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Hollyrood Requires improvement

Inspection Summary

Overall summary & rating

Requires improvement

Updated 4 February 2020

About the service

Hollyrood is a residential care home providing accommodation and personal care for up to 25 people with autism. The registered manager reported at the time of the inspection they were only using 15 bedrooms and would not accommodate more people.

The service had not been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. The service was institutional and much bigger than most domestic style properties. The provider had tried to mitigate the effects of the environment by dividing the service into smaller living areas and supporting people to increase their access to community facilities. Further work was planned to provide more suitable accommodation for people.

People’s experience of using this service and what we found

The systems to support people to take the medicines they were prescribed were not safe and increased the risk that people may be harmed. Staff did not keep accurate records of the medicines they supported people to take.

Records of support for people were not always completed in ways that maintained their dignity and privacy.

The systems for checking how the service was operating did not always identify shortfalls. Checks had been completed but did not identify poor medicines practice or issues with people’s records.

Relatives were happy with the support people received at Hollyrood and said they felt they were safe. Staff knew what to do to keep people safe and were confident any concerns would be taken seriously.

Risks to people’s well-being and safety were assessed, recorded and kept up to date. Staff supported people to manage these risks effectively.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People had support plans that were specific to them. These plans were reviewed with people and their relatives regularly, to ensure they were up to date. The plans contained clear information about people’s communication needs. Staff had worked with people to ensure information was accessible for them and they used the communication methods people preferred.

People were supported to maintain good diet and access the health services they needed.

The registered manager provided good support for staff to be able to do their job effectively.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was good (published 22 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the Safe, Caring and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection areas


Requires improvement

Updated 4 February 2020

The service was not always safe.

Details are in our safe findings below.



Updated 4 February 2020

The service was effective.

Details are in our effective findings below.


Requires improvement

Updated 4 February 2020

The service was not always caring.

Details are in our caring findings below.



Updated 4 February 2020

The service was responsive.

Details are in our responsive findings below.


Requires improvement

Updated 4 February 2020

The service was not always well-led.

Details are in our well-led findings below.