Holly Grange House Care Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

This is the first inspection for this newly registered service. This key question has been rated requires improvement. This meant people did not always have choice and control and their immediate needs were not always met.

This service scored 60 (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 always treated people with kindness, empathy and compassion and respected their privacy and dignity.

People were positive about the attitude and approach of permanent staff. Comments included: “The majority of staff are caring”, “I think that the staff are very caring” and “They all work very hard to please and care for us.” People described staff as being respectful of their privacy and dignity. One person told us, “They put a towel across me to preserve my dignity and to give me more privacy when delivering personal care to me.”

Relatives were equally happy with how staff cared for their family members. One relative told us, “They (staff) are kind, caring and compassionate.” Another relative said, “Everybody I’ve met has been open, forthcoming, very friendly and very chatty with [Name] when they come in to see her, I have no concerns on that front.” A third relative said, “I’m very aware they are trying to create a nice atmosphere for people to live in. A smile goes a long way, and all the staff are very happy in how they present themselves, it’s very reassuring.”

Permanent members of staff spoke about people with kindness and respect. During our inspection we observed a person was seated in the lounge looking out of the window. A staff member approached them, sat beside them and said, “Im just checking you’re okay. You look a bit sad. The person smiled and replied, “I’m okay.” The staff member said, “That’s good to hear as long as you are okay. I’ve been busy and haven’t had much time to check in with you today.”

Whilst people and relatives described the service as caring, on the day of our inspection, half the staff on duty were agency workers who did not appear to know people well. As a result, opportunities to build meaningful connections, engage people in conversation, and provide compassionate interactions were not always maximised.

The provider treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences.

People generally felt that permanent staff understood what was important to them and their likes and dislikes. One person told us, “The staff know my needs and how to address them. Well, most of them. They know my likes and dislikes especially how I like my tea and how much I like to have.” A relative commented, “Going back to the 2 or 3 regular staff who interact with her, they have a pretty good understanding of what she likes, I think that’s one of the reasons she’s comfortable where she is, on the whole, if she gets the people who look after her regularly.” Another relative told us, “They (staff) are very well aware of his preferences, recently [Name] decided he no longer likes decaffeinated tea, so they went out and got him some special teabags. They’ll always go out and fetch anything that he needs.”

Permanent staff recognised the importance of recognising people’s individuality when providing their care. One staff member told us, “All our residents are individuals, and they all have their own little quirks. That’s what makes this job so rewarding. Learning what they like and doing our best to do what they want us to do.” A second staff member explained that when they knew a person’s background and interests, “It gives you something to talk about and it makes them feel happy that someone is paying an interest in them."

People were supported and encouraged to decorate their bedrooms with personal items that incorporated aspects of their faith, families, background and personal interests.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

People’s independence and choice were not always promoted. There was little evidence of person-centred activities which related to interests that were important to people in the past or that were important to them now.

Some people expressed frustration at the lack of activities. One person told us, “There are not always activities as they sometimes take the worker (lifestyle staff member) to do care work when they are short.” Other comments included: “I don’t think that the activities are geared towards us” and “There is nothing to do here, there is an activities co-ordinator, but she is not often here. I would like to get out a bit more than we do. The place I was at previously, we went out for a coffee or to a garden centre, just to get out of this building would be nice." Other people felt there was enough for them to do. One person told us, “We have plenty of activities, some I’m not keen on because some are not age appropriate.” Another person said, “I do as many activities as I can. I love the balloon activity and the bowling.”

The part-time ‘lifestyle’ staff member was not working on the day of our inspection, and we were told care staff would lead engagement and interaction with people in communal spaces. However, we found there were long periods of inactivity in the lounge areas when there was little happening to interest people or provide activity and occupation that was meaningful to them. There were missed opportunities to engage people with daily tasks or interests and to maintain life skills.

Care staff told us they did not have time to provide activity or stimulation. One staff member said, “We do our best to give the residents choices and to give them the time to make choices. It’s hard because we are so busy doing set jobs that have to be done so it can be rushed for the residents.”

Despite this, people did feel able to make their own daily decisions and felt their independence was respected. Comments included: “They do encourage me to be independent. I do most of my own personal care and am assisted with showering and bathing”, “I do my own personal care, but if you need help, I can guarantee that they (staff) would be there” and “I am able to make my own decisions, I do not like to be told what to do.”

The registered manager recognised the promotion of independence and choice through the provision of meaningful occupation was an area for improvement. A second ‘lifestyle’ staff member had recently been recruited, and all staff were due to receive further specialist ‘Dementia training’. The registered manager explained, “This training will enhance colleagues’ ability to deliver engaging activities and meaningful experiences for all residents. It will support improved one-to-one engagement, community and social outings.” The provider told us they planned for activities and engagement to be available for people 7 days a week.

Relatives were seen to visit and were welcomed into the home.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Some people did not feel staff were responsive to their needs. One person described having to wait long periods for their call bell to be answered. They told us, “I ring my bell to ask for something; they are meant to come in 10 minutes. It has taken up to an hour on many occasions.” Another person said, “Sometimes when I press my buzzer, they can take a long time.” However, some people had more positive experiences with 1 person stating, “When I press my buzzer, they are pretty good, no more than 5 minutes.” We have further reported on this in the safe section of this report.

However, we did observe occasions when staff responded to people’s needs in the moment and acted promptly to ensure people’s comfort. For example, a staff member immediately responded when a person said they were cold and would prefer a warmer top.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

We received mixed feedback from staff on whether they felt valued and supported. Whilst most staff told us they felt appreciated and listened to by the registered manager, others told us they did not feel recognised or valued within the organisation. Staff spoke of feeling tired and comments included, “It’s mentally and physically exhausting,” and “I hardly take breaks, we don’t take breaks as we don’t have time.”

One staff member told us there was a ‘staff recognition award’ each month, but this was not always communicated or used to promote good practice.

Some staff told us the registered manager had adjusted their working hours or shifts to support their mental or physical wellbeing. One staff member commented, “[Registered manager] will help where she can. I know she has changed shifts for some staff if they are having personal issues.”

The provider had systems to support staff wellbeing. Staff had access to an employee assistance programme which gave them financial information, health support and other benefits to support their well-being. At Christmas staff had received a thank you voucher and a member of staff told us how working on their birthday was recognised by the management team, with a cake and celebration to say thank you.