Hollywynd Rest Home

Hollywynd Rest Home is a residential care home providing care and support for up to 40 people. People were living with a range of needs associated with the frailties of old age and some other physical and mental health needs. 27 people were living at the service on the day of our inspection.

People’s experience of using this service and what we found

People received personalised care and support specific to their needs and preferences. One person told us, “I’m very grateful to them, I’m very happy.” People were protected from the risks of harm, abuse or discrimination because staff knew what actions to take if they identified concerns. There were enough staff working to provide the support people needed. Staff understood the risks associated with the people they supported. Risk assessments provided guidance for staff about individual and environmental risks. People received their medicines safely, when they needed them.

Care was person-centred and promoted people’s dignity, privacy and human rights. People’s individual needs and choices were recognised, and respected. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The provider and staff had worked hard to develop good leadership. Quality monitoring systems had been embedded and morale was good amongst the staff team. We received positive feedback in relation to the care people received and how the service was run. One person told us, “I love it here, they are all so very good.” A relative added, “The manager is on the ball, she is organised, I would certainly recommend the home to others.”

Staff had the skills and knowledge to meet people’s needs and preferences. They received training, regular supervision and attended team meetings to support them in their roles. People’s nutritional and hydrational needs were met. There was also regular involvement from health and social care professionals.

We observed a kind and caring culture. People spoke positively about the support staff gave to people. We observed positive interactions between people and staff throughout the inspection.

People’s care plans were personalised and gave staff the information they needed to support people. We saw people were supported with their communication needs and their preferred activities in accordance with their care plans.

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 good (published 25 August 2021).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has remained good based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Hollywynd Rest Home is a residential home providing personal care for up to 40 older people, with a variety of different care and support needs. At the time of the inspection 25 people were using the service.

People’s experience of using this service and what we found

People were safe at Hollywynd Rest Home. Staff demonstrated a good knowledge of how to protect people from harm. There was an effective system to identify risks associated with people's care. These were recorded and regularly reviewed. Health professionals were contacted, where appropriate, to support people as needed.

The home was clean and tidy. Hollywynd had a robust cleaning regime in place to support good infection prevention and control. Some staff were seen at the inspection to not be wearing personal protective equipment (PPE) correctly. This was raised with the provider and deputy manager and was rectified immediately.

Staff knew people well and were engaging in their interactions. People received their medicines in a safe and personalised way, with an electronic system to promote accuracy of records and administration.

People, relatives and staff spoke positively about the home. One person told us, “There are lovely staff here, they always take the time to help in anyway they can.” A staff member said, “[Deputy manager] is very approachable, nothing is too much trouble and I feel confident in raising any concerns I have.”

Robust audit systems were in place to identify any areas which required improvement and action was taken to develop practice if needed. Regular health and safety checks were made to ensure the environment was safe and well kempt.

People were involved in decision making about their care and were supported to maintain independence. They were given opportunities to give feedback on their care and told us they felt comfortable in doing so.

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 good (published 16 November 2019).

Why we inspected

We received concerns in relation to a variety of matters, including the environment, infection prevention and control, staffing levels and skills, and people’s care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We also looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has not changed. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hollywynd Rest Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice.

There was a clear system in place to alert staff to new positive cases within the home. This consisted of a verbal handover, alerts on the electronic care planning system, which staff accessed through hand-held devices, and a discreet marker outside the person’s bedroom.

Staff regularly monitored people who had coronavirus, using prompts on the electronic care planning system to record how they were and their symptoms.

Staff received a high level of practical and emotional support from the management team. This included delivering provisions when they were isolating at home if required. Information on external sources of support had been shared with staff.

A visiting area had been set up in the conservatory, with a separate entrance for visitors and a screen. The staff team had liaised directly with family members and friends to ensure they understood the safety procedures for visits once the home was re-opened.

We were not assured of best practice in some areas. There was no clear approach to keeping staff and people in small contact groups to reduce the risk of spread in the event of a person testing positive for coronavirus. Our observations of the way some staff used PPE did not meet with best practice guidelines.

