Hollybush Residential Home

Updated 21 August 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One inspector carried out this inspection.

Service and service type

Hollybush Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We spoke with four people who lived at the service about their experiences of the care provided. We spoke with three members of staff, including the provider and two relatives.

We reviewed a range of records. This included five people’s care records and medication records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with a visiting healthcare professional who regularly visits the service.

Updated 21 August 2021

About the service

Hollybush Residential Home is a residential care service providing personal care and support for up to 14 people aged 65 and over. There were 14 people living at the service at the time of this inspection. The service is an adapted house, situated in a residential street in Newquay.

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

Records of people's care had been regularly updated. Five people were seen to be up and dressed, with four dozing in the lounge before 7am on the day of this inspection. Care plans were individualised and detailed most people’s needs and preferences. However, it was not always recorded when people preferred to get up or go to bed. This meant it was not possible to establish if people chose to be up, dressed and in the lounge before 7am in the morning.

People and their relatives told us that people had a choice about when they got up and went to bed.

Care plans included risk assessments and guidance for staff on how to meet people’s support needs. This meant any identified risks to people were minimised.

There were clear records to show, when assessed as needed, staff were monitoring specific health needs such as people’s weight, food and drink intake and the risk of skin damage. Where people had been assessed as requiring pressure relieving mattresses, to protect them from skin damage, these had been provided.

Some people living at Hollybush were living with dementia. Suitable pictorial signage was in place to support people to move around the service independently.

People were relaxed and comfortable with staff and had no hesitation in asking for help from them. Staff were caring and spent time chatting with people as they moved around the service. People who wished to remain in their bedroom did so. Those spoken with confirmed this was their choice.

The service had suitable safeguarding systems in place, and staff knew how to recognise, and what to do if they suspected, abuse was occurring.

People told us the food was good. One person commented, “The food is really good here.”

Relatives were positive about the care and support provided. Comments included, “We are very happy with everything” and “The staff are lovely and it is always very clean.”

There were sufficient staff to ensure people’s needs were met. Staff told us they received appropriate support and training.

The building was clean and there were no malodours. There were appropriate procedures to ensure any infection control risks were minimised. Cleaning and infection control procedures had been updated in line with COVID-19 guidance to help protect people, visitors and staff from the risk of infection. Suitable visiting arrangements were in place for families to visit as per the current government guidance. The service had not experienced any positive cases of COVID-19 throughout the pandemic.

People received their medicines as prescribed. There were appropriate processes for ordering, recording and storing medicines. The temperature of the medicine refrigerator was monitored. However, staff were not able to monitor the maximum and minimum temperature of this refrigerator. This was immediately addressed by the provider during the inspection. Regular audits were carried out of the medicines records to help ensure any errors would be identified in a timely manner.

The service was managed effectively. Staff were working well together, and one staff member said, “I am happy here, we are well supported.”

Any changes in people’s health were escalated to the relevant professional and relatives were kept informed. One visiting healthcare professional told us, “We visit regularly and have no concerns.”

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.

The provider told us that people and their relatives had not recently been asked for feedback on the service’s performance. This was due to the impact of COVID 19. We were assured that a survey would be sent out in the coming weeks.

There was a stable staff team who knew people well and worked together to help ensure people received a good service. People, their relatives and staff told us the staff and management were approachable and listened when any concerns or ideas were raised.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

The inspection was prompted due to concerns received from one person. We received concerns in relation to people, living at Hollybush Residential Home, who were being woken up very early in the morning, being dressed and taken to the lounge. We were also told that people were asked to go to their rooms at 10pm and remain there. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 remained good. This is based on the findings at this inspection.

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 coronavirus and other infection outbreaks effectively.

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

Follow up

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