HF Trust - Hollycroft

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last inspection we rated this key question Requires improvement. At this inspection the rating has changed to Outstanding. This meant service leadership was exceptional and distinctive. Leaders and the service culture they created drove and improved high-quality, person-centred care leading to good outcomes and an excellent quality of life for people using the service.

This service scored 89 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider, registered manager and staff team had a shared vision, strategy and culture. The culture at the service was exceptionally positive. Staff understood their main role was to support people to have the best experiences possible. The registered manager had a clear vision of ‘supporting people to reach their full potential’ and this was shared and embraced by the staff team. The registered manager explained, ‘‘This is [people’s home] and they should be in control of all aspects of the service. We [me and the staff team] understand it is easy to live in fear of what might go wrong when people want to do things but that is not how people live their lives. We help them be as safe as possible but will never say no. They are supported to do absolutely anything they want to do, and this is mine and the staff teams’ philosophy.’’

The registered manager shared examples with us and explained how they and the staff team had worked incredibly hard to drive and promote a positive culture at the service. They explained that before they started this work, people were not involved in discussions about their support or how they spent their time. People attended local day services every day and were not given the opportunity to take part in any aspect of the service, such as who worked there, the cooking, the cleaning or the decoration of the service. The registered manager told us and showed us how they had now supported the staff team to discuss and make changes to how people were supported so they were fully involved in all aspects of the service.

People now spent their time following their interests, attending community activities and following their preferred past times. The staff team had encouraged and supported people to be an active part of the service in areas such as cooking and cleaning. The registered manager fully involved people in the redecoration of the service when they started working there. People had been supported to decorate the service with photographs to give the service a real feel of friendship and community. People were fully involved in recruiting new staff members to work at the service. This involved meeting the staff member and asking them questions in people’s preferred ways and style to see if the staff member was a good fit for the service. One person said ‘‘I love meeting new staff. We can say if we are happy or not afterwards.’’ A relative explained, ‘‘We have always been happy with the service, but I don’t think we realised how much better it could have been until recent years. [Family member] is just so much more confident and conversant than they have ever been. They have truly been supported to become themselves.’’

The atmosphere and culture at the service both between people and staff was exceptionally positive. People were incredibly happy and relaxed whilst being supported by the staff team. We observed people to spend their time how they chose to do so and people showed how happy they were by signing, singing and dancing. There were clear positive friendships between the people living at the service. People had been supported by the registered manager and staff team to embrace an understand each other as individuals. Staff prompted and encouraged people to spend time together at the service doing mutually liked activities such as artwork or playing games. One person using the service communicated using signs and gestures and the staff team had ensured other people using the service had learnt these signs and what they meant. We observed the extremely positive impact this had for the person who felt included in discussions, and people who communicated with them were delighted to be able to converse with them in their chosen way. It was clear this had enabled people living at the service to have true friendships. One person said, ‘‘Used to be in a place with no friends and it is not good. Here, there are lots of friends and we have really good staff. It is really good.’’ Another person told us, ‘‘I love everyone who lives here. They are all my best friends.’’ Another person enthusiastically showed us how happy they were living with their peers’ using signs and body language. A relative told us, ‘‘It’s a fantastic dynamic at the service and they manage to make it feel like a real family atmosphere but also keep everything individual to [family member]. They have the freedom to do whatever they want to do. Staff encourage them and everyone living at the service to be their own person and I think this is amazing.’’

The registered manager and staff teams’ vision to support people as individuals and to reach their full potential was reflected in the outcomes people had. Without question, there had been a marked reduction in the number of times people needed more focused support to feel better if they were upset or anxious. One person said, ‘‘I get angry and sad but just talk to staff now and they will help me.’’ People felt completely at ease talking about their feelings with staff and having support to feel better in a calm and beneficial way. Every person living at the service now explored their personal interests on a daily basis and had a marked increase in their presence in the local community. One relative said, ‘‘The only way I can explain it is that staff just ‘get’ [family member]. They know exactly what to do to get the best out of them and know exactly what to say to make them feel better if they are upset. [Family member] is so delighted to talk with us when we speak with them about what they have been up to and is so happy to live at the service. This makes us so assured that they are having the best life they can have.’’

