Holly House Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. The provider encouraged a culture of communication, and honesty in admitting mistakes. This helped to mitigate the risks associated with closed cultures. A closed culture is a poor culture that can lead to harm, including human rights breaches such as abuse. The management team encouraged visits to the service and listened to any issues raised by people, their relatives, advocates, and staff.

We spoke about learning with staff and members of the management team. They told us they worked positively with people and their relatives, alongside the partner professionals funding people’s placements. We saw systems were in place to make sure any concerns were investigated, and lessons learnt to identify and embed good practice. Any lessons and consequent changes were relayed to staff through regular handovers, meetings, and supervision sessions.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People had ‘Hospital Passports’. This is information that was specifically designed to help healthcare professionals and services to understand their needs, preferences, and ways of communicating. This was to help make sure they received the care they needed if they had to go to hospital. This information had not been updated to reflect 1 person’s changing needs and the deputy manager told us they would address this as a matter of priority.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Systems were in place to protect people from the risk of abuse. The provider had safeguarding policies and procedures in place. Staff were provided with training in safeguarding people and were aware of actions to take to safeguard people.

During our visits we saw staff treated people respectfully and supported people to remain safe. Feedback from people and their relatives was positive. People told us they were safe and treated with kindness. Throughout our visits we observed staff interacted with people to provide inclusive and person-centred care. People and relatives said they would be comfortable to raise concerns should they need to and they were confident they would be listened to.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS)

We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.

The service provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People told us they felt safe living in the home. For instance, 1 person said, “I like it here. Yes, I am safe.”

Risks to people were assessed, recorded in their care plans and updated when people's needs changed. People’s risk assessments included areas such as getting out and about, medicines and finances. Risk assessments were detailed and provided staff with clear information about what the risks were and actions they should take to help mitigate risk.

Staff received training and support in supporting people with a learning disability, and autistic people who had, or may be at risk of developing, behaviours of distress. The service worked with other professionals, supporting this approach, and helped to make sure people were consistently supported when they were distressed. Where people communicated their needs or feelings through their behaviour they had positive behaviour support plans. These supported staff to provide care that mitigated risks and included ways to avoid or minimise the need for restricting people’s freedom. Incidents were reviewed and learned from to help reduce restrictive practices.

Overall, the service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Regular checks were completed by the provider to make sure the environment and equipment was safe for people to use. Where people needed alterations to keep them safe this was done in the least obtrusive way, to maintain a homely feel to the environment people were living in.

Risks were assessed on a regular basis to ensure environmental safety. However, there was a need to make the fire risk assessment more robust and some radiators needed to be assessed, as they were not covered to reduce the risk of burns. We discussed this with the management team who undertook to address these areas as a matter of priority.

Safe recruitment procedures were in place, and the provider made sure there were enough staff, to meet people’s needs. The provider made sure staff had training, skills and competence to understand and meet the needs of autistic people and people with a learning disability.

People and relatives said they felt there were enough staff to meet people’s needs. They spoke positively about the staff team. One person told us, “The staff are nice. I feel safe with all the staff.”

Staff gave positive feedback about the support they received from managers. Most staff had worked in the home for several years. They told us they enjoyed their work and had formed positive and warm relationships with people using the service. They told us they received training to carry out their roles well and felt well supported by the management team.

The service assessed and managed the risk of infection. The provider had policies and procedures regarding infection prevention and control (IPC) and had systems in place to monitor practice. Staff used personal protective equipment (PPE) appropriately and when required.

Staff supported people to keep their home clean and tidy. One person said, “I like my room. Staff help me to keep my room clean.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. The provider had systems and processes for their safe management of people’s medicines. Staff received training in administering medicines and their practice and competence was assessed. People we spoke with were happy with the support they received with their medicines.

The provider understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and made sure people's medicines were reviewed by prescribers in line with these principles.