family member] has been living at the service things have been 100% fantastic. The trust the staff team have built up with [family member] and the trust they have for them has put [family member] in the best place they have been in their whole lives. I cannot say enough the difference [staff] have made to our lives.’’

Staff spoke about people knowledgably and with kindness and compassion. We observed staff speaking with people kindly and in line with the way they wanted to be communicated with. The way in which staff respected people’s dignity was exceptional and led to people being extremely happy with their support. One person needed a lot of support in areas such as managing their personal care. However, they were very keen to have as much dignity as possible. The way in which staff supported this person to have the time and space to maintain their dignity and attend to their own care as far as possible meant a lot to the person. We saw how happy they were when this happened, and they signed to tell us they were happy. A relative said, ‘‘[Staff team] know exactly how [family member] thinks and how their mind works. They promote them being themselves and as a result [family member] is over the moon with what they are able to do themselves now.’’

Several people using the service had wanted to form relationships with other people for most of their life but had not been supported to do so effectively. Since living at the service people had been supported to form these relationships. Staff fully understood how to respect these relationships and supported them with the utmost dignity, compassion and respect. For example, one person needed staff support to access the community. Staff worked with people and the person they were in a relationship with to identify areas where they could have privacy but still be able to call on staff support where this was required. The difference this made to people was incredible. One person who had wanted to form a relationship for many years told us, ‘‘I have a [relationship] now and we go out together. We cook dinner together. Its good.’’ A relative told us, ‘‘I could give you a few things the staff team have done exceptionally well, but above all else, I think the way in which they have supported, educated and facilitated the development of [family members’] relationship with [person] has been amazing. They show one another respect and honesty and are clearly so very happy.’’ Another person had been supported to build a lasting and meaningful relationship with their peer. They enthusiastically told us the day of the week they were seeing this person and what they did when they saw them which made them excited and happy. The support people had to build these meaningful and lasting relationships was outstanding.

The way the registered manager and staff treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences was exceptional.

Staff knew people incredibly well as individuals and knew precisely how they liked to be supported. They explained what people’s preferences likes and dislikes were and understood how important these were when supporting people. They fully supported people in line with their chosen likes, dislikes and preferences, showing complete respect and understanding for these. In the past, people had not been given the opportunities to discuss their individual support needs and had been supported to attend learning centres and day opportunities on a daily basis. Whilst people were happy doing this, they had not been aware of the ways in which they could be supported to follow their own interests as individuals. Since the registered manager had been working at the service, they had encouraged the staff team to fully explore these with people leading to really good outcomes. Specific examples of how people’s individual needs were met are explained in the ’Equity in experiences and outcomes’ section of this report.

One person had a real interest in building and making things, however found it difficult to do this in a ‘work’ environment. Staff worked with the person, their family and partners to support this person by building their own large tool shed in the garden. The person had full access to this shed and a lot of tools enabling them to build items and work at their own pace. Staff had also encouraged the person to complete their own health and safety checks of the shed and all the tools. The person would often choose to work in the shed for extended periods of time which could lead to social isolation. Staff had recognised this and also supported and worked with the person to be in control of their own breaks and to have a day off where they relaxed. The person was delighted with this outcome and felt fully in control of how they spent their day working. The person said, ‘‘I am happy chilled and relaxed when I am at work. I do what I want and I feel good.’’ A relative told us, ‘‘[Family member] likes independence and responsibility and would spend every second of the day doing their work. Its great staff encourage them to hang out with housemates and supported him to have days off which has really helped his wellbeing and made them more relaxed and enabled them to enjoy their time.’’

One person had a close bereavement and found talking about this very difficult. Staff understood and supported their individual needs relating to this. They organised art and music therapy for the person to enable them to express how they were feeling in ways that made sense to them. This fully enabled the person to work through and understand their feelings. Another person had a desire to learn to read and write and to learn to count numbers. This desire was explored, researched and fully supported by the registered manager and staff team. As a result, the person could now write and count to a level they were unable to do so before. The person told us, ‘‘I feel proud about this.’’ A relative said, ‘‘The staff team are brilliant. They know exactly what makes [family member] happy and even if they don’t, they will always get in contact and ask us.’’

Staff had worked with and identified people’s individual interests in relation to their day to day living. People had been fully supported to embrace their individual likes such as gardening, washing cars, cooking and organising waste and recycling. This is something that had not been discussed with people until the registered manager had empowered and worked with the staff team to accommodate this. One relative told us, ‘‘You can hear how proud [family member] is each and every time we speak with them. They are so incredibly happy. I thought they were doing well before but have really had my eyes opened as to how much they could achieve and how fulfilling their lives could be.’

Supporting people to be independent and have full choice and control of their lives was a key aim and a priority for the registered manager and staff team. They fully enabled and supported people to be as independent as they could be and to have as much choice and control as they could in all aspects of their support.

