Background to this inspection
Updated
28 August 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by two inspectors 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. The second day of the inspection was carried out by one inspector.
Service and service type
The Hollies 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced on the first day and announced on the second day. Inspection activity started on 11 June 2019 and ended on 12 June 2019. We visited the service on both dates.
What we did before the inspection
We reviewed information we had received about the service since the last inspection in 23 November 2016. This included details about incidents the provider must notify us about, such as abuse or when a person dies. We sought feedback from the local Healthwatch for information about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. Healthwatch told us they had no feedback about the service at this time.
The provider completed a Provider Information Return (PIR). We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
During the inspection, we spoke with five people using the service, two care workers, one team leader, the cook, the accounts and office manager, the activities coordinator, a manager being inducted to succeed the registered manager and the registered manager.
We reviewed a range of records based on the history of the service. This included four people's care records and medicines records. We also looked at five staff files including their recruitment, supervision and training records. We reviewed records relating to the management of the service, quality assurance records and a variety of policies and procedures implemented by the provider. We also looked at other records the provider kept, such as meetings with people and surveys they completed to share their views.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data sent to us in a timely manner.
Updated
28 August 2019
About the service
The Hollies Residential Home provides accommodation and personal care for 39 older people. The service can support up to 40 people.
People’s experience of using this service and what we found
People were positive in their feedback. Comments included; “I feel safe living here. You know that wherever you are in the service, if you have your buzzer, the staff respond quickly. I haven’t had any falls since I have lived here”; “I like living here. I fall over quite a bit, I can call for help and they come quickly”; and, “The atmosphere here is very good.”
We found that there were no comprehensive quality monitoring systems such as care plan audits in place. However, a new quality audit document was being implemented. This would ensure robust monitoring of the service by the registered manager. This was an area for improvement.
Medicine audit by the management was not being carried out. This would have created management oversight of medicine administration in the service. They told us they would review the medicine audit system. This is an area for improvement.
People knew how to complain. However, we found no evidence that concerns raised had been listened to and acted upon by the provider. This is an area for improvement.
People were safe at The Hollies. Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. The provider followed safe recruitment practices.
People participated in activities, pursue their interests and maintained relationships with people that mattered to them.
Staff understood the importance of promoting people’s choices and provided the support people required while promoting and maintaining independence. This enabled people to achieve positive outcomes and promoted a good quality of life. One person said, “I am encouraged to look after myself, I am as independent as I can be.”
People received the support they needed to stay healthy and to access healthcare services. Each person had an up to date care plan, which set out how their care and support needs should be met by staff. These were reviewed regularly.
We observed people’s rights, their dignity and privacy were respected.
Staff supported people to maintain a balanced diet and monitor their nutritional health.
Medicines were stored and managed safely by staff. There were policies and procedures in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.
People received care from staff who were well supported with induction and training.
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.
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 (Report published on 10 December 2016).
Why we inspected
This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements. Please see the Responsive and Well Led sections of this full report.
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.