We carried out a review of the data available to us about Holly Nook on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Holly Nook, you can give feedback on this service.
We found the following examples of good practice.
The provider had policies and procedures in place to ensure staff followed effective infection control guidance.
Staff and visitors had access to personal protective equipment (PPE) and there was a plentiful supply. We saw staff wearing PPE in line with current guidance.
Professional visitors were required to show a negative lateral flow test and evidence of COVID-19 vaccination status. Visiting arrangements were robust and in accordance with the most recent government guidance.
Social distancing was observed as far as it was practicable to do so. Staff had completed training in infection control, COVID-19 and putting on and taking off PPE.
Staff and people using the service were tested regularly for COVID-19 and action was taken if a test was positive.
The home was very clean throughout and additional cleaning measures were in place.
Holly Nook provides personal care in a supported living setting for up to six people with learning disabilities or autistic spectrum disorder. At the time of our inspection there were five people living at the service.
People's experience of using this service and what we found
Systems were in place to ensure people were protected from abuse and investigate any concerns. Risks linked to people's care were considered and monitored. Environmental risks were considered. The service ensured there were enough staff, who had been safely recruited. People received care from staff who knew them well and had relevant experience. People were supported appropriately with their medicines.
People's care was based on an assessment of their needs and their choices. Staff had access to training and support. People were supported to regularly access health care service's to maintain their wellbeing.
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.
The service had regard for the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
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 opportunities to gain new skills and become more independent.
People were well supported by staff who had a good understanding of their individual needs and preferences. There was evidence people were supported to make day to day decisions and it was clear people had been given meaningful opportunity to participate in care decisions. People's privacy and dignity were respected and supported.
People's care plans contained good detail about how they should be supported, and we witnessed staff following this guidance. Staff understood people's communication needs. People were supported to engage in a range of activities. There had been no recent formal complaints recorded. Information on people's end of life choices were recorded, as appropriate.
Audits and quality checks were in place to ensure the service maintained good standards of care and were continually looked at to develop the service, ensuring positive outcomes for people.
Rating at last inspection and update
The last rating for this service was Good (published 16 May 2017)
Why we inspected
This was a planned inspection based on the previous rating.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.
The home had a registered manager. 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.
The provider continued to have systems in place to safeguard people from harm and abuse and made sure that safeguarding alerts were raised with other agencies, such as the local authority safeguarding team, in a timely manner. Staff knew how to report any concerns related to abuse.
Staff had systems and documents in place to identify risks when meeting people's needs. The risk assessments showed ways that these risks could be reduced.
There continued to be sufficient numbers of qualified, skilled and experienced staff to meet people's needs. The provider operated safe recruitment procedures.
Medicines were stored and administered safely. Clear and accurate medicines records were maintained.
Staff knew each person well and had a good knowledge of the needs of people. Training records showed that staff had completed training in a range of areas that reflected their job role and enabled them to deliver care and support as appropriate.
Staff received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to make sure they knew how to protect people's rights.
People's relatives were extremely complimentary about the caring attitude of the staff. It was clear from our observations and discussions that staff knew people well and tailored the provision of care and support to meet individual needs. The language and approach used by staff was genuine and caring.
People were supported to maintain a varied and healthy diet in accordance with their preferences and healthcare needs.
People knew how to make a complaint if they were unhappy. There was a complaints guide for people on the notice board. This enabled people to know how to complain in a format they could understand.
People spoke positively about the way the home was run. The provider had a clear set of values and we observed that both the registered manager and staff followed these. The registered manager and staff understood their respective roles and responsibilities.
The provider continued to have systems to monitor and review the quality of service they provided. Prompt action was taken to improve the home and put right any shortfalls identified.
This inspection took place on 24 December 2014 and was unannounced.
Holly Nook was last inspected in May 2013 and we found they were meeting the regulations we looked at.
Holly Nook provides accommodation and personal care for up to six people with learning disabilities and autistic spectrum disorders. On the day of the inspection four people were living at the home. The home had a registered manager. 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 working at Holly Nook understood the needs of people who used the service and we saw that care was provided with kindness and compassion. People and their families told us they were happy with the care provided.
People were relaxed and happy on the day of the inspection. We saw staff talking with people in a friendly manner. We saw staff assisted people as they needed whilst encouraging people to be as independent as possible.
We saw care records were of a high standard and contained detailed information to guide staff who were supporting people. Risk assessments were completed and regularly reviewed. We found people were supported to live full and active lives and had access to the local community.
People were able and encouraged to take part in activities which reflected their individual hobbies and interests. People were also supported to maintain strong relationships with their families.
Staff were well supported through a system of induction, training, supervision, appraisal and professional development. There was a positive culture within the service which was demonstrated by the attitudes of staff when we spoke with them and their approach to supporting people to develop their independence. We saw the service was organised to suit the needs of the people who lived there.
People were supported by sufficient numbers of staff on duty. Staff told us that staff numbers were always one to one but could be increased to address changes in risk or changing support needs.
We looked at the arrangements in place for the administration of medicines and found these to be safe. Medicines were stored securely in a locked cabinet. Medicines stored tallied with the number recorded on the Medication Administration Records (MAR). Arrangements were in place for the storage of controlled drugs if required. We saw from training records, all staff had received medicines training.
The service was well led. The registered manager was respected by staff, people who used the service and their relatives. They regularly monitored the quality of the service provider through questionnaires and a system of audits.
People experienced care, treatment and support that met their needs and protected their rights. They told us 'I love doing craftwork, going fishing, cooking and art. I get to do all the things I like.'
People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. A visiting relative told us "The staff are very thoughtful and nothing is too much trouble, I have no concerns."
People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.
The provider had an effective system to regularly assess and monitor the quality of service that people receive.