Holly Lodge Nursing Home

Updated 24 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on the 30 November 2018 and was unannounced. The inspection was carried out by one inspector, a specialist nurse advisor and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to our inspection we reviewed the information we held about the provider. This included notifications received from the provider about deaths, accidents and incidents and safeguarding. A notification is information about important events that the provider is required to send us by law. We used the information the provider had sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help inform our inspection planning.

During the inspection we spoke with 13 people using the service and five visiting relatives. People living at the home had varying levels of communication so we therefore used our Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experiences of people who could not talk with us. We spent time observing the support provided to people in communal areas, at meal times and the interactions between people and staff.

We also spoke with 18 members of staff including the provider’s director of services, registered manager, head of care, nursing and care staff, the chef and domestic staff. We looked at 12 people’s care plans and care records, six staff recruitment, training and supervision records and records relating to the management of the service such as audits and policies and procedures. Following our inspection, the provider and registered manager also sent us information we requested.

Updated 24 January 2019

This inspection took place on 30 November 2018 and was unannounced. Holly Lodge Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection there were 57 people living at the home.

Holly Lodge Nursing Home provides specialist care and support for people living with dementia and physical health care needs. It’s a large purpose-built nursing home spread over two floors accessed by internal lifts and is set in extensive landscaped grounds surrounded by woodlands. At the time of our inspection there was an experienced registered manager 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. They were aware of the legal requirement to display their CQC rating.

At our last inspection of the service on 7 November 2016 we rated the service overall as ‘Good’ and 'Requires Improvement' in Effective. This was because people's dietary needs and preferences were not always respected and met by staff. This was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found improvements had been made and the breach of Regulation 9 had been met.

Risks to people were assessed and safely managed by staff. Medicines were managed, administered and stored safely. People were protected from the risk of abuse, because staff were aware of the types of abuse and the action to take to ensure peoples safety and well-being. There were systems in place to ensure people were protected from the risk of infection and the home environment was clean and well maintained. Accidents and incidents were recorded, monitored and acted on appropriately. There were safe staff recruitment practices in place and appropriate numbers of staff to meet people’s needs in a timely manner.

There were systems in place to ensure staff were inducted into the service appropriately. Staff received training, supervision and appraisals. There were systems in place which ensured the service complied with the Mental Capacity Act 2005 (MCA 2005). This provides protection for people who do not have capacity to make decisions for themselves. 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. People’s nutritional needs and preferences were met. People had access to health and social care professionals when required and staff worked well with health and social care professionals to meet their needs.

People told us staff treated them with kindness and respected their privacy and dignity. People’s diverse needs were met and staff were committed to supporting people to meet their needs with regard to their disability, race, religion, sexual orientation and gender. People were involved in making decisions about their care. There was a range of activities available to meet people’s interests and needs. The service provided care and support to people at the end of their lives. People’s needs were reviewed and monitored on a regular basis.

There were well-led systems in place to monitor the quality of the service provided. People’s views about the service were sought and considered. The provider worked in partnership with other professionals to ensure people received appropriate levels of care and support to meet their needs.