Further information is in the detailed findings below.

We found the following examples of good practice.

Visiting was by appointment and there were different arrangements in place to allow for individual preferences and weather conditions. Visitors used face masks and visits were risk assessed using a health questionnaire.

The layout of the service had allowed for isolation when needed. Extra time was arranged for designated staff to spend time with people who were isolating. Staff were spending time with people reading, watching television and being a companion during meals.

Some people were going out to local shops independently. Arrangements had been made to allow this to continue with Covid-19 precautions in place.

Hollywynd Rest Home is a care home providing accommodation and personal care to older people. The service can support up to 40 people. At the time of the inspection the service was providing support to 28 people. Hollywynd Rest Home is a large building that has been adapted to suit the needs of people living there. It has a communal lounge, a dining room, a conservatory and a secure garden. Accommodation is based over two floors and there is a passenger lift in between floors for people with mobility needs.

People’s experience of using this service and what we found

The environment was warm and homely, and we observed positive communication between staff, people and their relatives. People and their relatives we spoke with, all gave us positive feedback about the home and told us that staff were kind and caring.

Individual and environmental risks were managed appropriately. People had access to appropriate equipment where needed, which meant people were safe from harm. Appropriate recruitment procedures were in place to help ensure only suitable staff were employed. People were involved in the recruitment of staff to ensure they were happy with the staff supporting them.

There were appropriate policies and systems in place to protect people from the risk of abuse and the registered manager and staff understood the signs to look for. People were supported to take their medicines safely and as prescribed. We identified some areas for improvement to ensure staff had clear guidance for ‘as and when required’ medicines. The registered manager took immediate action to address this.

Staff had received appropriate training and support to enable them to carry out their role safely. They received regular supervision to help develop their skills and support them in their role.

Activities had been developed in line with people's wishes and there was varied and interesting activities to promote health and well-being.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff supported people and showed an understanding of equality and diversity and people were treated with dignity, and their privacy was respected. People and relatives told us there was an emphasis on providing person centred care within the home. People's care plans contained detailed information about them and their care and support needs to help staff deliver personalised care. The management team reviewed the care and support provided to people to make sure it continued to meet their needs.

The registered manager and provider carried out regular checks on the quality and safety of the service. Staff were positive about the management of the service and told us the registered manager was very supportive and approachable.

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 Good. (published May 18 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Hollywynd Rest Home is a residential care home, which provides accommodation for up to 40 older people. At the time of our inspection there were 27 people living at the home. Nursing Care is not provided. Hollywynd Rest Home is a large, detached, older style property situated close to the town centre of Worthing. Communal areas included a large sitting room, open planned dining room with another sitting area and a conservatory which looked out on the garden. There was a sitting area on the ground floor corridor to allow people to sit and rest when needed. The home provides accommodation over two floors with a passenger lift and stair lift available to access all floors.

The service had a registered manager in place. 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 and associated Regulations about how the service is run. Both the registered manager and provider were available on the day of our inspection.

The last inspection took place on 22 and 23 December 2015. As a result of this inspection, we found systems were in place but not consistently used to identify risks. Guidance for staff on how to reduce risk was, at times, limited. This was a breach of Regulation 12 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that care plans were being updated at the time of that inspection; however this was a work in progress and not all people had a care plan which reflected their needs. We also found that activities were available however; these were not scheduled in a way that ensured people’s social needs were always met. This was a breach of Regulation 9 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following the last inspection, the provider wrote to us with their action plan to confirm that they had addressed these issues. At this visit, we found that the actions had been completed and the provider has now met all the legal requirements.

At this inspection, people described staff as kind and caring. People told us they felt they were treated with respect and dignity. Most observations reflected this. However, we observed examples where staff were not always caring, respectful or people’s dignity and this was not consistently maintained. This is an area requiring improvement.