The registered manager was an exemplary inclusive leader who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. They had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Without exception people and their relatives gave extremely positive praise and feedback about the kind and compassionate nature of the registered manager. They unanimously spoke about how much of a better place the service was since the registered manager had been in post. People’s comments included, ‘‘[registered manager] and all the staff are so lovely and kind.’’ and ‘‘[registered manager] is the boss, and yes, they are the best.’’ A relative said, ‘‘Since [registered manager] has been in post the service has never been better. They have grown and fostered a consistent and truly magnificent staff team, whereas this has always been a bit up and down in the past. They organise and lead the staff so well and are never stopping, always on the look out for what is best for the people living at the service. We are the happiest we have ever been.’’ Another relative told us, ‘‘Over the last few years the service is like black compared to white as to how it used to be and how it is now. [Registered manager] has led and fostered a fantastic staff team and the impact this has had for [family member] has been phenomenal. The whole staff team do everything they can and more to make sure [family member] can do what they want to do, and I have never seen them so happy and relaxed as a result.’’

The registered manager truly understood the importance of including people in all aspects of the service. They had an excellent understanding of their job roles and understood all aspects of current best practice guidance around supporting people living with a learning disability such as RSRCRC. Since they started working at the service they had worked with and encouraged the staff team to put people in control of all aspects of their lives. Before people started living at the service, there was a very long transition process to make sure not only that the person would be happy at the service, but also the other people already living there. One relative explained, ‘‘We had a long trial over a couple of months where [family member] would stay at the service several nights a week and would spend the day doing things with staff and the other people who lived there. We felt so comfortable by the end of it because of how happy [family member] was and how positive the staff team were that they could meet all their needs.’’ Another relative told us, ‘‘[Family member] had only really lived in one place before moving to the service but the way staff supported them was fantastic. They moved at [family members] pace making sure they took their feelings in to account at all times. It was a wonderful experience.’’

The staff team had also been encouraged and supported to make sure people were involved in all aspects of the service. People took part in the recruiting of new staff to the service. They were fully involved in the decoration of the service and had full control of aspects of their daily lives including how to spend their time, when to leave the service to pursue their interests, cooking and cleaning. Staff supported people to set and achieve their own specific goals. These included but were not limited to, losing weight, having regular exercise, exploring new interests or building their confidence and independence. One person was very happy to take part in cooking. It took the person a long time to choose when and how to take part, however staff were patient and compassionate as they supported the person. Another person had been supported to go out for regular exercise twice a day to help maintain their mobility. Another person had been supported to follow their interests in numerous ways by joining groups in the community. One person said, ‘‘It is never boring here. We are always up to something.’’ A relative explained, ‘‘I think for the first time in their life [family member] feels they can truly live how they want to live. We didn’t realise what they were capable of or how happy they could be. The registered manager and staff team have worked wonders.’’

The staff team were also very positive about the registered manager. They said they felt completely included in all discussions about people’s support and the direction of the service. The registered manager led by example, not expecting anything from staff they were not willing to do themselves. They were a very active presence at the service, spending a lot of time working with the staff team whilst they were supporting people. This gave them a true understanding of people’s support needs and enables them to fully support staff with any ideas they had about how best to meet people’s preferences and choices. The registered manager supported staff to follow up on actions people wanted to happen. For example, they supported staff to research and put risk assessments and care plans in place for people when they tried something new or wanted to take positive risks

The registered manager and staff team fostered an incredibly positive culture where people were continually encouraged to speak up and could always be assured their voice would be heard.

The registered manager and staff team had a firm understanding of the importance people’s voices had in the running of the service. Staff were continually discussing how people were feeling with them on a daily basis and there were incredibly detailed recorded discussions about what people wanted to do and how they wanted to spend their time. The staff team knew nothing was out of reach for people and whenever people spoke about what they wanted to do, they would be supported to help them achieve their goals.

The registered manager understood whilst information about how to raise concerns or complaints were available to people, people may still not fully understand how to make a complaint or may be reluctant to do so. They had therefore worked with the staff team and the person to identify other signs which may indicate people were not happy or were concerned about something. They had then formed detailed care plans, explain what signs may indicate people were not happy with their support and also ‘triggers’ which may impact how people are feeling. This meant staff were aware of when people may wish to raise concerns, however found it more difficult to articulate they wanted to raise a more formal complaint. The impact his had for people was profoundly positive. Staff were completely in tune with how people may show they were upset or wanting to raise concerns. Each time people showed they were unhappy, staff recorded in detail what had happened and what they did in response to support people. They discussed this together to inform their practice and ensure a united approach to supporting people to identify and speak up about how they were feeling. This fully enabled people to have their voices heard. It also had dramatically decreased the number of times people felt unhappy or felt they could not speak up, as they were assured staff knew them very well and could pre-empt when they may feel unhappy and need support. One person said, ‘‘I just grab hold of one of the staff if I need to talk.’’ A relative explained, ‘‘[Staff] have given [family member] the confidence to speak up and tell them if they have any concerns whereas before they would hold how they were feeling inside. This is very reassuring for me and it’s incredible how relaxed they are now.’’

