Hollydale

Hollydale is a care home providing personal care and accommodation for up to eight people with learning disabilities and/or physical disabilities. At the time of inspection there were eight people living in the home.

People’s experience of using this service:

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. The service continued to embed these key principles within the service to empower people to live the life they chose.

The service was a large home, bigger than most domestic style properties. It was registered to support eight people. Eight people were using the service. This is larger than current best practice guidance. There were two communal areas. The service had tried to mitigate the impact of this on people. People's bedrooms were spacious and reflected their taste and preferences. People had busy lives which reduced the amount of time they spent in the home.

People living at Hollydale received an exceptionally person centred service. The provider went above and beyond to understand and respond to people's needs and preferences. Using highly responsive techniques they had supported people's ability to express themselves and included their wishes in care planning and activities. People were engaged in a broad range of meaningful activities which improved their quality of life.

People continued to be safe and protected from the risk of abuse and avoidable harm. Comprehensive risk assessments followed best practice guidance and included positive risk taking to optimise people's opportunities to engage in activities.

The provider followed their robust recruitment procedure which ensured all staff had been safely employed. Induction training was thorough and the training for staff was up to date which meant they could provide effective care.

People's needs had been thoroughly assessed and their care plans included input from families and community based professionals. People's health needs were identified and they were supported to maintain regular appointments and screening.

People were supported to eat and drink, the service employed a speech and language therapist (swallowing) who provided specialist advice for people needing modified diets. Dieticians were involved when required for people who were nutritionally at risk.

The provider were compliant with the requirements of the Mental Capacity Act and associated Deprivation of Liberty Safeguards. People had been supported to make decisions in line with the best interest process in the Act.

Staff were observed to be kind and caring throughout the inspection. People were supported respectfully in ways that upheld their dignity. Excellent communication strategies ensured people had been supported to express their views.

The service was well led by a committed manager who continued to maintain high-quality, person-centred care, by leading by example and using effective checks and audits of care provided. Good communication at handovers, team meetings and one to one meetings ensured the team were well supported and informed.

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

Rating at last inspection:

At the last inspection the service was rated as good in all domains and good overall. At this inspection the service has improved to outstanding in the responsive domain and good in the other four. This meant the service was rated as Good overall.

Why we inspected:

This was a planned comprehensive inspection.

Follow up:

We will continue to review information we receive about the service until we return to visit as part of our re-inspection programme. If any concerning information is received, we may inspect sooner.

Hollydale is a residential care home registered to provide care for up to eight young adults who have a learning disability. All facilities in the home were provided on one level and all of the bedrooms for people who used the service were of single occupancy. At the time of the inspection there were eight people living in the home.

The service had registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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. At the last inspection on 23 March 2014, we found the service was meeting the regulations that were applicable at the time.

During this inspection we found the service was meeting the requirements of the current legislation.

People’s relatives we spoke with told us their family members were safe in the home. People who used the service were laughing and smiling in the presence of staff. It was clear that people who used the service were comfortable and happy in the presence of the staff.

Staff we spoke with were able to demonstrate an understanding of the appropriate procedure that they would take if they suspected any concerns around people’s safety and care. Policies and procedures were in place for staff to follow in the event of any concerns.

Staff told us that there were sufficient numbers of staff on each shift to enable them to deliver care and spend quality time with people who used the service. We saw sufficient numbers of staff were available to meet people’s individual care needs both on the day of our inspection and on the staff duty rotas.

Staff records demonstrated that necessary steps were taken by the provider to ensure suitable staff were recruited to work at the home.

The storage, administration and recording of medicines was managed safely. We saw relevant checks were taking place to ensure medicines were stored safely and at the correct temperature.

Staff had undertaken relevant training and competency checks to ensure people who used the service received their medicines safely and in line with policy and procedure.

Staff had completed up to date mandatory training as well as specialised training. This would enable them to meet people’s individual needs. Staff told us they received regular supervision from the provider and felt supported in their roles.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The registered manager and staff were aware of their responsibilities in relation to MCA and DoLS. Policy and procedures were in place to guide and support staff.

People had to access to health care professionals and services that they required. Documentation confirmed reviews of people’s health had been undertaken.

People's experiences of care were overwhelmingly positive. Relatives told us that they were very well looked after by an exceptionally caring staff team. We observed staff responded to people with knowledge of their individual needs. People who used the service were seen laughing and smiling and reacting positively to all the staff team.

Privacy and dignity was respected by staff. Staff were seen knocking on bedroom doors and waiting to enter. Staff were aware of the importance of private space for individuals when it was required.

Systems were in place to effectively deal with any complaints. There was a policy in place and records of completed investigations were seen. Relatives told us they were confident if they raised any concerns they would be dealt with appropriately.

Activities provided to people who used the service were outstanding. There was a comprehensive activity programme which was tailored around people’s individual choices, preference and likes. A relative told us the activity programme was a success. We saw people who used the service undertaking a number of activities during our inspection. There was a dedicated activity team who ensured all activities were regularly reviewed and monitored to ensure people were enjoying them.

Care records were informative and contained up to date, detailed information on peoples individual needs. Relatives told us they took an active role in their family members review and were happy with the care they received. Records confirmed the involvement of health professionals in peoples care.

The registered manager was committed to continuous improvement. The leadership and oversight of the service was exceptional. Audits and quality monitoring was completed, comprehensive and provided evidence of a quality service being delivered.

Relatives and staff we spoke with were extremely positive about the registered manager. A professional who regularly visited offered positive feedback about the leadership in the home. Team meetings were taking place and staff we spoke with confirmed they played an active role in these. A service user council had been developed to ensure people who used the service had a voice in the day to events taking place in the home.

There was a busy atmosphere in the home and residents were carrying out activities of their choosing, others were out in the community. There was a jovial feel and residents and staff were happily interacting.

We spoke with some parents of people who lived at the home and received very positive feedback. People expressed extreme satisfaction with all aspects of the service and spoke highly of staff, managers and the owner. Comments included:

'Care is at the centre of everything there.'

'We have been extremely pleased over the years with everything. We feel exceptionally lucky to have found this service.'

'I cannot speak highly enough of them. They are an extremely committed staff team and they go above and beyond.'

During this inspection we looked at standards relating to care, welfare and medicines management. We also assessed arrangements for staff recruitment and training and looked at how the provider monitored standards. We found that the service was compliant with the majority of areas we inspected. However, we identified some concerns in relation to the management of medication. We have asked the provider to make improvements and will be carrying out further checks to ensure the improvements are made.