25/08/2015
During a routine inspection
This inspection took place on 25 August 2015 and was unannounced. At the last inspection in January 2014 we found the service was meeting the regulations we looked at.
Hollyfield House is a small home which provides care and accommodation for up to nine adults with learning disabilities, autism spectrum disorders and complex communication needs. At the time of our inspection there were nine people living in the home. The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a 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 people were safe at Hollyfield House. Staff knew how to protect people if they suspected they were at risk of abuse or harm. They had received training in safeguarding adults at risk and knew how and when to report their concerns if they suspected someone was at risk of abuse.
Where risks to people had been identified because of their circumstances and specific needs, there was guidance for staff on how to minimise these in order to keep people safe from injury or harm in the home and community. Regular maintenance and service checks were carried out of the premises to ensure the environment and equipment was safe. Staff kept the home free of obstacles and objects so that people could move freely and safely around.
There were enough suitable staff to care for and support people. Appropriate checks were carried out by the provider to ensure staff were suitable and fit to work at the home. New staff had to demonstrate an appropriate level of competency before they could work with people unsupervised. All staff received relevant training to help them in their roles. Staff felt supported by the registered manager and were provided with opportunities to share their views and ideas about how people’s experiences could be improved. Staff had a good understanding and awareness of people’s needs and how these should be met. The way they supported people during the inspection was kind, caring, and respectful.
People were supported to keep healthy and well. Staff ensured people were able to promptly access healthcare services when this was needed. Medicines were stored safely, and people received their medicines as prescribed. People were encouraged to drink and eat sufficient amounts to reduce the risk to them of malnutrition and dehydration.
Individualised care plans had been developed for each person using the service which reflected their specific needs and preferences for how they were cared for and supported. These gave staff guidance and instructions on how people’s needs should be met. People were appropriately supported by staff to make decisions about their care and support needs and encouraged by staff to be as independent as they could be. Staff used different methods of communication to ensure people could be involved in making these decisions.
The home was open and welcoming to people’s visiting relatives and friends. People were encouraged to maintain relationships with people that were important to them and to undertake social activities and outings of their choosing. People were supported to raise any concerns and there were arrangements in place to deal with people's complaints, appropriately.
The registered manager demonstrated good leadership. They ensured people’s views about how the care and support they received could be improved were regularly sought by staff. They ensured staff were clear about their duties and responsibilities to the people they cared for and accountable for how they supported people to meet their care goals and objectives.
The provider and managers carried out regular checks of key aspects of the service to monitor and assess the safety and quality of the service that people experienced. The registered manager took appropriate action to make changes and improvements when this was needed. The service used external scrutiny and challenge to ensure that appropriate care and support for people on the autistic spectrum was being provided. They shared good practice and learning with other similar services and organisations to effectively support people on the autistic spectrum.
Staff had sufficient training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) to understand when an application should be made and in how to submit one. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.