There was a complaint and speaking up policy in place at the service. Where people and relatives had raised concerns in the past these had been looked in to and addressed promptly. Relatives told us they knew how to raise concerns but had no reason to do so. Staff told us they knew how to raise concerns and felt comfortable and confident in speaking up at the service. People were given easy to understand information about who they could speak with if they were worried about the service or wanted to talk about anything. They were also encouraged to feed back about the service in meetings with staff members. The management team kept a record of complaints to help inform learning and make sure issues raised were not repeated. A relative told us, ‘‘I have absolutely nothing to complain about but if I did, I know I could approach any of the staff team.’’

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Staff told us they enjoyed working at the service and felt well supported by the management team. The provider supported their equality and wellbeing by offering preferred working patterns and discussing their job roles with them regularly. The provider had multiple opportunities to identify and celebrate success with the staff team, such as award ceremonies and meetings. The providers recruitment process was fair and equitable.

The registered manager and staff team had clear responsibilities, roles and systems of accountability or good governance. Audits were effective in identifying where improvements could be made and the registered manager had a good oversight of risk and the quality of people’s care and support. This covered areas such as health and safety, improvements to the service, people’s experiences and staff training and supervision. Plans were in place to ensure the sustainability of the service in certain situations such as if there was a fire or a staffing issue. One relative said, ‘‘[Registered manager] is completely on the ball and leads the service well.’’

The registered manager and staff team completely understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement. People had been fully and completely supported to be a part of their local communities in meaningful ways.

Since the registered manager had worked at the service they had encouraged and supported staff to help people access and be a part of the local community in ways that made sense to them. They explained people had not been supported to make ties in the local community and when they started work at the service this was a top priority for them and the staff team. People had been supported to access local areas of interest such as pubs and cafes and over time had made long lasting friendships with those in the local community. As a result, people from the local community had joined together and funded some decoration work to the garden area of the service as they had found out how important the garden areas of the service was for people. This partnership working had led to a great outcome for people. One person said, ‘‘I like going to the pub. Have lots of friends there I do.’’

People had been supported to attend local community activities such as coffee mornings. Thanks to the building of relationships with these people in the community, members of the public set up a specific coffee morning for people who used signs to communicate. These were incredibly inclusive events open to all people using the service and other members of the public who could come and learn signs with people who communicated in this manner. People had clearly really benefitted from this and working in partnership in this way had meant people using the service were truly seen and celebrated as individuals in the local community. One person used signs and body language to tell us how excited they were when they went to these events. A relative said, ‘‘The way staff have helped [family member] to be a part of the community, always heading out and about and to be seen is truly remarkable. They have so many friends and have such a great social life which is something they have always wanted and deserved.’’

People were supported to take part in community initiatives such as local gardening volunteer work for charities if they chose to do so. Staff supported people using the service to decorate the windows at the front of the service to coincide with events happening in the local community. Members of the public had grown used to this and often positively commented on how important people’s presence and contribution to the community was. A relative explained, ‘‘[Staff] do everything they can to support [family member] to be as seen as everyone else is seen. [Family member] is thrilled every time they see us, letting us know all that they have been up to.’’

As discussed throughout this report, people had been completely supported to discuss and follow their interests in the community and achieve their goals. Without exception feedback from relatives and evidence showed how much being a part of the local community had impacted people’s lives in a hugely positive way. People were more confident and happier in their day to day lives. One relative said, ‘‘The staff have truly helped [family member] meet their full potential and open his horizons. They love everything they do at the service.’’ Another relative told us, ‘‘[Family member] goes to all sorts of places now and it is not too far to say the staff are supporting them to follow their dreams and ambitions.’’

People’s community ties had not only socially been amazing and improved confidence but had also created a safer environment for people. The registered manager had made significant efforts to work in partnership with local health professionals to promote good outcomes for people. The local GP now completed regular calls and check ups with people on a 6-weekly basis. They accommodated one person who found it more difficult to travel by vehicle by having their appointments at a closer location in the community, meaning they were able to walk to their appointments. One relative said, ‘‘Health wise we are completely assured all of [family members] needs are taken care of.’’

The provider and registered manager focused on continuous learning, innovation and improvement. They had improvement plans in place based on findings from internal and external audits and findings. Actions on improvement plans were monitored to help make sure improvements were benefitting people using the service. Staff told us they were involved in discussions and meeting about the service and their feedback about how to improve the service was listened to and taken seriously. The findings at this inspection showed there had been significant improvements at the service since our last inspection. People were incredibly happy with their support and relatives told us they felt the service had improved exponentially and their family members were receiving the best care and support they could have. One person said, ‘‘This is the best place. It is my comfort.’’ A relative told us, ‘‘The service is just going from strength to strength in my view. I am thrilled at what has happened and what this means for [family member].’’