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Holy Name Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 28 July 2018

The inspection took place on 12 June 2018, it was unannounced.

Holy Name Care Home is a purpose built home encompassing a church site and is situated in a residential area of North Hull; it is close to main bus routes into Hull city centre. The service is registered to provide personal and nursing care for a maximum of 64 people, some of whom may be living with dementia. The bedrooms are all for single occupancy and all have en suites which consist of a shower, sink and toilet. There is a large dining room, a number of open plan seating areas, two small conservatories, a hairdressing salon and courtyard gardens for people to use. The service has a separate area for people living with dementia called Penny Lane.

Holy Name is a 'care home'. People in care homes receive accommodation and nursing or personal care as 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 registered manager in place. 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.

At the last inspection in May 2017 we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in regulation 9, person-centred care, regulation 12, safe care and treatment, regulation 14, meeting nutritional and hydration needs and regulation 17, good governance.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, effective, responsive and well-led to at least good.

At this inspection we found continued breaches in person-centred care, safe care and treatment and good governance, and that care had not been provided in a safe way for some people living at the service. Governance and quality monitoring was not robust. The provider had improved the monitoring of people’s nutritional and hydration needs to ensure this breach of regulation was resolved. The service has been rated requires improvement for the second time.

There remained some areas of concern regarding management and administration. One person may have been given medicine to help calm them when their behaviour was settled. Action was not taken to liaise with people’s GP’s to change the times of their eye drops to ensure they were not asleep. People’s medicine was not always in stock and there were gaps on medicine administration records. Further guidance for staff about ‘when required’ medicine and ‘variable dose medicine’ needed to be put in place for staff. Recording of a controlled medicine was found to be inaccurate. Supplementary charts to help staff assess people’s medicine needs were not always completed.

Some people’s care records were person-centred with their likes, dislikes and preferences for their care and support recorded and their risk assessments were detailed. However, other people’s care records still did not contained all the correct information to make sure their full and current needs could be met. Further work still needed to be undertaken in this area. Staff contacted health care professionals for help and advice to maintain people’s wellbeing. End of life care was provided at the service.

Quality assurance checks and audits had been improved in relation to maintaining people’s nutritional and hydration needs. However, other quality assurance checks and audits were not robust; they had failed to find the issues we found during our inspection. Further work was required in this area.

Staff protected people from harm and abuse and understood how to report concerns to the management team, local authority and to the Care Quality Commission. This helped to protect people. Infection control measures were in place.

Staff recruitment procedures were robust; gaps in potential staff’s employment history were investigated. Checks were undertaken to make sure people were suitable to work in the care industry, where issues were found these were discussed and a decision was taken if employment could be offered.

General maintenance was undertaken to make sure the service remained a pleasant place to live. Accidents and incidents were monitored and emergency plans were in place to help to protect people’s health and safety.

People’s mental capacity was assessed. We found care and support was provided in line with the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible

Improved monitoring of people’s dietary and fluid needs had been implemented to ensure people’s needs were met.

Staffing levels were monitored to make sure there was enough skilled and experienced staff to meet people’s needs. Staff undertook training in a variety of subjects to maintain and develop their skills. Supervisions and appraisals were provided. Further training for staff was planned in relation to supporting people living with dementia.

The environment was maintained. Pictorial signage helped people to find their way around. Gardens provided an inviting outside space to people.

People were treated with dignity, respect and kindness by staff and the management team. There was a confidentiality policy in place for staff to follow. Care records were stored securely in line with current data protection legislation.

A complaints policy was in place to inform people how to raise issues. People were provided with information about advocacy services available to help them raise their views.

People told us they were satisfied with the service they received. People living at the service, relatives and staff’s views were sought and were acted upon. Links with the community were in place and fund raising occurred for different charities.

Inspection areas

Safe

Requires improvement

Updated 28 July 2018

The service was not always safe.

Medicine management and administration was not always robust. Risks to people's wellbeing were not always managed appropriately.

Staff understood the action they must take to protect people from abuse. Staffing levels provided met people's needs. Recruitment was robust.

Systems were in place to prevent the spread of infection.

Effective

Good

Updated 28 July 2018

The service was effective.

Staff were provided with training, supervision and a yearly appraisal to maintain and develop their skills.

People’s rights were respected and care was provided with consent or in people’s best interests. Minor issues found were corrected swiftly. Staff understood the principles of the Mental Capacity Act 2005.

People’s dietary needs were assessed and monitored. People were assisted to eat and drink, and concerns were raised with health care professionals to ensure their dietary needs were met.

Caring

Good

Updated 28 July 2018

The service remained caring.

People confirmed staff were caring and kind.

Staff provided caring support to people and their privacy and dignity was respected.

Responsive

Requires improvement

Updated 28 July 2018

The service was not always responsive.

Some people's care records still lacked important information about how staff were to support them, which may lead to some people not receiving the right care and support.

Activities were provided and people were encouraged to receive visitor's and go out in the community.

A complaints policy and procedure was in place. Issues raised were acted upon to improve the service.

Well-led

Requires improvement

Updated 28 July 2018

The service was not always well-led.

Governance and quality monitoring was not robust. Audits and checks in place to monitor the quality of the service had not found the issues that were present during our inspection.

People using the service, relatives and staff had their views asked for, feedback received was acted upon.

Statutory notifications were sent to the Care Quality Commission as required.