Hollow Oak Nursing Home Limited

Updated 3 October 2018

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 13 August 2018 and was unannounced. The inspection was carried out by an adult social care inspector.

Before the inspection we reviewed information available to us about this service. We looked at information we had from those who commissioned the services, professionals who visited the home and the local authority. This was to help us in gaining a clear picture of the service provision. We also reviewed safeguarding information and notifications that had been sent to us. A notification is information about important events that the provider is required to send us by law

The registered provider had completed a Provider Information Return (PIR). The PIR is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with people about the service. This included six people who lived at the home, four visiting relatives, the registered manager, three care staff, a member of nursing staff, the cook and the maintenance person. We looked at the care records of five people who lived at the home and at the risk assessments and daily notes relating to those plans. We also looked at records relating to the management of the service. These included audit records, policies and procedures, accident and incident reports We looked at the recruitment, induction and training records of staff recently employed to work in the service. We looked at the records of medicines and we checked on the quantity and storage of medicines in the home. We also checked the building to ensure it was clean, hygienic and a safe place for people to live.

We used the Short Observational Framework for inspection (SOFI) SOFI is a way of observing care to help us understand the experience of people who could not easily talk with us.

We used a planning tool to collate all this evidence and information prior to visiting the home.

Updated 3 October 2018

The inspection took place on 13 August 2018 and was unannounced. At the last inspection in November 2015, the service was rated Good.

Hollow Oak Nursing Home (Hollow Oak) is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

Hollow Oak provides nursing care for up to 27 older people and is an established family run business. The home is in a period house that has been adapted and extended for its present use, including two conservatories and a modern extension. The bedrooms in the home vary in size and layout, are individually decorated and retain many original features. There is car parking available and well kept lawns and gardens to the side and rear with outdoor seating for the people living there. At the time of the inspection there were 22 people living there.

There was a registered manager at the home. 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.

At this inspection we found the service remained good overall. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. At this inspection we also found the service was continuing to improve and demonstrated some characteristics of 'outstanding' and that they were continuing to develop the service for the future. The service was particularly skilled at caring for and supporting people and their families at the end of life and responding quickly to people's changing needs.

People told us they were happy and felt safe at the home. People told us that the staff were “so very, very good” and “kind” and they supported them when they needed it. People who lived there told us, “The staff are marvellous and speak to me and my family with genuine feeling and that “Nothing is too much trouble, they always have time to listen.” Relatives told us their loved ones’ care had been “exceptional” and “outstanding" and that staff responded "quickly and compassionately" to people’s needs. We saw staff showed real concern and compassion for people's wellbeing and responded quickly when people required their help. Professionals who visited the service spoke very highly of the service provision and said that it was "very responsive" and "person centred" in the care provided.

People told us they were happy with the variety and choice of the home cooked meals being provided and that there was always a choice at meals. We observed regular snacks and drinks were provided between meals to help make sure people received adequate nutrition and hydration.

The service had an effective safeguarding policy and staff had undertaken safeguarding training and could explain the process. Staffing levels were consistent and flexible to meet changing needs and staff recruitment procedures were robust. The staff team worked well together and had the skills, knowledge and experience required to support people with their care and social needs. Registered nurses were available to support people's day to day nursing needs.

Medicines management systems were safe and staff had undertaken appropriate training in medicines administration. Staff were being appropriately trained for their roles and well supported by the registered manager. Systems were in place to give staff the opportunity to discuss their work and have appraisals.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they worked within the law to support people who might lack capacity to make some of their own decisions. People living in the home were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and the policies and systems in the service support this practice.

Risk assessments had been developed to identify and minimise the potential risk of harm to people during the delivery of their care. These and detailed individual assessments and care plans had been developed and were kept under review and updated when necessary to reflect people's changing needs and to make sure their care preferences had not altered. Hollow Oak supported people with life limiting illnesses and as they approached the end of life. Staff were knowledgeable about this important area of care and had received end of life care training on supporting people and their families.

The registered provider continued to improve the environment for the people who lived there. The building was being well maintained and was a clean and homely place for people to live. We saw that equipment in use was regularly cleaned and had been serviced and maintained as required.

Systems were in place to deal with any complaints or concerns raised about the service. The registered manager treated complaints as an opportunity to learn and improve the service.

People had access to a range of organised and informal activities. Relatives told us that they were welcomed in the home and their views and feedback were encouraged. Quality assurance surveys and regular meetings were used to seek the views of people who used the service and there were a number of audits being carried out to monitor systems and to focus on continually improving the service for the people who lived at Hollow Oak. The registered provider was in the home daily to oversee this.

Further information is in the detailed findings below.