Archived: Hollyrood

Updated 24 August 2021

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 so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one inspector.

Service and service type

Hollyrood 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 did not have a manager registered with the Care Quality Commission (CQC). Registered manager’s and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. However, a manager was in post and was due to begin the process of registering with the CQC.

Notice of inspection

We gave a short notice period of the inspection. This was because of the COVID-19 pandemic. We wanted to be sure that no-one at the service was displaying any symptoms of the virus and needed to know about the provider’s infection control procedures to make sure we worked in line with their guidance. Due to the COVID-19 pandemic, we needed to limit the time we spent at the service.

What we did before the inspection

Before the inspection we reviewed the information we held about the service and the service provider. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law. We used all of this information to plan our inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with seven members of staff, including the manager, the deputy manager, regional support managers and three care staff. Many people were not able to fully verbalise their views and used other methods of communication, for example pictures. Due to people's needs, we spent time observing people with staff supporting them.

We reviewed a range of records. This included four people’s care records, medicine records, and further records relating to the quality assurance of the service, including accident and incident records.

After the inspection

We spoke with three relatives by telephone to gain further feedback around the care delivered.

Updated 24 August 2021

About the service

Hollyrood is a residential care home that provides care and accommodation for people with autism and learning disabilities. It was registered for the support of up to 25 people. 14 people were living at the service on the day of our inspection.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was registered before Registering the Right Support was developed. The service has not been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. The guidance ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning

disabilities and/or autism to live meaningful lives that include control, choice, and independence.

This service was able to demonstrate how they were meeting most of the underpinning principles of right support, right care, right culture.

Right support:

• The service was much bigger than most domestic style properties. The provider had tried to mitigate the effects of the environment by dividing the service into smaller living areas and supporting people to increase their access to community facilities. Further work was planned to provide more suitable accommodation. People received personalised care and support specific to their needs and preferences. People were protected from the risks of harm, abuse or discrimination because staff knew what actions to take if they identified concerns. There were enough staff working to provide the support people needed. Staff understood the risks associated with the people they supported. Risk assessments provided guidance for staff about individual and environmental risks. People received their medicines safely, when they needed them.

Right care:

• Care was person-centred and promoted people’s dignity, privacy and human rights. People’s individual needs and choices were recognised, and respected. This had been effective in supporting people to achieve goals and encouraged them to learn and grow as individuals. People were supported to have 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.

Right culture:

• Despite the need to keep people safe during the COVID-19 pandemic taking priority, the provider and staff had worked hard to develop good leadership. Quality monitoring systems had been embedded and morale was good amongst the staff team. We received positive feedback in relation to the care people received and how the service was run. One relative told us, “[My relative] has been at the home a long time, he has improved no end. When I think about the things he’s doing now to what he used to be able to do, I’m really pleased”.

Due to the COVID-19 pandemic, the provider had ensured that appropriate infection control procedures for the pandemic were in place to keep people safe. This included increased cleaning and ensuring adequate supplies of personal protective equipment (PPE) were available. Staff completed training in relation to COVID-19. We were assured the provider managed infection prevention and control through the COVID-19 pandemic.

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 requires improvement (published 3 February 2020) and there was a breach 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

We undertook this focused inspection in light of concerns we had received in respect to the care people were receiving. Concerns included, infection control, staffing levels and a negative and closed culture at the service. A decision was made for us to inspect and examine those risks. Therefore, this report covers our findings in relation to the Key Questions: Is it Safe? and Is it Well-led? We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe and Well-led sections of this full report.

We reviewed the information we held about the service. No areas of concern were identified in the key question of effective, caring and responsive. We therefore did not inspect these. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has improved to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hollyrood on our 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 re-inspection programme. If we receive any concerning information we may inspect sooner.