Holly Cottage

Updated 12 September 2024

Date of Assessment: 18 December 2024 and 15 January 2025. The service is a care home and provides support to people with a learning disability and autistic people, as well as those living with physical disabilities and sensory needs. There were 9 people in receipt of accommodation and personal care living at the service at the time our assessment. We conducted an announced site assessment on the 18 December 2024, and an unannounced out of hours assessment on the 15 January 2025. We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities.

Care plans were often contradictory, and not always clear about people’s needs. We found some risks had not been identified and mitigated. This placed people at possible risk of harm. People were not always involved in assessments of their needs and their ability to consent to care and treatment had not always been assessed appropriately. People had enough to eat and drink to stay healthy, although some health care plans required further detail to ensure people’s needs were fully met. Care was person-centred and promoted people’s dignity and privacy. The service was clean and well-maintained. Staff told us they felt valued and supported. There were enough skilled staff. Staff managed medicines well and worked well in partnership with professionals. However, some processes were not robust and required review. The provider did not always have a good learning culture, but people told us that they could raise concerns. We found gaps in processes; however, the service had started taking steps to improve governance systems. The provider was in breach of legal regulations relating to consent, safe care and treatment and good governance. We have asked the provider for an action plan in response to the concerns we found.

Updated 12 September 2024

People we spoke with were positive about the quality of their care and they felt safe. People understood their rights but were not always fully involved in planning their care. Relatives told us that people received high quality care from knowledgeable staff who treated them as individuals. One person said, “[Person] is very safe here. The front and back gates are locked and have CCTV cameras in operation. We also have access to the home 24/7 but are only admitted when the staff let us in at the gates”. Some people could not directly tell us about their experience. We used a structured observation tool to assess whether they received good care. We observed their interaction with staff and found staff responsive to people’s needs. A relative told us that the service provided activities to keep people physically and mentally active. They said ‘[Person] accesses the community on a fairly regular basis for walks, shopping, exercise, theatre or whatever [they] choose. Whilst in the community [they are] accompanied by [their] 1:1 staff member.’ However, we found that people’s opinions had not always been considered by the provider when assessing mental capacity, and some assessments seen were for multiple decisions and not in line with the Mental Capacity Act 2005. People were offered choices. We saw a menu plan offered people a choice of meals, and observed staff prepare food in line with individual needs. People felt able to complain and were confident action would be taken, and improvements would be made. People knew staff and leaders well. One person told us, ‘All the staff are lovely.’ The manager was readily available, and we observed good interactions with people. One person came to the office several times to seek reassurance from the managers and always went away with a smile on their face.