21 October 2014
During a routine inspection
The Hollies Care Home provides accommodation and care for up to 22 people some of who are living with dementia. There were 21 people living at the home when we visited.
This unannounced inspection took place on 21 and 22 October 2014. The previous inspection was undertaken on 13 January 2014 and had been undertaken as a dementia themed inspection. During this inspection we found that three regulations were not being met. We received an action plan update in July 2014 stating that action had been taken to address all of the issues raised at the inspection. We asked the provider to make improvements to ensure that each person had their individual needs assessed and planned for and that care was delivered in a way that met people’s needs. We found that this action had been completed. We also asked that improvements were made to ensure that people received the necessary support from other medical and social care professionals. We found that this action had been completed. We also asked the provider to improve the way they monitored the dementia care they provided at the home. We found that this action had also been completed.
At the time of this inspection a registered manager was 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.
During this inspection we found that staff did not have the knowledge to protect people from the risk of harm. Although staff had received safeguarding training they were not aware of the procedures to follow if they suspected anyone had experienced any harm.
There were poor arrangements for the management of medicines which meant that people were put at risk of harm. People’s individual health and safety risks were assessed, however the management of these risks were not clearly recorded.
CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). No applications had been made to deprive people of their liberty and the manager had not considered whether any applications were required. Arrangements to act in accordance with people’s consent were not always in place. Where people were thought not to have capacity to make certain decisions, mental capacity assessments were not carried out and there was little evidence that decisions were made in people’s best interests in accordance with the Mental Capacity Act 2005 (MCA).
Information from accidents and incidents hadn’t been analysed to ensure that any necessary action had been taken to prevent reoccurrence.
Satisfactory checks were completed during the recruitment of new staff so that only suitable staff worked at The Hollies. People living in the home and the staff confirmed that there were enough people working on each shift to meet people’s needs. Our observations during the inspection confirmed this.
Staff had received an induction so that they could carry out their role.
Staff knew how to care for people and what their support needs were. However people weren’t always involved in the planning and reviewing of their care. The care plans didn’t always reflect people’s current support needs.
People were supported to eat and drink sufficient amounts of food and drink. They were also supported to access a range of health care services to monitor their health and treat any health conditions that they had.
There were caring and supportive relationships between people living in the home and care staff. Most people were treated in a caring way and this demonstrated that a positive caring culture existed in the home.
The manager investigated and responded to people’s complaints, according to the provider’s complaints procedure and people were aware of how to make a complaint
People told us they felt their privacy and dignity were respected and made positive comments about staff. Care staff were able to tell us, and we saw, how they respected people’s privacy and promoted their dignity. Activities were enjoyed by people and we saw they were offered choices around activities and people who need it, were given the time to consider these choices.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.