This inspection visit took place on the 5 and 6 November 2018 and was unannounced.

At our last inspection in October 2017 we found the provider was in breach of one regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We issued requirement notices in respect of that breach.

Following the last inspection the provider sent us an action plan to show what they would do and by when to improve the key question Well Led to at least good. During this inspection we found improvements had been made and the provider had systems in place to minimise the risk to people who use the service in respect of identified maintenance concerns.

Holly Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission [CQC] regulates both the premises and the care provided, and both were looked at during this inspection.

Holly Lodge is a detached house providing residential accommodation for 11 adults with a learning disability approximately one mile from the town of Lymington in Hampshire. The home has eight single rooms in the main house and three self-contained flats in the grounds of the home providing residential accommodation for a further three adults. At the time we visited, there were eight people living at the service.

There was not 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. A new manager was in post and had applied to the CQC to become the registered manager.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People, their relatives and staff told us the registered manager was supportive and approachable.

People were supported by staff who knew them well. Staff we spoke with were enthusiastic about their jobs, and showed care and understanding both for the people they supported and their colleagues.

Staff understood what it meant to protect people from abuse. They told us they were confident any concerns they raised would be taken seriously by the management team.

Medicines were stored safely and securely, and procedures were in place to ensure people received their medicines as prescribed.

The service had robust recruitment procedures to make sure staff had the required skills and were of suitable character and background.

People and their relatives told us they enjoyed the food served which considered peoples individual dietary needs and preferences.

Staff understood the requirements of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The provider’s policies and systems supported this practice.

People’s privacy and dignity was respected and promoted. Staff understood how to support people in a sensitive way, while promoting their independence. People told us they were treated with dignity and respect.

There was a range of activities and therapies available to people living at Holly Lodge. People’s care records reflected the person’s current health and social care needs. Care records contained up to date risk assessments. There were systems in place for care records to be regularly reviewed.

There was a complaints policy and procedure in place. People’s comments and complaints were taken seriously, investigated, and responded to.

There were effective systems in place to monit

The inspection took place on the 30 and 31 October 2017 and was unannounced.

The service did not have 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 previous registered manager had left on 31 May 2017 and the service had been managed from 5 June 2017 by a registered manager from one of the provider’s homes nearby, the deputy manager from that location and the assistant regional director. An application for registered manager at this location was received by the commission on the 25 June 2017 and was in progress.

Holly Lodge is a detached house providing residential accommodation for 11 adults with a learning disability approximately one mile from the town of Lymington in Hampshire. The home has eight single rooms in the main house and three self-contained flats in the grounds of the home providing residential accommodation for a further three adults.

The provider had systems in place to respond to and manage safeguarding matters and make sure that safeguarding concerns were raised with other agencies.

People living at Holly Lodge told us people were cared for safely and if they had any concerns they would speak to the staff or management.

Assessments were in place to identify risks that may be involved when meeting people’s needs. Staff were aware of people’s individual risks and were able to tell us of the strategies’ in place to keep people safe.

There were sufficient numbers of qualified, skilled and experienced staff deployed at all times to meet people’s needs. Staff were not hurried or rushed and when people requested care or support, this was delivered quickly. The provider operated safe and effective recruitment procedures.

Medicines were ordered, stored, administered and disposed of safely.

Staff received supervision and appraisals providing them with appropriate support to carry out their roles.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

Some people were not able to verbally communicate their views with us or answer our direct questions. 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.

People were involved in their care planning. Care plans were routinely reviewed to check they were up to date.

People were treated with kindness. Staff were patient and encouraged people to do what they could for themselves, whilst allowing people time for the support they needed.

The provider completed regular health and safety checks, including maintenance. However they did not always respond to identified concerns that could compromise the safety of people in a timely way.

We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.