Holly Tree Lodge

Updated 26 September 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted as part of our Thematic Review of infection control and prevention in care homes.

Inspection team

One inspector carried out this inspection.

Service and service type

Holly Tree Lodge 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection-

We spoke with three people who used the service and two relatives about their experience of the care provided. We spoke with three members of staff including the registered manager, the team leader, and a care worker. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included three people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including action plans, audits, staff rotas and meeting minutes. We received feedback from one professional who regularly visited the service.

Updated 26 September 2020

Holly Tree Lodge is a residential care home providing personal care to 10 people with learning disabilities at the time of the inspection. The building was spread across a main house and three additional and separate bungalows.

The service was registered for the support of up to 14 people. This is larger than current best practice guidance. The size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras or anything else outside to indicate it was a care home.

People’s experience of using this service and what we found

People living at the service were happy and liked the staff that provided their care and supported them.

People felt safe because staff knew what they were doing, they had been trained, and cared for people in the way people wanted. Staff assessed and reduced people’s risks as much as possible. There were enough staff to support people with their care and support needs. The provider carried out key recruitment checks on potential new staff before they started work to ensure they were suitable.

People received their medicines and staff knew how these should be given. Checks were in place to ensure that medicines were given safely and stored correctly.

Staff supported people with meals and drinks, ensuring that people had enough to eat and drink and were involved in making choices and helping to prepare them.

Staff used protective equipment, such as gloves and aprons to prevent the spread of infection. The service had gained advice regarding the use of face masks during the current covid-19 pandemic. We advised the registered manager to include these decisions in people’s risk assessments.

Staff followed advice from health care professionals and made sure they asked people’s consent before caring for them.

Staff were kind and caring, they involved people in their care and made sure people’s privacy was respected.

Staff kept care records up to date. Complaints and concerns were dealt with and resolved.

People, staff and relatives were asked their views of the service and action was taken to change any areas that they were not happy with. The provider had systems in place to effectively monitor and bring about improvements in the service. Concerns were followed up to make sure action was taken to rectify the issue.

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 applied 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 as many opportunities as possible for them to gain new skills and become more independent. The service had implemented training on these principles to embed the values within the staff team

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

Rating at last inspection

The last rating for this service was inadequate (published 23 April 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.