Systems were in place to identify risks and protect people from harm. Care records contained guidance and information to staff on how to support people safely and mitigate risks. Risk assessments were in place and reviewed monthly. Where someone was identified as being at risk, actions were identified on how to reduce the risk and referrals were made to health professionals as required. Accidents and incidents were accurately recorded and were assessed to identify patterns and trends. Records were detailed and referred to actions taken following accidents and incidents.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People told us they felt safe at the home. Policies and procedures were in place and medicines were managed, stored, given to people as prescribed and disposed of safely.

There were sufficient staff in place to meet people's needs. The registered manager used a dependency tool to assess that staffing levels were based on people's needs. These were up to date and reviewed monthly. Robust recruitment practices ensured that new staff were vetted appropriately and checks were undertaken to confirm they were safe to work in a caring profession.

Staff received an induction into the service and senior staff checked competencies in a range of areas. Staff had received a range of training and many had achieved or were working towards a National Vocational Qualification (NVQ) or more recently Health and Social Care Diplomas (HSCD). Staff received formal supervision and annual appraisals from their managers.

The Care Quality Commission monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff had received MCA training and our observations confirmed staff promoted choice and acted in accordance with people's wishes. However, not all staff demonstrated a clear knowledge of the MCA and DoLS in our discussions with them. We fed back to the registered manager at the time of our visit. During the inspection, the registered manager took sufficient action to ensure all staff understood the rights of people living at the home. Throughout our inspection, we saw that people who used the service were able to express their views and make decisions about their care and support. We observed staff seeking consent to help people with their needs.

People had sufficient to eat and drink and were offered a choice throughout the day. They had access to a range of healthcare professionals and services. People’s rooms were decorated in line with their personal preferences.

People were involved in planning and reviewing their care as much as they could, for example in deciding smaller choices such as what drink they would like or what clothes to choose. Where people had short term memory loss staff were patient in repeating choices each time and explaining what was going on and listening to people's stories. Staff had good knowledge of people, including their needs and preferences. Care plans were individualised and comprehensive ensuring staff had up to date information in order to meet people's individual needs effectively.

People's privacy was respected. Staff ensured people kept in touch with family and friends. People were able to see their visitors in communal areas or in private. The service placed a strong emphasis on meeting people's emotional well-being through the provision of meaningful social activities and opportunities. People were offered a wide range of individual activities, which met their needs and preferences.

The registered manager told us complaints would be listened to and managed in line with the provider's policy. In the past 12 months, there had been no formal complaints. People said that they would be confident to make a complaint or raise any concerns if they needed to.

People and their relatives were involved in developing the service through meetings. People and their relatives were asked for their feedback in annual surveys. Staff felt the registered managers were very supportive and said there was an open door policy. Quality assurance systems were in place to regularly review and improve the quality of the service that was provided.

We used a number of different methods to help us understand the experiences of people using the service. People who lived in the home all told us "it's a great place to live" and "I like all the staff".

We looked at a selection of care records. We noted in four records that there was a lack of health monitoring to ensure that people's needs were being assessed and care planned appropriately. One relative told us "I've never been asked to be involved in the care plan".

We spoke with one relative who said "The care here is superb, the staff are amazing". Another said "they are very caring". One person who lived at the home told us "As far as care homes go, this one's great".

We viewed records relating to staff recruitment and found that the provider was operating effective recruitment procedures.

We found the lack of consistent recording systems meant that there was a risk that information may not be kept up to date and people may not be protected against the risks of unsafe or inappropriate care and treatment.

People and their relatives told us they were happy with the care they received while living at the home. One person told us ''we get a cup of tea before breakfast, that's lovely.''

We found people were protected from the risk of abuse as staff were trained to recognise abuse. Staff told us they knew how to raise a safeguarding concern if they needed to.

We reviewed the training records and found staff received appropriate training for their roles. The training provided staff with the knowledge and skills to deliver care that was safe and appropriate for people living in the home.

We found people has personalised care plans and risk assessments. We found for every identified risk there was a plan in place to address the risk. We saw people had daily preference lists that were used to meet their preferences.

We found the provider had a system in place to monitor the quality of the service they provided.