The Hollies Residential Home

Updated 16 February 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 6 January 2022 and was unannounced.

Updated 16 February 2022

About the service

The Hollies Residential Home provides personal and nursing care for up to 22 people across two floors. There were 17 people over the age of 65 using the service at the time of the inspection.

People’s experience of using this service:

Quality assurance processes were not consistently implemented to help the provider and the registered manager to identify and act on areas which could pose a risk to people’s safety. There was a lack of robust provider-led audits in place to hold the performance of the registered manager and other staff to account. Enough improvement had not been made since our last inspection. This was an ongoing breach of regulations.

There were not always enough suitably trained, skilled and experienced staff to support people at night. There was not a formal induction process in place and some staff had not completed all required mandatory training. Staff did not receive an appraisal of their work. This represented a breach of regulations.

Some further work was needed to ensure that 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. We did note there was an inconsistent approach to the assessment of people’s ability to make decisions. We also raised concerns about the low number of Deprivation of Liberty Safeguard applications that had been made for people. We have made a recommendation to the provider about this.

The risks to people’s health and safety were not always recorded within their records, although people told us they felt well supported and safe living at the home. Staff had a good understanding of how to identify and report any signs of abuse or neglect. The home was clean, although one communal room had a strong smell of urine and parts of the ground floor were cluttered. Action was taken after the inspection to address this. Improvements had been made to the way people’s medicines were managed. Accidents and incidents were investigated, but records used to record these investigations and subsequent actions taken were limited.

People’s needs were assessed prior to them moving to the home; however, this did not always result in detailed care plans and risk assessments to help to reduce risks to health and safety. Where people received support with their meals, staff did so effectively and in line with dietary requirements. Parts of the home required maintenance to ensure the home environment was safe for all. People had access to other healthcare agencies to help them to lead healthy lives. Visiting professionals praised the care provided by staff.

People liked the staff, they found them to be caring and respectful and they received personal care in a dignified way. People’s independence was encouraged and privacy respected. People’s care records were person-centred and contained guidance for staff to support them in their preferred way. Innovative methods had been used to provide people with information in formats they could understand.

People were supported to take part in activities to reduce the risk of social isolation. People felt able to make a complaint and were confident their complaint would be acted on. End of life care was not currently provided; however, more detailed care planning was required to ensure people could receive this care in their preferred way if needed.

The registered manager had a good knowledge of their regulatory requirement to report concerns to the CQC. People told us they would recommend the service. People’s views were requested and acted on.

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

Rating at last inspection: The last rating for this service was requires improvement (published 20 August 2018) and there were two breaches of regulation. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-led key question sections of this full report.

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

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.