Archived: Sue Ryder - Holme Hall

During this inspection we found that the registered provider had taken action to improve practices within the service in line with their action plan from March 2016. We found these improvements were sufficient to meet the requirements of Regulation 12 and 18. This meant the service had met the breaches of regulation imposed at the previous inspection.

Sue Ryder - Holme Hall is registered to provide care and support including nursing care for up to 40 people over the age of 18 years old with a range of neurological conditions including Brain Injury, Multiple Sclerosis, Huntington's Disease, Cerebral Palsy, Stroke and Parkinson's Disease. The service is located in Holme-on-Spalding-Moor in the East Riding of Yorkshire. At the time of this inspection there were 24 people using the service.

The service has three floors. The ground floor is used for communal space and administration, Blue floor is the first upstairs level and accommodates people with complex neurological conditions and Green floor is the second upstairs level and accommodates people who are more independent.

The registered provider is required to have a registered manager in post and at the time of our inspection the manager’s application to register was being processed by the Care Quality Commission (CQC). 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found that the care staff had a good knowledge of how to keep people safe from harm and the staff had been employed following robust recruitment and selection processes.

We found that improvements had been made to the safe management of medicines. People received their medicines on time and as prescribed by their GP. The recording and administration of medicines was much better than at our previous visit and medicines were stored safely and disposed of appropriately.

People had their health and social care needs assessed and plans of care were developed to guide staff in how to support people. The plans of care were individualised to include preferences, likes and dislikes. People who used the service received additional care and treatment from health professionals based in the community. People had risk assessments in their care files to help minimise risks whilst still supporting people to make choices and decisions.

Improvements had been made to the frequency of staff supervisions and the number of staff attending training sessions. People who used the service were cared for and supported by qualified and competent staff that were regularly supervised and received appraisal regarding their personal performance. Communication was effective, people’s mental capacity was appropriately assessed and their rights were protected.

People received adequate nutrition and hydration to maintain their levels of health and wellbeing.

People had been included in planning menus and their feedback about the meals in the service had been listened to and acted on.

People were able to see their families as they wanted. There were no restrictions on when people could visit the service. We saw that staff were caring and people were happy with the care they received. People had access to community facilities and most participated in the activities provided in the service.

We observed good interactions between people who lived in the service and staff on the day of the inspection. We found that people received compassionate care from kind staff and that staff knew about people’s needs and preferences. People were supplied with the information they needed at the right time, were involved in all aspects of their care and were always asked for their consent before staff undertook support tasks.

People’s comments and complaints were responded to appropriately and there were systems in place to seek feedback from people and their relatives about the service provided. We saw that the manager met with people on a regular basis to discuss their care and any concerns they might have. This meant people were consulted about their care and treatment and were able to make their own choices and decisions.

People’s wellbeing, privacy, dignity and independence were monitored and respected and staff worked to maintain these wherever possible.

The staff told us that the service was well managed. The manager monitored the quality of the service, supported the members of staff and ensured that there were effective communication and response systems in place for people who used the service.

Our brief chats with people at this inspection indicated they were happy in the service and from what we observed people were settled and relaxed with the staff and other service users.

We found that improvements had been made with regards to record keeping. Care plans and wound care records were seen to be up to date, descriptive and person centred. One person told us 'The staff are very good at giving me care when I want this and in line with how I have asked for it to be delivered.'

People were supported to be able to eat and drink sufficient amounts to meet their needs. Two people we spoke with said they received sufficient drinks and meals and had choices offered to them.

Discussion with people who used the service indicated they received their medication on time and when they needed it. Staff supported people to be as independent as possible, whilst keeping them safe.

Robust employment and recruitment practices were in place. Discussion with people who used the service indicated they were satisfied with the competency of the staff who looked after them.

We saw that there were sufficient numbers of staff on duty to meet the needs of the people who used the service. The service had a staff training programme, which meant the staff received professional development and support.

The provider had an effective quality assurance system in place and people's views and opinions of the service were listened to and acted on where necessary.

We found that the care plans did not always contain sufficient written information about people's specific care needs and the support being offered by the staff to meet their needs. However, our observations of the service and discussion with people and staff indicated that appropriate care was being delivered.