The Hollies

Updated 18 January 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 5 January 2022 and was announced. We gave the service one day notice of the inspection.

Updated 18 January 2022

About the service

The Hollies provides accommodation and care for adults with learning disabilities and autistic spectrum disorder.

The service has 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. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service accommodated people in six purpose-built bungalows and three individual apartments within the same grounds. It was registered for the support of up to 21 people. At the time of the inspection 15 people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size.

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

People were cared for by sufficient numbers of experienced and competent staff who were deployed to meet their care needs. Since the last inspection, people’s dependence needs had been reassessed and the deployment of staff reconfigured. This impacted on people receiving consistency and continuity in care from staff they were familiar with. Robust staff recruitment procedures were used to ensure staff were suitable to care for people.

The prevention and control of infections were minimised due to infection control best practice being followed. Since the last inspection, new cleaning schedules had been introduced and the service had been deep cleaned with an additional deep clean booked. However, increased oversight of cleanliness was required to ensure consistency.

The provider used different systems and processes to monitor safety and quality. Since the last inspection a refurbishment plan had commenced with many improvements made to people’s living environment. However, repairs and maintenance reported by staff to the provider had not been responded to in an effectively and timely manner. This had impacted on people’s safety. Staff responsible for health and safety checks had not identified some maintenance issues identified during this inspection.

People in the main had received their prescribed medicines and staff had detailed information of people’s support needs in relation to medicines. Inconsistencies were identified with one person’s medicine administration, but this had not impacted on their health.

Staff were aware of their role and responsibilities to protect people from abuse and avoidable harm. Where safeguarding concerns had been identified, action had been taken to investigate and mitigate risks in conjunction with the local authority external safeguarding team. Incidents were reviewed for themes and patterns and to consider if incidents could have been avoided or managed differently. Staff had detailed information about how to meet people’s behavioural needs and the use of physical intervention had reduced in the last 12 months.

The restrictions placed on people’s freedom and liberty had reduced for some people. 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 were involved as fully as possible in the care and support they received, this included greater opportunity of accessing the local community and pursuing interests, hobbies and experiencing new opportunities.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. People were supported to identify and achieve personal goals, and this had resulted in a person moving into supported living.

People were involved as fully as possible in the care and support they received, this included greater opportunity of accessing the local community and pursuing interests, hobbies and experiencing new opportunities.

People received effective care and support from staff who were trained, supported and knew them well. Staff moral had improved since the last inspection, they were positive about their role and about the improvements made at the service. People received a choice of meals and drinks and their nutritional needs had been assessed and were regularly reviewed. Staff worked effectively with external health professionals in assessing, monitoring and managing people’s health conditions and needs.

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 6 April 2018) and there were three breaches in regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of these regulations. However, a new breach in regulation was identified. You can see what action we have asked the provider to take at the end of this full report.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit at the next scheduled inspection. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk