Hollymede Cottage is a ‘care home’. People in care homes receive accommodation and personal care under a contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. Hollymede Cottage accommodates up to fourteen people in an adapted building. At the time of our inspection, 12 people were using the service.

This inspection took place on 7 March 2018. The inspection was unannounced, this meant the staff and provider did not know we would be visiting. At the last inspection on 13 October 2015 the service was rated ‘Good’. At this inspection, we found the service remained good.

The was no registered manager in post, but a person had been recruited to this role who was looking to register with the CQC. 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 received regular supervision and had been given the training they needed to meet people’s needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so.

People were cared for and supported by staff that understood their needs and knew them well. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights. The care and support people received was individualised.

The service had appropriate systems in place to keep people safe and staff followed these guidelines when they supported people. There were a sufficient numbers of care staff available to meet people’s care needs and people received their medicine as prescribed and on time.

The provider had a robust recruitment process in place to protect people from the risk of avoidable harm. They had been recruited safely with the skills and knowledge to provide care and support to people.

People’s health and emotional needs were assessed, monitored and met in order for them to live well. The service worked closely with relevant health care professionals and people received the support they needed to have a healthy diet that met their individual needs.

Audits were carried out and people were asked their views about the service. This information was used to look at how the service could be improved.

This inspection took place on 13 October 2015 and was unannounced.

Hollymede Cottage is registered to provide accommodation with personal care for up to 14 people. The service is not registered to provide nursing care. There were 14 people using the service on the day of our inspection which included one person who was receiving respite care.

There is 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.

The service had appropriate systems in place to keep people safe and staff followed these guidelines when they supported people. There were sufficient numbers of care staff available to meet people’s care needs and people received their medication as prescribed and on time.

The provider also had a robust recruitment process in place to protect people from the risk of avoidable harm. Staff who had been recruited safely with the skills and knowledge to provide care and support to people.

People’s health and emotional needs were assessed, monitored and met in order for them to live well. The service worked closely with relevant health care professionals. People received the support they needed to have a healthy diet that met their individual needs.

People were treated with kindness, respect and dignity by staff who knew them well and who listened to their views and preferences.

People were able to raise concerns and give their views and opinions and these were listened to and acted upon. Staff received guidance about people’s care from up to date information about their changing needs.

There was a strong manager who was visible in the service and worked well together with the team. People were well cared for by staff who were supported and valued.

Management systems were in place to check and audit the quality of the service. The views of people were taken into account to make improvements and develop the service.

We saw that people who used the service were treated with respect and their privacy and independence were encouraged where it was safe to do so. We could see that people’s individual needs were assessed appropriately and feedback from people who use the service showed that they were satisfied with the home and felt well cared for. They said they felt safe and that it was a caring service.

We found that staff were properly supported to provide care and treatment to people who used the service. Appropriate changes had been made to ensure that an accurate record was being maintained for each person using the service. We could see that appropriate information and documentation was in place to support the care and treatment of people living in Hollymede cottage.

We spoke with two relatives and three people who use the service who told us that people at Hollymede Cottage, including those who have difficulty with communication were supported in promoting their independence and community involvement where possible. They said that people were treated with dignity and respect and that people were encouraged to express their views and were involved in making decisions about their care and treatment.

We saw that people were asked for their opinion or their agreement and their answers were listened to and respected. One person told us "I feel safe here" and two relatives we spoke with, had no concerns regarding the risk of abuse.

At the previous inspection in February 2012 we raised concerns with the provider that the recruitment processes were not robust enough to safeguard people and that that not all staff were sufficiently trained, supported and supervised in their role. At this inspection adequate actions had been taken to become compliant.

We also raise concerns in February 2012 regarding not acting on people’s views and poor auditing practices to monitor and support good outcomes for people. The provider was able to demonstrate compliance through improved systems of quality monitoring. Records, whilst improving remain non compliant as care plans require development to demonstrate accurate person centred care practices.

During our visit to Hollymede Cottage we were able to hold a conversation with two people who lived at the home and also with three visiting relatives. Other people living at the home made comments about particular issues, such as the quality of the meals, whether or not they liked their room and if they liked staff. Some of our information about people’s experiences was gathered through observing and listening to the everyday interactions and activities at the home.

People told us they received good care and Hollymede Cottage and that their privacy, dignity, independence and right to exercise choice were respected and supported. They told us that there were lots of meaningful activities for people to take part in and lots of comings and goings that provided interest. We saw that this did happen in practice during our visit on 29 February 2012.

People told us they felt safe at Hollymede Cottage and that staff took time to talk with and listen to them and we saw this during our visit. People using the service spoke highly of the staff. One person said, "The staffs’ approach to people is very good. I have a very high opinion of the staff, they are interested in the people here, they are real grafters." Another person said, "They do a remarkably fine job."

People told us they received a quality service at Hollymede Cottage. One person said, “It is like a high quality hotel, you would have to travel far to find another like it. Its success is that it is so small, you get to know people, and there are always things happening.”