The inspection visit took place on the 1st and 2nd October 2014 and the first day was unannounced.
The Hollies is a large detached house built in 1801 in the centre of Norton. The home provides services for up to 18 adults with mental health needs.
We last inspected the home on 13th October 2013 and found the service was not in breach of any regulations at that time.
There was a registered manager in post who had been registered with the Care Quality Commission for two and a half years. ‘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.’
On the first day of our visit the registered manager explained the policies and procedures in relation to the Mental Capacity Act and Deprivations of Liberty Safeguards (DoLS) were not kept separate and were incorporated within other policies. On the second day of our visit the manager had rewritten the policies so they were stand alone. The registered manager had the appropriate knowledge to know when an application should be made and how to submit one. This meant people were safeguarded. We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards.
People told us they felt safe living at the home. We found the registered manager had appropriate systems in place to protect people from risk of harm.
We found people were provided with support and care by staff that had the appropriate knowledge and training to effectively meet their needs. The skill mix and staffing levels were also sufficient. Robust recruitment processes were in place and followed, with appropriate checks undertaken prior to staff working at the service. This included obtaining references from the person’s previous employer as well as checks to show that staff were safe to work with vulnerable adults.
Staff had opportunities for ongoing development and the manager ensured that they received supervision, yearly appraisal and training relevant to their job roles.
People who lived at the service were encouraged to live fulfilling lives and it was clear from our observations that staff had developed good relationships with people and understood individual needs. We saw kind and caring interactions and people were offered choices and had their dignity and privacy respected.
Good arrangements were in place to ensure people’s nutritional needs were met. Where risks had been identified there was input from the relevant healthcare professionals. People could not compliment the food enough.
People had their needs assessed and these were detailed within their care records, which were up to date and reflective of people’s current needs. People’s care records contained a good level of information and provided staff with the information they needed to effectively meet people’s physical and mental health needs.
People had opportunities to be involved in a range of activities, which were influenced by their hobbies, interests and lifestyle preferences. We noted that people who lived at the service were able and encouraged to maintain relationships with their friends and family and enabled to take risks.
People were provided with information about concerns and complaints. We found people’s concerns were responded to appropriately by the registered manager and there were systems in place to learn from complaints and incidents.
From the discussion we had with people who lived at the service, healthcare professionals, staff and other professionals, we found the home was a well-led service. There were effective systems in place to monitor and improve the quality of the service provided. We saw that the culture was one that takes account of people’s views and embraced continual improvement and development.