About the service:

Holyhead Care centre is registered to provide accommodation and personal care for up to 26 people with mental health support needs. At the time of inspection, 23 people were using the service.

People’s experience of using this service:

People continued to receive safe care. Staff understood safeguarding procedures that should be followed to report abuse and incidents of concern. Risk assessments were in place to manage risks within people’s lives, whilst also promoting their independence.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out . Staffing support matched the level of assessed needs within the service during our inspection.

Staff training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Training was provided to make sure that people’s needs were met and they were supported effectively.

Staff were well supported by the registered manager, and had one to one supervisions . The staff we spoke with were all positive about the senior staff and management in place.

People's consent was gained before any care was provided. 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 supported this practice

Staff continued to treat people with kindness, dignity and respect and spent time getting to know them. Care plans reflected people’s likes and dislikes, and staff spoke with people in a friendly manner.

People were involved in their own care planning and were able to contribute to the way in which they were supported. People and their family were involved in reviewing their care and making any necessary changes.

A process was in place which ensured people could raise any complaints or concerns. Concerns were acted upon promptly and lessons were learned through positive communication.

The service continued to be well managed. The provider had systems in place to monitor the quality of the service. Actions were taken and improvements were made when required.

Rating at last inspection:

Good (report published 25/12/15)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 2nd November 2015 and was unannounced.

Holyhead Care Centre is a care home providing personal care and accommodation for a maximum of 24 people. It supports younger and older adults with mental or physical health care needs. At the time of our visit there were 24 people living at the home.

The home has 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.

People who lived at Holyhead Care Centre felt safe and were supported by staff who had undertaken training to support with people who had mental and/or physical health conditions.

Staff understood the provider’s policies and procedures on how to safeguard people from abuse. They followed people’s individual risk assessments which provided them with information on potential risks associated with people’s care and how to manage them.

Recruitment checks were carried out prior to staff starting work at Holyhead Care Centre to ensure their suitability to work with people in the home.

Whilst most medicines were managed and administered safely, further information was required for when people should be given medicine that was prescribed on an ‘as required’ basis. The registered manager had a good understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff had undertaken training to help ensure they understood how people who lacked capacity could be supported to make decisions.

Staff understood the importance of obtaining people’s consent before undertaking care and support. We saw people had been assessed to determine how decisions could be made in their best interests and applications for DoLS had been completed and were in the process of being assessed by the Local Authority.

There were sufficient staff to meet people’s needs both in the home, and to support people with their hobbies and interests outside of the home. People received care and support which was tailored to their individual needs. People enjoyed the food provided at the home and were involved in menu planning.

Staff were motivated to work with people who lived at Holyhead Care Centre and had a caring approach. They treated people with dignity and respect.

Staff and people who lived at the home told us they had confidence in the management team. They told us they felt that they were approachable and that they could discuss any concerns or issues with them.

There were systems in place to monitor the quality and safety of the service, these were effective and action had been taken to address any problems identified in the home.

We visited unannounced and spoke with four care staff and six people who used the service. We also spoke with a visiting professional, the manager of the service and the director of the service.

We observed interactions in the home and looked at a sample of care records. We saw staff were attentive to the needs of people in the home, consulted them and explained what was happening. We found it difficult at times to understand what some people at the home were trying to tell us. Members of staff were able to understand and assist people in ensuring we understood them. We saw that staff enjoyed a good rapport with people who lived at the home. We saw lots of smiles from people. We had positive responses from people in the home, such as “I like the staff” “The staff are good” and “The food is good”.

Staff we spoke with were very positive about working at the home. Most staff had worked at the home for several years. Staff showed a good knowledge of the needs of people in the home and supported them in accordance with those needs.

We noted a few minor shortcomings in the environment and were assured by the manager that these were in the process of being improved.

We visited the home without letting anyone know in advance. The home can accommodate 24 elderly people. On the day of our visit there were 21 people living there. We spoke with three people who lived at the home at length, as well as with staff, the manager and a relative. We looked in detail at the experiences of three people who lived at the home and observed care and interactions throughout the home. Some people had speech impairments which made it difficult to understand them at times. Staff or other people who lived at the home were able to help us understand words and phrases they used.

We observed good positive interactions between staff and people who lived at the home and heard positive remarks by people about the home and staff.

One person said “I really love it here. They have a lift which helps me get around and I can smoke in the outside smoking area”.

Another person living at the home referred affectionately to a member of staff: "This is a nice little girl here - she's my friend".

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The home supports people to do a wide variety of activities in and out of the home. Concern was expressed by one member of staff regarding appropriate manual handling of people. We found some uncertainty over whether this was being done appropriately at all times.

We found that one person had recently commenced work at the home without evidence of a proper induction.

People using the service had few direct comments on the service. Thumbs up, smiles, and friendly remarks indicated that the service has a positive effect on their well-being. Two visitors were positive in their views about the service, with remarks centring on how people were much more alert and stimulated, and that they have lots of activities and attention. 'Really pleased', 'a lot more lively', 'always welcome here' were typical remarks.