The Hollands care home is a purpose built two storey nursing home. The Hollands is situated off the main high street in the Farnworth area of Bolton. The home is registered to provide personal and nursing care for 39 people.
This inspection took place on the 04 August 2015 and was unannounced. There were 36 people using the service at the time of the inspection. The majority of people living at the home were younger people who had a mental health related illness.
We last inspected this home on 17 April 2013. At that inspection we found the service was meeting all the regulations that we reviewed.
The home had a manager who was registered with the Care Quality Commission (CQC) and who was present on the day of the inspection. 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 and associated Regulations about how the service is run.
Staff spoken with were able to demonstrate an understanding of whistle-blowing procedures and they knew what to do and who to contact if any allegation of abuse was made to them or if they suspected that abuse had occurred.
We found that most of the people living at the home were self-caring and staff offered assistance as and when required. We saw that staff received the essential training and support necessary to enable them to do their job effectively and care for people safely.
People who used the service told us they felt safe living at the home and they spoke positively about the kindness of staff and their caring attitude. We observed that when assistance was required it was provided in a discreet and sensitive manner. We saw that staff were patient with people and that conversations were friendly and respectful.
Procedures were in place for the safe management of people’s medicines and we found that medicines were managed safely.
We noticed some areas of the home had been painted and refurbished. We found the downstairs lounge required attention and the carpet needed replacing. We discussed the ongoing improvement plan with the registered manager. The registered manager told us this was being actioned and that quotes were being tendered for new flooring. We saw a sample of the new floor that had been selected. We saw the conservatory, which was entered from the door in the garden was in need of refurbishment. The conservatory was used as a smoking area as most of the people living at the home smoked. Discussions with the manager and the provider were ongoing with the possibility of relocating the conservatory away from the main building.
People’s care records contained enough information to guide staff on the care and support needs required. People and their relatives were involved and consulted (where appropriate) about the development of care records. This helped to ensure the wishes of people who used the service were considered and planned for. The care records showed that risks to people’s health and well –being had been identified to help eliminate risk.
During the inspection we observed people were going out unaccompanied to the local shops. We saw risk assessments were in place for people going out to help ensure their safety.
We saw that arrangements were in place to assess whether people were able to consent to care and treatment. We found the provider was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.
Staff spoken with had a good understanding of the care and support people required.
People who used the service were living with a range of mental health needs. We saw for some people that personal care and grooming was not a high priority. We discussed this with the registered manager who told us that people living at the home managed their own budgets and made choices on how they spent their money. The registered manager and staff had to act with sensitivity when addressing people’s personal hygiene.
We saw there was enough equipment available to promote people’s safety, comfort and independence.
We spoke with people about the food. We received mixed responses with some people telling us the food was fine, however some comments were made that the food was boring and bland. We saw that stocks of fresh and dried food were in ample supply and a range of snacks and drinks were available.
To help ensure people received effective care, systems were in place to monitor the quality of the service provided. Regular checks were undertaken on the running of the home and there were opportunities for people to comment on the facilities and the quality of the care provided.