We carried out a review of the data available to us about Intermediate Care Service on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Intermediate Care Service, you can give feedback on this service.
Holly Bank House provides intermediate care services to people that live in the Walsall area. This includes people that live in their own homes and people that are staying in a care home as part of their rehabilitation pathway. The aim of the service is to help people recover skills and confidence to live at home, maximising their level of independence so that their need for ongoing homecare support can be appropriately minimised. Interventions for majority of people will typically last up to six weeks. At the time of the inspection the service was supporting 38 people.
People’s experience of using this service and what we found
People told us they felt the service was safe and there were sufficient staff to meet their needs. Staff supported people to remember to take their medicines and were aware of how to keep people safe from potential risk of harm. Risk assessments were in place and staff knew how to support people’s individual needs to ensure they provided a consistent level of care. Staff wore gloves and aprons to ensure they protected people from cross infection.
Staff had received training for their role to maximise people’s potential to regain independent skills which they may have lost when they were unwell. The service worked in partnership with healthcare colleagues to ensure people had access to the support they needed to meet both their social and healthcare needs. People had choice and control of their lives and staff were aware of how to support them in the least restrictive way.
People made positive comments about the staff that supported them. People told us the staff encouraged them to be independent, protected their privacy and treated them with dignity and respect.
People told us they were happy with the service provided, and they knew who to contact if they had any concerns. People were continually consulted and involved in the way their support was provided. The service was monitored to ensure people were making progress to regain their skills and to ensure their needs were being met.
Staff felt supported in their roles, and described the management team as approachable, open and transparent in the way they managed the service. Systems were in place to monitor the delivery of the service and the registered manager had acknowledged that more audits were required to check and monitor the records completed.
Rating at last inspection
The last rating for this service was Good (published 9 September 2016).
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Holly Bank house is registered to provide accommodation and personal care to people with physical disabilities and sensory impairments. The service provides care to people both within Holly Bank House and within their own homes. At the time of the inspection, there were 20 people receiving short term care within the residential unit and 126 people receiving support in their own homes.
There were two registered managers in post. One manager was registered to provide support to people within the residential unit and a second manager had been registered to oversee the provision of personal care to people within their own 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.
Staff understood how to report concerns about people at risk of harm and were able to manage risks to keep people safe. Staff had been recruited in a safe way and there were sufficient numbers of staff available to meet people’s needs.
People had their medication needs met by staff that had been trained in how to do this. People were supported to take their medication independently where possible.
Staff had access to regular training and supervision to enable them to support people effectively. Staff understood how to uphold people’s rights in line with the Mental Capacity Act 2005 and ensured that people’s dietary needs were met.
There were strong links with healthcare professionals and people had access to support from a variety of healthcare and social care services.
People were supported by staff who were kind and treated them with dignity. Staff encouraged people to maintain their independence and regain skills they had previously lost.
People had their needs assessed prior to receiving support and had their progress reviewed regularly. Records held personalised information about people’s needs and staff knew people well.
There was a clear complaints procedure in place and complaints made had been fully investigated by the registered manager.
The registered managers had sought people’s feedback on the service and used this feedback to make improvements to the service. There were systems in place to monitor the quality of the service.
During our visit we spoke with three people who were receiving care and treatment at Holly Bank House, three relatives, nine staff members, a senior manager employed by Walsall Metropolitan Borough Council and the manager.
People we spoke with were positive about the care they or their relative had received. One person said: "I have had excellent care and support and am getting more independent". Another person said: "I cannot fault them I just wish I had come here earlier".
During this inspection staff confirmed that there were improved arrangements in place to ensure they received supervision and training to deliver safe and appropriate care. Records we looked at confirmed this.
We found that there were suitable arrangements to check the quality of service provided.
We found that the service had met the requirements of the warning notice and was compliant with the regulations.
After our inspection the provider of the service sent us an action plan that detailed the improvements that would be made. As part of this inspection we checked that the stated actions had been undertaken to ensure that risks to people were minimised.
Our Pharmacy Inspector visited on 11 December 2013 and checked arrangements that were in place to ensure that the management of people's medicines was safe and appropriate. We found required improvements had been made and people's medicines were managed safely and appropriately.
We visited the service again on 19 December 2013 to check that staff were supported to deliver care and treatment to people who used the service safely and to an appropriate standard. We found that the service had again failed to meet this requirement and we are currently considering what action will be taken against the provider.
During this inspection we spoke with six people who were staying and receiving care and support at Holly Bank House. People we spoke with were positive about the care that they received. One person told us: "I was told I was going to a care home and I must admit I was worried. I need not have worried it's a marvellous place the staff are very helpful". Another person said: "It can be noisy at night but it so much better than hospital".
People who were staying at Holly Bank House at the time of our inspection told us that they were asked about the care they needed and were kept informed about their progress.
We found that there were appropriate systems in place to identify, respond and report safeguarding concerns and protect people from the risk of abuse.
Medication practices required improvement to ensure that people were adequately protected against the risks associated with unsafe or inappropriate practice in relation to medicines.
People we spoke with told us that staff were helpful and caring. However systems to support staff including supervision and training required improvement.
Required information was available which accurately detailed the service provided.
Checks about the quality and effectiveness of the service were unavailable. This meant that we were unable to determine if the service had an appropriate audit system.
Holly Bank House had recently changed the service it provided following the integration of two services and two staff groups. We were told before we visited that the changes had resulted in shortfalls which had put people at risk of harm.
The service provided support to enable people to be more independent and when possible return to their own home or support them to find more suitable accommodation. Required information was not available which detailed the service which would be provided and how it to would provided.
We found that we had not been informed about all safeguarding concerns and action was needed to ensure that staff respond and report all concerns as they should.
Medication practices required improvement to ensure that people were adequately protected against the risks associated with unsafe or inappropriate practice in relation to medicines.
Improvement was needed to ensure that the service is compliant with the regulations and people receive safe and appropriate support.
We found that people had an individual person centred care plan. We were told that people's support needs were agreed before they transferred to Holly Bank from hospital. One member of staff we talked to said, 'It is about supporting people to be more independent".
We found that staff were appropriately trained and supported to meet people's needs. We found that staff met regularly with their manager and had regular staff meetings where developments for the service and people's needs and how they should be met were discussed.