Holly Tree Lodge is a care home, which provides residential care for up to 14 people with learning disabilities. The service consists of a large house and three individual bungalows.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and felt confident in how to report them.

People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed. Staff received an induction and on-going training. They had attended a variety of training to ensure they were able to provide care based on current practice when supporting people. They were supported with regular supervisions.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people.

People were able to make choices about the food and drink they had, and staff gave support when required to enable people to access a balanced diet. There was access to drinks and snacks throughout the day.

People were supported to access a variety of health professionals when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure in place which was accessible to all. Complaint had been responded to appropriately.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

Further information is in the detailed findings below

This inspection was carried out 24 June 2015 and was unannounced.

The inspection was carried out by one inspector.

Holly Tree Lodge is a care home, which provides residential care for up to 14 people with a learning disability. On the day of our inspection 9 people were using the service.

There was a registered manager in post. 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.

People felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and how to report them.

People had risk assessments in place to enable them to be as independent as they could be.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs.

Effective recruitment processes were in place and followed by the service.

Medicines were managed safely and the processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

Staff received a comprehensive induction process and ongoing training. They were very well supported by the registered manager and had regular one to one time for supervisions.

Staff had attended a variety of training to ensure they were able to provide care based on current practice when supporting people.

Staff always gained consent before supporting people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were very knowledgeable of this guidance and correct processes were in place to protect people.

People were able to make choices about the food and drink they had, and staff gave support when required.

People were supported to access a variety of health professional when required, including dentist, opticians and doctors.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well.

People and relatives where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was kept at all times.

People were supported to follow their interests.

A complaints procedure was in place and accessible to all. People knew how to complain.

Effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

During this inspection we used a number of different methods to help us understand the experiences of people using the service, because some people had complex needs which meant they were not always able to talk to us about their experiences. We spoke with five people using the service during this inspection. People told us they were happy living at Holly Tree Lodge. One person said about the staff; “They are lovely. I like my key worker. She takes me shopping.”

People experienced effective, safe and appropriate care. Care plans were well documented to promote continuity of care.

We found that people living in the home received their prescribed medication when they needed it and in a way that suited them.

We found the premises to be maintained to ensure the home remained safe for people using the service, staff and visitors.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

Suitable arrangements were in place to address people's comments and complaints, and ensure they were listened to.

We spoke with five out of the ten people currently living at the home. People told us they were well looked after by staff, who were very nice.

Two people said they liked living in their own bungalows and one person said, “I like my bungalow. I keep all my own things here and I can watch my favourite films.”

People we spoke with told us they assisted with household chores such as cleaning their rooms and cooking. On the day of our visit one person had cooked their own lunch; They told us”I like to cook my own meals whenever I can.”

One person told us about the staff “they help me when I need it.” Another person said “I look after myself but they will help me if I’m struggling.”

During our visit to Holly Tree Lodge on 01 March 2012 we spoke with some of the people living at this home. They told us they liked living here, and that staff treated them with respect.

People told us they were involved in deciding about some of the care and support they needed, and could make choices about how they lived their lives. They said they were given help when they needed it and we saw that staff offered personal care to people in a discreet and sensitive way.

People we spoke with during our visit to this home told us they felt safe here, and that staff treated them well. We observed that staff were kind, caring and attentive and there was good interaction between the staff and the people living at the home.

Our inspection identified that there were a number of issues about the service provided at this home, relating to the environment, people’s involvement in making decisions about the care they received, care planning and risk assessments, and quality assurance. These are detailed in the report.