During the inspection we gathered evidence against the outcomes we inspected to help answer our five key questions; is the service safe, effective, caring, responsive and well led?Below is a summary of what we found. The summary is based upon our observations, discussions with people who used the service, their relatives and the staff who supported them and from looking at the records held in the home. We also observed the interactions between people living there and the staff supporting and caring for them.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
The people we spoke with who lived at Hollow Oak told us that they felt safe living there and that staff listened to what they had to say.
We saw that risk assessments had been carried out to help make sure that people who lived there received safe and appropriate care and treatment. This included the important areas of nutrition, personal care, skin care and wound management, mobility and moving and handling and the risk of falls.
We saw that the premises and grounds were being well maintained and were accessible to the people living there. Appropriate measures were in place to ensure the security of the premises to keep people safe. The service had systems in place to manage and monitor the prevention and control of infection and a clean environment.
The home had a range of equipment to support the people who lived there. We saw that all the equipment was serviced and checked regularly to ensure it was safe for people to use.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes and we saw that appropriate policies and procedures were in place. The home had appropriate policies and procedures in regard to The Mental Capacity Act 2005. The manager of the home was knowledgeable about the Mental Capacity Act 2005 and the Mental Capacity Act Codes of Practice. This meant people could be confident that their rights would be protected.
Is the service effective?
We saw that the staff in the home treated people with respect. People were supported to carry out as much of their care as they could themselves, with the care staff assisting them to do the things they couldn't manage on their own. This supported people to maintain their independence and control over their lives.
We found that people's health and care needs had been assessed with them and they were involved in deciding the care and treatment they wanted, including at the end of life. We saw records that showed staff had undertaken accredited end of life training to give them the skills and knowledge to look after people properly at that time. Where people had been identified as at higher risk due to complex needs, appropriate specialist services had been contacted for advice and support.
Is the service caring?
Everyone we spoke with made positive comments about the staff employed at this home. We were told they were, 'Very kind' and 'A lovely bunch'. We observed that people living at Hollow Oak were comfortable and confident with the staff on duty.
Where people needed additional time to be able to express their views and wishes we saw staff gave them the time they needed to do this. The staff in the home took the time to talk with people as they went about their duties. We saw many positive interactions between the staff on duty and people who used this service. These positive interactions supported individuals' wellbeing.
Is the service responsive?
We saw that people living there were involved in the way the home was being run. They were able to take part in activities they wanted to inside and outside the home and to decide for themselves how they spent their time.
The care plans and information we looked at about the people using the service was written in a holistic and positive way. We saw from the sample of care plans we looked at that the plans of care, treatments and support were subject to evaluation, review and alteration in response to changes in people's needs and preferences.
We could see that the manager and staff monitored people's conditions and made timely referrals to others to access the care people needed. The manager took responsibility for making sure care had been well coordinated between different services involved in people's care and support.
Is the service well led?
When we visited the home we found there was an effective and verifiable system being used to assess and monitor the quality of the services and records about the care and support people living at the home received. Formal systems were in place to audit the quality of the service provided. We saw that the findings of these audits and the analysis of trends and incidents in the home was used to learn from, inform practices and continually improve the service. This helped to ensure that people received a consistently good standard of care at all times.
We saw that information about the safety and quality of the service was being gathered from different and relevant sources and that this was being recorded and stored securely. People we spoke with told us they were asked their views on the way the home was run at the home's 'resident and relatives' meetings and that their suggestions were welcomed by the manager and provider. We saw that where people had made suggestions about such things as meals and activities inside and outside the home they had been acted upon.
Staff working there told us they felt well supported by the manager of the home and the provider and said their views and ideas about the service were listened to. Staff we spoke with told us it was a good place to work and they were clear about their roles and responsibilities. Staff we spoke with had a good understanding of safeguarding procedures and whistle blowing to report on poor practice. Staff we spoke with said they were confident the manager and provider would support them if they needed to raise concerns.