Holland House

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. This is the first assessment for this newly registered service. This key question has been rated 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 provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. There was a process in place for recording accidents and incidents, however the review and debrief activity after an incident was inconsistent. Managers had oversight of incidents and would review these, however a debrief was not always conducted to evidence learning. Staff told us they had informal discussions about what went wrong and if things could be improved, but this was not always evidenced. The registered manager took this feedback onboard during the inspection and told us they would look at ways to formalise this process.

The provider 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.Relationships had been built with healthcare professionals in the local area to ensure people had access to the support they required. Staff monitored people’s health and would raise concerns when needed. People were supported to access their health care appointments and details about people’s needs were available to share, when required, which helped ensure smooth transitions across services.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. Staff were trained and were knowledgeable on how to identify abuse and how to report this. Managers ensured a system was in place to help keep people safe, working well with the local safeguarding teams to ensure action was taken when needed. The registered manager understood their responsibility when depriving someone of their liberty to keep them safe. The correct applications were in place when needed to help safeguard people.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. However, during the inspection we found that some areas of risk did not have a care plan in place or a risk assessment to ensure staff were aware of all mitigations to keep people safe. For example, people who had been identified of being at risk of diabetes did not have a care plan in place for the management of this. People did not have care plans in place that explained their ability to manage finances, and no associated risk assessment had been developed. Staff knew people well and could tell us how they were managing these risks, however, the documentation did not evidence this. During the inspection the registered manager worked quickly to address these concerns, implementing financial care plans for the people the same day of the inspection.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. There was a process in place for reporting any maintenance concerns and action was taken quickly when issues were raised. People’s rooms were personalised to suit their tastes, needs and preferences. Efforts had been made to ensure people could understand their environment to help keep them safe. For example, pictorial signage was used in the kitchen to make people aware of equipment and hazards.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.Recruitment procedures and checks were robust to ensure potential staff were suitable to support vulnerable people. New staff received a thorough induction and were supported by managers. Staff were trained to provide safe care and felt confident in doing so. A dependency tool was used to help calculate staffing needs, which was reviewed by the management team to ensure safe staffing numbers.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff encouraged and supported people to help keep the service clean. They worked together daily, and people learnt how to keep their environment infection free. Managers did checks on infection, prevention and control to ensure a high standard. People told us the service was always clean. A family member commented, “It’s very clean, (person’s) home is like walking into a new house, it’s immaculate.” With another family member telling us the service had, “Very high standards.”

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. Medicines were administered and stored safely by competent staff. Guidance was in place, which was specific to each person’s preference on how they would like to receive their medicines and staff followed this. The service ensured people’s behaviour was not controlled by excessive and inappropriate use of medicines. Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and ensured that people’s medicines were reviewed by prescribers in line with these principles.Managers carried out regular checks on the management of medicines to help keep people safe.