Holly House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

The provider always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

Care records were extremely detailed and demonstrated thorough assessments had been undertaken about how to support people’s needs effectively. These were being reviewed regularly with evidence of the involvement of professionals in supporting and directing care. Daily checks and monitoring was ongoing and recorded incidents of escalating behaviour, engagement in household tasks and supporting people to engage in a meaningful way about their care and decisions was seen. People told us they were happy they had been involved in decisions about their care. A relative said, “There was a lot of communication. We were instrumental in getting [person] in there. Person has been involved in their care plan.” We discussed 1 person who required increased support with the management, they told us they were looking at alternative measures to ensure their individual assessed needs were met in their current environment.

Staff told us people and families were involved in the development of care records and reviews and that handovers and care plans were reviewed as needed and they knew how to access these. They said, “Families are involved in care plans, we ask families about people’s life history, and they tell us. We do have resident (person) of the day. The seniors, and the registered manager will update care plans” and, “Seniors write care plans with the help of carers because we look after them every day and know them well. The person and their family are also involved.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People were encouraged in meal preparation and food service with the support of the staff team. People told us they liked the food and were able to choose what they wanted to eat. One person talked about their passion for baking and that this was supported by the staff team, we observed them baking when we visited. A relative said, “[Person] gets involved in cooking and I’ve asked them to include more vegetables. They restrict [person] for takeaways, they let [person] have them, but not as often.” We observed people eating their meal of choice and the food looked tasty. We discussed with the management how they ensured meal preparation was undertaken without compromising on people’s 1:1 support.

Supplies of food were available and the safety in the kitchen had been considered. Kitchen checks were done and menu folders with cooking instructions had been developed. The service, along with people had made a bespoke meal notice board with velcro pictures of meals available for the week. Staff knew people’s likes and choices for their meals and how to support them safely. Nutritional needs and oral care needs were reflected in care records. The management team confirmed they would ensure 1 persons care record was updated to ensure it reflected guidance from a professional without delay. However, we saw that records included information about professionals. This included meetings with the staff team, management and wider partners. Policy information and guidance was available to the staff team to support evidence-based care delivery.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Detailed assessments were undertaken, the service worked very well with professionals. Evidence of the involvement of professional’s and people’s representatives was seen across a range of records, reviews and meetings with the team.

Whilst some professionals were very positive. One told us, “I have found staff at the home responsive to my contact and supportive of our work.” However, others discussed the challenges of meeting people’s complex needs. One said, “The service should be acknowledged for putting their hands up to support [person]. But the management is not effectively cascading guidance to frontline staff.” We discussed this with the provider who was able to demonstrate good effective systems in place in relation to the involvement and working with partners. Relatives told us they were involved in their family members initial assessment and that their needs were met. Comments included, “I was involved” and, “They go out of the way to help [person] with what they need and wants.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. The service tailored the care provided to individuals according to their individual needs and supported people to access support including health reviews, as needed. Records included comprehensive information about people’s medical needs, relevant professionals involved in their care and treatment and how to link in with them. Relatives told us they were kept up to date with regard to health care appointments and any outcomes from these. One said, “They will call if [person] is unwell.”

Staff supported people in a positive way. There was some information about healthy eating and some guidance to support healthy eating. We saw a variety of foods available to people. Some snacks were seen in people’s bedrooms chosen by them.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Assessments of people’s health needs was undertaken as it was required in the service. Information confirmed people’s choices were considered, reviews of these assessments were ongoing. A range of records including regular meetings with people, staff and professionals noted what was discussed and agreed to ensure people’s needs were met. Good information was seen in relation to supporting good oral care and evidence of the involvement of dentists was recorded. Staff had undertaken relevant training and information and guidance to support staff in providing good oral care for people was available.

Relatives told us the service supported their family member to achieve the best possible outcomes. One said, “I can’t praise Holly house more. They’ve always had [persons] best interests at heart.” Staff and the management discussed the positive relationships they had with professionals and linked in with them as required. They discussed the importance of promoting and improving outcomes for people. One said, “[Person] is encouraged to live a healthier life, staff put music on so [person] gets up and dances without realising they are moving and exercising.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Care records confirmed capacity assessments in a number of areas had been done. Evidence confirmed DoLS applications were completed, checked, reviewed and were ongoing. People and relatives raised no concerns in relation to consent, and people told us they were asked permission before undertaking any activity. Whilst we saw most staff knocking and asking permission before entering people’s rooms, this was not always the case. The management provided assurance they would remind all staff about the importance of seeking consent at all times.

Information about ensuring consent was obtained was detailed in policy and guidance. Staff had undertaken relevant training. Staff understood consent and the MCA and DoLS. Comments included, “Always ask for consent before any interventions.” The registered manager told us, “Although people have a DoLS in place they are promoted to be involved in all aspects of their lives and we support them and offer new opportunities.”