Archived: Holly Court Care Home

Holly Court Care Home is a residential care home providing accommodation and personal care to up to 25 older people and those living with dementia. At the time of our inspection there were 25 people using the service.

People’s experience of using this service and what we found

Medicines were managed safely and risks to people and the environment had been assessed. People told us they felt safe and considered there were enough staff to offer support; staff felt there were times when another member of staff was needed. A dependency tool was not in use, and we have made a recommendation about this. A dependency tool helps providers determine staffing levels are appropriate based on the number of people living at the home and their individual care needs.

Recruitment practices were robust, and people and relatives spoke positively about staff approach. There were systems and processes in place to safeguard people from the risk of abuse. The home was clean and free from odours.

Staff received a mixture of on-line and face-to-face training covering mandatory elements. Staff new to care completed the Care Certificate. People’s rights were respected, and the service was working in accordance with the Mental Capacity Act.

People had mixed views about the food and drinks offered to them. The provider and registered manager needed to make improvements to the environment and to staff practice to ensure mealtimes were a more positive experience for people.

People were supported to maintain relationships which were important to them and were involved in a range of activities. People’s communication needs were met and there was a process for managing complaints and concerns.

Quality monitoring and audits at the service were not effective or robust. These systems had not identified the shortfalls we found in the dining experience, care planning and electronic systems. These needed to accurately reflect the care provided.

People and relatives spoke positively about the management team and staff commented on the positive teamwork approach in the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 29 November 2022) and there were breaches of regulation in relation to the administration of medicines, staff training and good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made, however the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We carried out an unannounced comprehensive inspection of this service on 12 and 13 October 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report covers our findings in relation to the Key Questions of safe, effective, responsive and well-led.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement based on the findings at this inspection.

At this inspection we found the provider had made improvements in relation to the administration of medicines, staff training and the provision of activities, but they remained in breach of good governance. We have made a recommendation in relation to staffing.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Holly Court Care Home on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Holly Court Care Home is a purpose built care home registered to provide accommodation and care for up to 25 people. It is registered to support both older adults, younger adults as well as people living with dementia. At the time of inspection 22 people were living at the home.

People’s experience of using this service and what we found

Improvements were required with medicines management, record keeping, staff training and supervision, person centred care; including care planning and the provision of activities and the audit and governance process.

People told us they felt safe living at the home. People and relatives felt enough staff were deployed to keep people safe, although staff were very busy and had little time to sit and chat with them. Staff completed safeguarding training and knew how to report concerns. Accident, incidents and falls had been documented, with analysis completed to help minimise a reoccurrence. The home was clean, with effective cleaning and infection control processes in place.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People told us they received enough to eat and drink. However, records of food and fluid intake were inconsistent. The environment was suitable for the people living at the home, with aids and adaptations in place to support people to navigate around the home and use facilitates safely.

People and relatives were happy with the care provided and spoke positively about the staff who supported them. People told us they were offered choices each day, their dignity and privacy was respected, and they were supported to remain as independent as possible.

Each person had a care plan in place, which detailed how they wanted to be supported. The home was in the process of transferring to an electronic care planning system, which had resulted in some record keeping issues. People and relatives told us they knew how to complain but had not needed to. People had communication care plans in place, to ensure staff knew about any issues they may have and the best way to communicate with them.

People and relative views had been sought through meetings and surveys, to ensure they were involved in the running of the home. People told us they enjoyed living at the home and would give it their recommendation. Relatives also commented on Holly Court being a nice home, which they would recommend to others.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 1 September 2021 and this is the first inspection under the current provider. The last rating for the service under the previous provider was good, published April 2020.

Why we inspected

This inspection was prompted by a review of the information we held about this service and to provide a rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Holly Court Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to medicines management, staff training and supervision, person centred care, record keeping and the home’s audit and governance process at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.