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Archived: Holly House Residential Care Home Requires improvement

Reports


Inspection carried out on 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.

Inspection carried out on 09 January 2015

During a routine inspection

This inspection took place on the 9 January and 16 January 2015 and was unannounced. The service was found to be meeting the required standards at their last inspection on the 07 August 2013.

Holly House is a residential care home which provides accommodation for up to ten people with mental health needs. At the time of our inspection ten people lived at the home. There was no registered manager at the home when we inspected. The provider told us that they had been without a manager since September but had advertised the position.

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.

The provider did not have adequate systems in place to maintain appropriate staffing levels to meet people’s needs, this meant that people who used the service may not have had their needs met in an appropriate timescale. However there were effective recruitment policies in place.

People were protected from abuse and felt safe at the home. Staff were knowledgeable about the risk of abuse and the service had appropriate reporting procedures in place.

The home provided activities for people which included music nights and days out in London. There were plenty of activities for people to participate in should they want to.

There were regular meetings for people and they were involved in making decisions in relation to the way the service was run. People were involved in their care plan reviews and were encouraged to chose the decoration in their rooms.

There were suitable arrangements in place for the safe storage, management and disposal of medicines.

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.

The home was without a registered manager. The provider was there to provide management cover but due to staff shortages also worked providing care and support to people. We saw audits for medicines and infection control but there was no development plan for the service. Information from audits, survey’s, complaints, incidents and accidents was not used to develop or improve the service.

People had access to healthcare professionals such as GP’s and dentists and people’s health was monitored regularly. All people who lived at the home were encouraged to be independent and were supported by staff to go out into the community.

At this inspection we found that the registered  person had not protected people against the risk of sufficient numbers of suitably qualified, competent, skilled and experienced staff to meet peoples needs. This was a breach of Regulation 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 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.

Inspection carried out on 7 August 2013

During a routine inspection

The people we spoke with said that they were happy with the care and support they received from staff. One person said "I am well looked after. I go to the gym regularly and at weekends I stay at home. The food is good and the staff are helpful." Another person said "Everything is fine. I have no concerns."

During our inspection, we found that the provider was meeting the standards we had inspected. We noted that people had been consented to their treatment and that they had been involved in the decisions about their care and support. People had been involved in planning their menu each week and food and hydration was available at all times. There was an effective system in place for the management and administration of medicines and that the recruitment process was robust to ensure that people were supported by qualified, skilled and experienced staff team.

Inspection carried out on 20 March 2013

During a routine inspection

We spoke with people who used the service and staff members. People told us that staff were nice and took care of them. One person told us that Holly house was "the best care home" they had been in.

People using the service approached us during the inspection and expressed that they were happy with the service being provided. While we were at the service we met with staff and management. We saw that staff were visible and many of the people using the service were sitting in the communal kitchen area rather than in their rooms.

We were told that some people had gone to the local gym. We could see that people were well looked after and their personal care was maintained.

During our inspection we did find some food items that had past their use by date, we also found that some frozen meat products had not been stored correctly.