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Inspection carried out on 27 August 2020

During an inspection looking at part of the service

Hollybank Rest Home provides care and accommodation for up to 23 older people who are physically frail or may be living with dementia. At the time of our inspection there were 22 people living at the home.

We found the following examples of good practice.

• Visits were by appointment and staggered to minimise visitor numbers. A designated visiting room had been set up, with a purpose built large clear screen, enabling socially distanced visits. An Ipad had been purchased and an account set up for the residents to use. Closed ‘window visits’ had been arranged for a person living with dementia who was used to seeing a relative who lived nearby.

• The registered manager had put up a covid information board at the suggestion of residents, as part of increased communications.

• Where staff had health concerns, or family health concerns, they had been supported to shield. The registered manager arranged the staff rota to enable all staff to attend testing on Thursdays. A new member of staff had self-isolated at home for seven days after leaving their previous employment, and was tested before starting work at Hollybank.

• Contingency planning demonstrated good community links and networking. For example, in an emergency the service could use a local restaurant’s freezers to store food.

Further information is in the detailed findings below.

Inspection carried out on 16 May 2018

During a routine inspection

Hollybank is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection.

Hollybank is located in the village of Botley on the outskirts of Southampton. Hollybank provides care and accommodation for up to 23 older people who are physically frail or may be living with dementia. At the time of our inspection there were 21 people living at the home. The home provides long term care and respite care. It does not provide nursing care. There is a car park located at the front and a garden to the rear of the property. The accommodation is arranged over two floors with a passenger lift, stair lift and stairs available for accessing the first floor. The home offers 17 single rooms and three shared rooms. All the rooms have ensuite facilities.

At our last inspection in February 2017, the service was rated as ‘requires improvement’ and was not meeting the legal requirements in relation to medicines management. This inspection found that whilst some improvements had been made, some concerns were still identified with regards to the safety of medicines management.

Overall risks to people’s safety and wellbeing were assessed and planned for, but people’s care plans and other records relating to their care did not always reflect this.

The recruitment practices and checks were not always sufficiently robust.

People were appropriately protected from harm or abuse as staff had received training in safeguarding adults, and had a good understanding of the signs of abuse and neglect.

There were sufficient numbers of experienced staff to meet people’s needs.

The home was clean and good infection control practices were followed.

Staff worked in accordance with the Mental Capacity Act 2005 and the deprivation of liberty safeguards were applied appropriately.

Staff received training, supervision and an induction which ensured they had the skills and knowledge to support people appropriately.

Hollybank provided a secure but comfortable and homely environment that was appropriate to people’s needs.

People’s nutritional needs were met and where necessary a range of healthcare professionals had been involved in planning and monitoring people’s support to ensure this was delivered effectively.

People were cared for by staff that were kind and caring and with whom they had developed good relationships. People were treated with dignity and respect.

Staff had a good knowledge and understanding of the people they were supporting which helped to ensure people received care and support which was responsive to their needs.

People were engaged in activities that were meaningful to them and were supported to retain links with their local community.

Complaints procedures were in place and information about how to make a complaint was freely available within the service.

People spoke positively about the leadership of the service.

There were systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support.

Inspection carried out on 15 February 2017

During a routine inspection

Hollybank Rest Home is located in the village of Botley, on the outskirts of Southampton and can accommodate up to twenty three older persons. The accommodation is arranged over two floors with a passenger lift and stair lift available to access the upper floor. All of the rooms are ensuite with three offering shared accommodation. The home does not provide nursing care. There were 20 people living in the home when we inspected.

The service did not have a registered manager. 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. A new manager had been appointed and was in the process of applying to become registered with CQC. They had been working within the service full time since December 2016.

Medicines were not always being managed safely. Whilst medicines audits were undertaken, these were not being fully effective at driving improvements to ensure the safe use of medicines.

Staff had received training in safeguarding adults, and had a good understanding of the signs of abuse and neglect. Staff were confident the manager would act upon any concerns they raised.

People had risk assessments and where risks had been identified, measures were in place which helped to ensure that the risk was minimised.

Safe recruitment practices were followed and appropriate checks had been undertaken which made sure only suitable staff were employed to care for people in the home. There were sufficient numbers of experienced staff to meet people’s needs.

Staff sought people’s consent before providing care and people were encouraged and supported to make decisions about their care and support. The manager was making improvements to ensure mental capacity assessments were more clearly documented and completed in line with relevant legislation.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which apply to care homes. Where people’s liberty or freedoms were at risk of being restricted, the proper authorisations were either in place or had been applied for

New staff received a service based induction which involved learning about people’s needs and key policies and procedures. Staff felt the training provided was adequate and helped them to provide effective care.

People told us the food was tasty and that they were supported to have enough to eat and drink.

People were cared for by staff that were kind and caring and with whom they had developed good relationships. Staff showed people kindness and patience and showed a genuine interest in the people they supported.

People were involved and engaged in making decisions about the care and support provided and were treated with dignity and respect.

Care plans contained the information needed to support staff to provide people’s care in a manner that was responsive to their individual needs.

People were supported to take part in a range of activities and make choices about how they spent their time.

People spoke positively about how well organised and managed the service was. There was an open and transparent culture within the service and the engagement and involvement of people and staff was encouraged and their feedback was used to drive improvements.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have asked the provider to take at the back of this report.