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Holbeche House Care Home Requires improvement

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Inspection report

Date of Inspection: 20 August 2014
Date of Publication: 7 October 2014
Inspection Report published 07 October 2014 PDF | 92.87 KB


Inspection carried out on 20 August 2014

During an inspection in response to concerns

We carried out this inspection in response to a number of concerns that we had received about the care and treatment that people received. Some allegations raised centred on concerns over a number of staff leaving the provider’s employ and the impact this had on the care delivered to people. It was stated that people were at risk due to a lack of consistency in the way care was provided.

We checked to see that people’s health and well-being was being promoted by the care home.

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with four people using the service, two visitors, six members of staff, and the acting manager and area manager. We also looked at five records relating to people’s care and other records related to the running of the service.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe at the home although we heard some concerns about the availability of staff. One person told us staff responded in a reasonably time. Another told us, “Sometimes there are not enough girls, they work very hard”. A relative told us, “There are not enough staff” and, “Changes need to be made” but was encouraged by the response of the new manager in providing reassurance as to what they were doing about the views of relatives.

The manager and staff told us that a number of staff had left the home recently and this had impacted on the ability of staff to provide effective and consistent care. The manager told us what steps they had taken to minimise the impact of reducing staffing levels, for example agency staff that were employed were as far as possible the same staff. They also told us that they were actively recruiting new staff. From our observations and looking at the staff rotas we saw that the provider was working to maintain staffing levels so that people’s needs were met and they were safe.

Procedures for dealing with emergencies were in place and staff were able to describe these to us. People’s records did not always describe how their safety should be promoted. For example ensuring monitoring systems were in place to alert staff when someone maybe at increased risk of falls.

The manager and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). This is legislation that makes provision relating to persons who lack capacity, and how decisions should be made in their best interests when they do so. At the time of our inspection the manager had made some applications and they, and senior staff were able to describe the circumstances when an application should be made and knew how to submit one.

Is the service effective?

People all had an individual care plan which set out their care needs. People’s relatives told us they had not been involved in the assessment of the health and care needs for people they represented and had not contributed to developing their care plan. People told us that the care and support they received was as they wanted it to be. We saw that assessments included people’s specific health care needs although we did see that information in some care plans was not always accurate. Staff we spoke with did understand how to meet people’s needs appropriately.

People told us that staff ensured they saw external healthcare professionals as needed to promote their healthcare.

We saw that staff knew people’s individual care needs and wishes although planning for people’s individual needs was not always accurate.

Is the service caring?

We saw on the day of the inspection that people were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people.

Staff we spoke with were aware of people’s preferences, interests, aspirations and diverse needs. Our observations of the care provided showed that people’s individual wishes for care and support were taken into account and respected. People we spoke we told us that, “The girls are nice” and, “The people that look after me are alright”. We did hear concerns from relatives about some people’s care that the manager was to investigate.

Is the service responsive?

People told us, that they were satisfied with their day to day routines although we saw limited activities on the day of our inspection. The manager and staff told us this was an area that needed improvement. A relative commented that, “They do dancing, singing, used to do baking and have fun days such as the Black Country day”.

People knew how to make a complaint if they were unhappy. Some relatives told us that concerns they had raised had not been responded to. This meant that some relatives felt their complaints were not taken seriously.

We did see that the manager was putting forums in place to gain the views of people and their relatives. We heard that the manager had changed residents and relative’s meetings to an evening time so as to assist their attendance. Staff we spoke with also told us they felt the manager was listening to them one telling us the manager, “Listens to our views”.

We have asked the provider to tell us what improvements that will make in relation to responding to people’s complaints.

Is the service well-led?

The home had a system to assure the quality service they provided. The way the service was run had been regularly reviewed. We saw this had helped the new manager, who had been in post a short while, to identify areas that required improvement and tell us how they intended to put right any shortfalls they had found.

Information from the analysis of accidents and incidents had not always been used to identify changes and improvements to minimise the risk of them happening again.

People’s personal care records, and other records kept in the home, were not always accurate and complete.

We have asked the provider to tell us what improvements that will make in relation to improving people’s personal care records.