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Reports


Inspection carried out on 19 December 2017

During a routine inspection

Hollyrose House is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Hollyrose House accommodates up to 12 adults who have mental health needs. Hollyrose House is a large detached house situated in a quiet residential area in Grays and close to all amenities and facilities. The premises is set out on two floors with each person using the service having their own individual bedroom and adequate communal facilities are available for people to make use of within the service.

At the last inspection on 22 October 2015, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

This inspection was completed on 19 December 2017 and there were 12 people living at Hollyrose House.

A registered manager was 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.

Our key findings across all the areas we inspected were as follows:

• Suitable arrangements were in place to keep people safe. Policies and procedures were followed by staff to safeguard people and staff understood these measures. Risks to people were identified and managed to prevent people from receiving unsafe care and support. The service was appropriately staffed to meet the needs of the people using the service. People received their medication as prescribed and in a safe way. Recruitment procedures were followed to ensure the right staff were employed. People were protected by the provider’s arrangements for the prevention and control of infection. Arrangements were in place for learning and when things go wrong.

• Staff had a thorough induction to carry out their role and responsibilities effectively. Staff had the right competencies and skills to meet people’s needs and received regular training opportunities. Suitable arrangements were in place for staff to receive regular formal supervision. People’s nutritional and hydration needs were met and they were provided with drinks and snacks throughout the day. People received appropriate healthcare support as and when needed from a variety of professional services. The service worked together with other organisations to ensure people received coordinated care and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

• People were treated with care, kindness, dignity and respect. People received a good level of care and support that met their needs and preferences. Staff had a good knowledge and understanding of people’s specific care and support needs and how they wished to be cared for and supported.

• Support plans were in place to reflect how people would like to receive their care and support, and covered all aspects of a person's individual circumstances. Social activities were available for people to enjoy and experience both ‘in house’ and within the local community. Information about how to make a complaint was available and people’s representatives told us they were confident to raise issues or concerns.

• Suitable arrangements were in place to assess and monitor the quality of the service provided. There was a positive culture within the service that was person-centred, open and inclusive. The service sought people’s and others views about the quality of the service provided.

Further information is in the detailed findings below.

Inspection carried out on 22 October 2015

During a routine inspection

The inspection was completed on 22 October 2015 and there were 11 people living in the service when we inspected.

Hollyrose House provides accommodation and personal care for up to 12 people who have mental healthcare needs.

The service had a 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.

Staff had a good understanding and knowledge of safeguarding procedures and were clear about the actions they would take to protect people.

There were sufficient numbers of staff available. Appropriate recruitment checks were in place which helped to protect people and ensure staff were suitable to work at the service. Staff told us that they felt well supported in their role and received regular supervision.

Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. Care plans were sufficiently detailed and provided an accurate description of people’s care and support needs. The management of medicines within the service was safe.

Appropriate assessments had been carried out where people living at the service were not able to make decisions for themselves and to help ensure their rights were protected. People had good healthcare support and accessed healthcare services when required.

People were supported to be able to eat and drink satisfactory amounts to meet their nutritional needs. The mealtime experience for people was positive.

People were treated with kindness and respect by staff. Staff understood people’s needs and provided care and support accordingly. Staff had a good relationship with the people they supported.

An effective system was in place to respond to complaints and concerns. The provider’s quality assurance arrangements were appropriate to ensure that where improvements to the quality of the service was identified, these were addressed.

Inspection carried out on 2 September 2014

During a routine inspection

At the time of this inspection there were ten people living at Hollyrose House.

Below is a summary of what we found. The summary describes what people using the service, relatives and staff told us, what we observed and the records we looked at.

If you want to see the evidence supporting our summary, please read the full report.

This was an unannounced inspection. We spoke with four people who used the service. We also spoke with the manager and three members of staff. We looked at written records, which included copies of people's care records held in the office, staff personnel files, medication storage and administration systems and quality assurance documentation.

Is the service safe?

We found the home to be warm and clean. The accommodation was adapted to meet the needs of the people living there, was suited to caring for people with limited mobility and was properly maintained. People were protected by safe recruitment practices.

We saw that care plans and risk assessments were informative and up to date. Staff we spoke with were familiar with their contents, which enabled them to deliver appropriate and safe care. The provider had safe systems in place for the storage and administration of medicines.

Is the service effective?

People we spoke with were satisfied with the care and support they received. This was consistent with positive feedback reported in the provider's own annual quality assurance survey.

People were given information and support to help them understand the care and support available to them. They were encouraged to increase their levels of independence. People were also able to participate in a range of suitable activities.

Is the service caring?

We spoke with four people who used the service. One person said to us, "This is a great place. The best place I've ever lived." Another person said to us, "This is a smashing place; I can't fault it at all. It's an oasis for me and I don't want to leave." Everyone we spoke with said the food was very nice and they were well fed.

There was a calm atmosphere throughout the home and a good rapport between staff and the people who lived there. Staff knew needs of people, were attentive to their needs, offered them choices and treated them with dignity and respect.

Is the service responsive?

People were consulted about and involved in their own care planning and the provider acted in accordance with their wishes. Care plans and risk assessments were regularly reviewed.

Two staff members told us that the manager was approachable and they would have no difficulty speaking to them if they had any concerns about the service.

Is the service well led?

Staff said that they felt well supported by the manager and they were able do their jobs safely. The manager had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the service they were receiving.

Inspection carried out on 26 November 2013

During a routine inspection

As part of this inspection process we spoke with the provider/manager, deputy manager, four members of staff and three people who used the service.

Our observations suggested that people living at the service were happy, that they felt safe and were well cared for. It was evident that people who used the service had a good relationship and rapport with the staff who supported them. Comments included, "It's not too bad here, I have no complaints" and "Its alright."

People's health and personal care needs were assessed and there were detailed care plans in place for care staff to follow so as to ensure that people were supported safely and in accordance with people's individual preferences and wishes. Improvements were required to ensure that people who used the service received appropriate social activities. Staff spoken with demonstrated a good understanding of people's health and personal care needs and how each person wished to be supported.

The provider was able to demonstrate that a robust staff recruitment policy and procedure was in place and followed to ensure that people living at the service were kept safe. There was also evidence to show that appropriate arrangements were in place for staff to receive regular supervision and an annual appraisal. We found that medication practices and procedures were well managed and appropriate systems were in place to assess and monitor the quality of service provision.

Inspection carried out on 28 September 2012

During a routine inspection

We spoke with three people who use the service. People told us that they were happy with the care and support provided. Comments were generally positive and included "Yes, its fine here" and "I like it here, the staff are very nice." Three people spoken with suggested that they felt safe and that, if they had any concerns or worries, they would discuss them with a member of staff.

We found that further improvements were required by the provider for people who use the service to have their capacity assessed. We also found that arrangements for the safe storage and recording of medicines required strengthening. Further development is required to ensure that the staff roster is an accurate reflection of all staff working at Hollyrose House and that there are sufficient staff on duty to meet the needs of people living there. Further improvements were required for all newly employed staff to receive an induction. In addition we found that not all staff had up to date training in core subject areas. Care plan records require further improvement and development so as to ensure they were accurate and fit for purpose.