10 and 11 September 2015
During a routine inspection
This inspection took place on the 10 and 11 September 2015 and was unannounced. We last inspected the service on the 9 and 16 January 2015 and found that they were not meeting the required standards. At this inspection we found that they had not made the required improvements and were in breach of Regulation 12, 14 17 and 18 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Holly House is a residential care home which provides accommodation for up to ten people with mental health needs. At the time of the inspection there were ten people living at the home. The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
The provider did not have appropriate systems in place to ensure there were adequate staffing levels to meet people’s needs, and to keep people safe at all times. This meant that people who used the service did not always have their needs met in a timely or safe way.
People told us they felt safe living at Holly house. Staff told us they knew how to keep people safe. However risks to people’s safety and well-being were not always managed effectively.
There was a robust recruitment process in place which helped to ensure that staff employed at the service to support people were fit to do so. However the service had not been able to recruit staff to work at the service in recent months and this had led to inadequate staffing levels.
There were arrangements in place for the safe storage, management and disposal of people’s medicines. However there had been a recent incident involving an ‘overdose’ of medicines. This had been reported to the local authority safeguarding team who were investigating this incident.
People were not always protected from abuse although they told us they felt safe at the home. Staff were knowledgeable about the risk of abuse and the service had appropriate reporting procedures in place.
The staff supported people to participate in some activities which included people attending events in the community. However activities were sometimes postponed or cancelled due to lack of staff
The manager told us they had recently introduced ‘co-production meetings’ where people who used the service, their care coordinators and staff from Holly house attended and discussed a variety of topics related to the service.
The CQC is required to monitor the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of our inspection no applications had been made to the local authority in relation to people who lived at Holly House.
There was little information relating to quality audits or the monitoring of the service. We found that the information that was available was ineffective and was not used as a tool to improve the service.
People had access to healthcare professionals, including GP’s dentists and the local community mental health team (CMHT). People’s health was monitored regularly. People were encouraged to be as independent as possible and were supported when possible to go out into the community. However this was subject to the availability of staff.
At this inspection we found the provider to be in breach of Regulation 12, 14, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 You can see what action we told the provider to take at the back of the full version of the report.