Holly Nook is a residential care home registered to provide care for up to six people who have a learning disability. Five people were living at the service on the day of our inspection.

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’s privacy, dignity and independence were respected. People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

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.