Archived: The Hollies

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. At our last inspection we rated this key question good. At this inspection the rating has changed to requires improvement. This meant people’s needs were not always met through good organisation and delivery.

This service scored 54 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Whilst people spoke positively about their lives at the service, records did not consistently demonstrate how people had been involved in developing their care plans, setting goals or agreeing how support should be delivered. This limited assurance that care was consistently planned around people's individual aspirations and preferences.

Improvements were needed to demonstrate how people were placed at the centre of their care. The volunteer manager told us another person loved to go for rides in a car, but the service did not have a vehicle, which meant this person’s favourite activity may not happen as often as they wished for.

One person told us they loved living at the home, telling us, “I love the animals here.” However, we did not observe, and records did not tell us how they were involved with the miniature horses, dogs or peacocks on a day-to-day basis. This person also told us they ‘loved the garden’ but we did not observe them using the garden during our visit but were assured they enjoyed helping to water the flowers.

Relatives had no complaints about how their loved ones were cared for and felt their needs were met, with 1 relative telling us, “They have a good quality of life at the home.”

The volunteer manager told us they were in the process of improving people’s plans of care to ensure they were more person-centred and contained more information about people’s likes and dislikes. During our visit, we saw this was work in progress and greater personalised information was being added to records.

The provider did not always understand the diverse health and care needs of people and their local communities, to ensure care was joined-up, flexible and supported choice and continuity.

The registered manager ensured people were supported by a consistent, and small group, of volunteer staff along with themselves delivering care provision to people they knew well. However, the registered manager had not ensured they, or the volunteer staff, were sufficiently knowledgeable or trained to be able to consistently support people safely. This is reported on further in the safe section of this report.

The service did not employ any care staff or use agency staff. The registered manager had no contingency plan in place to ensure the smooth running of the home, in the event of themselves having unexpected leave. This meant people’s care provision may be disrupted in the event of the registered manager’s absence from the care home.

People did not always have any structured activities planned. For example, on the day of our visit, we did not observe people taking part in any activities. However, people appeared content with sitting and moving about the home as they wished to. Some planned activities took place. For example, 1 relative told us, “Once a month the manager brings all 3 people over and I do afternoon tea for them.”

The provider did not supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider did not meet the Accessible Information Standard because important information was not made available to people in formats they could access. For example, information about safeguarding and complaints.

Whilst people living at the home told us they would talk with the registered manager if they were unhappy about anything, there was no information about anything in an alternative format. For example, there was no ‘Service User Guide’ or information about what the service offered.

The registered manager told us, “Two people living here cannot read, so could not read their care plans.” There was currently no alternative format of their plans of care available to these people. We discussed this with the managers, and the volunteer manager told us they would try to incorporate this in their new care planning work. The absence of accessible information meant some people were unable to independently access important information about their care, their rights, how to raise concerns or what support was available to them. This reduced opportunities for people to make informed choices and exercise control over their lives.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Records did not reflect that staff involved people in decisions about their care and told them what had changed as a result.

Improvements were needed to show how people were able to share their feedback and ideas about care and support they received. The volunteer manager told us there were no systems or processes currently in place to gather feedback from people in the form of questionnaires, ‘resident meetings’ or one to one sessions.

Care records did not reflect how people were involved in decisions about their care. However, people living at the home expressed they were happy living there.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

Improvement was needed to put a system into place to enable people to summon help during the nighttime if they needed support.

Overall, people received the care, support and treatment when they needed it. The registered and volunteer managers gave us examples of when people were supported with foot care, and health care visits.

During our visit, we found no evidence that people’s needs had gone unmet by staff. One person moved about the home in a relaxed way and said, “Good morning to us” and came in and out of the room as they wished to. Another person chose to sit in the room with us and spoke with us when they wished to.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The registered and volunteer managers recognised the inequalities in accessing healthcare that some people with a learning disability or mental health support needs

may face. In response to this, they worked with people’s GP and learning disability teams to provide details of any changes in people’s wellbeing.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People were supported to discuss their future wishes if they wanted to. A discussion had taken place with 1 person about their future wishes should their health deteriorate and the registered and volunteer managers worked with healthcare professionals in seeking relevant advice and guidance.