Staff had worked with people to identify and help them increase their independence as far as possible. For example, one person was unable to cross roads safely by themselves. Staff worked with and supported the person step by step to build their confidence and independence, and the person could now do this completely independently. Another person had been supported to go out of the service into the local community completely independently both for walks and to access a local community activity. They had been nervous to do this but thanks to the support from staff, including being taught how to use a mobile phone they were now able to do this fully independently. They had also been supported to learn how to independently use public transport to visit their relative. Both the person and their relative told us this meant a lot to them. The person said ‘‘I love going to [community activity] and then I have a rest in my room.’’ A relative told us, ‘‘Staff fully support [family members] independence and individuality. Staff do everything they can and more to help make sure they are able to do whatever they want to do.’’

A key aspect of people’s daily lives which had been a focus for the registered manager and staff team in relation to independence and choice was how people shopped and cooked for their meals. Food meant a lot to people living at the service however, their independence in this area had not been fully explored with them in the past. Thanks to the efforts of the staff team and registered manager, people had been fully supported to take as much part in shopping and cooking as they were able or wanted to do so. This had a remarkably positive impact for people. One person said, ‘‘I cook a whole Sunday roast more or less by myself. The potatoes are the best. Its great.’’ Another person was visibly very happy to help prepare a meal. Staff were patient and understanding, working at the persons pace to help and support them to take part and be independent in their own time and choose how and what they did during cooking. The person showed how happy they were by singing and dancing. A relative said, ‘‘[Staff] make every effort to involve [family member] in things like shopping and cooking. I cannot believe what they are capable of doing and it is all thanks to the staff team.’’

The registered manager worked with the staff team to fully optimise staffing levels at the service, so people had the maximum opportunity to take part in daily living skills around the house and access the community. People’s independence in all areas of their lives, fully considering how independent they could be and how much support they needed was clearly recorded in very detailed care plans and risk assessments. As a result, people had opportunities to do what they wanted to do with staff support available only if and when they needed this. One relative told us, ‘‘[Family member] wants for nothing. I cannot tell you how much happier they have been living at the service the last few years.’’

People were supported to be in control and make choices about all aspects of their care. We observed staff offering choices to people such as what they wanted to eat or how they wanted to spend their time. Choices were offered to people in different ways such as verbally or by using photos and objects. The registered manager thought of innovative ways to make sure people were in control of their home environment and their support. For example, they had installed a camera phone at the front door and encouraged people to answer the door themselves. People found this easier when they could see who wanted to come in. Staff sat and spoke with people regularly to discuss their choices about what they wanted to do and how they wanted to be supported to achieve these. They then put actions in place to support people to achieve these choices. This had led to terrific outcomes for people such as learning to swim or be more confident in making friendships. One person said, ‘‘I like to exercise and the staff have helped me do this safely.’’ A relative told us, ‘‘One thing the service does that is truly exceptional is making each and every one of [family member’s] choices a reality for them. Nothing is out of reach for them.’'

Staff and the registered manager were incredibly alert to changes in people’s support needs and took immediate actions in response to these.

One person had started to live with a new support condition. This was challenging for them and had impacted several areas of their daily life. The registered manager had been incredibly proactive in reaching out to professionals who would be able to help them with this. Staff had also taken the time to sit and understand the impact this was having on the person’s enjoyment of known things they liked and on their independence. They discussed this with the person and together to fully update the persons care plans to accommodate this new need whilst also supporting the person to still follow their interests and maintain their independence. We observed this person to be extremely happy, dancing with the staff team and sitting chatting with them. It was clear working with the person and supporting them with this new need had not impacted the person in a negative way thanks to the efforts of the registered manager and staff team. A relative said, ‘‘[Family member] has had and is having some more difficult moments in relation to their health but the staff manage this really well and reassure me that they are able to support [family member] in the best way they can.’’

Staff put effective measures in place to respond to people when their needs change and help them maintain their independence. For example, one person had been supported to move bedrooms when it was no longer safe for them to use the stairs. This had been done fully with the person, with staff supporting them to understand the reason for the move and putting the person fully in charge of when the move happened and what their new room would look like. This resulted in a very successful move for the person. Staff also noted the person was not able to use the taps at the service and so, installed new ones the person was able to use. A relative told us, ‘‘[Staff] really do care about [family member] and do what they can to make them as comfortable as possible and to keep doing the things they love.’’ Another person was living with a support need that meant they were unable to respond to fire alarms or hear staff knocking at their bedroom door. Staff supported the person by purchasing a piece of equipment that alerted the person as to when an alarm went off or when someone knocked at their door another way. They fully supported the person to understand how to use this and it resulted in a fantastic outcome for the person. A relative said, ‘‘We never have to worry about [family member]. No matter what they need the staff are there to help them in a heartbeat.’’

Staff also took a proactive approach to responding to people’s needs before they needed more intense support. They discussed incidents where people may have been upset and discussed potential reasons as to why this was. Care plans and records were then updated and shared with the staff team to help ensure people’s needs were responded to immediately before they could become upset. This had a significant impact and people now needed intense support to feel better much less frequently.

The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care. Staff enjoyed working at the service and felt well supported by the management team. They had regular discussions and supervisions to discuss their job roles and any support they may need. Regular meetings with staff took place to discuss how well supported they felt and any improvements they felt would benefit the service.