The Hollies

Updated 28 June 2023

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 Health and Social Care Act 2008.

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.

The Hollies is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Hollies is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with 9 people who used the service about their experience of the care provided. We spoke with 5 members of staff including the provider, registered manager, care workers and auxiliary workers and we also spoke to 3 relatives and to 1 professional. We also spent time observing people during lunch time.

We reviewed a range of records. This included 3 people’s care records and 4 medicines records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 28 June 2023

About the service

The Hollies is a care home without nursing registered to provide accommodation and care for up to 20 people. People living at the service are older people, some of whom may be living with dementia. At the time of our inspection there were 16 people using the service.

The home is currently providing support to some people living with a learning disability, however, people’s primary need for admission was their dementia and personal care. We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

The model of care and setting maximised people’s choice, control and independence. Staff supported people to make choices about their daily lives and engage in activities, that were tailored to their individual needs and promoted their independence. People were supported to maintain and develop relationships.

People were supported by enough staff on duty who had been trained to do their jobs properly. People received their medicines in a safe way.

People were protected from abuse and neglect.

People's care plans and risk assessments were clear and up to date.

Right care:

People received good quality person-centred care that promoted their dignity, privacy and human rights. Staff knew people well and demonstrated an understanding of people’s individual care and communication needs. This helped ensure people’s views were heard and their diverse needs met.

People were treated in a dignified manner and staff were aware of people’s support needs. Staff were observed talking to people in dignified and respectful way. Staff delivered personal care needed and gained consent prior to providing any support. Care plans informed staff of any specific ways to best communicate with the person.

Right culture:

People led their life that reflected their personalities and preferences because of the ethos, values, and attitudes of management and care staff ensured people led confident, inclusive and empowered lives. Staff created an environment that inspired people to understand and achieve their goals and ambitions.

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

We last inspected the service in September 2021. At that time, we had concerns regarding the management of the service and The Hollies was rated Requires Improvement. We identified checks and monitoring had not always been completed. At this inspection we found that whilst improvements had been made, we have made 2 recommendations in this report.

At the previous inspection we found the management of medicines was not always safe. We found improvements had been made and that medicines administration records (MAR) were now stored securely, records were now maintained and no gaps were found in MAR. However, we have made recommendations over the use of ‘as required’ protocols and staff competency check and handwritten entries on MAR.

At the last inspection we found issues over the level of detail in peoples care plan was limited and that individual risks were not always presented in care records in enough detail to support staff. We also found the registered manager had not always notified CQC of incidents in line with regulation. At this inspection we found these issues had been resolved.

The environment was safe and there was equipment available to support staff in providing safe care and support. We did find 2 windows without restrictors in place. The maintenance person fitted these immediately. Health and safety checks of the environment and equipment were in place. However, we had been informed by the fire department that the service was required to replace all the internal fire doors. This work had already started.

Medicines were ordered, stored and disposed of safely. However as mentioned above in the previous inspection staff competency checks and ‘as required’ medicines still did not have a protocol in place.

We have made recommendations about the management of medicines. The report highlights the actions the provider had taken at the inspection.

People told us they were happy with the care they received, and people said they felt safe living there. Comment from one person was, “Very safe here!” People looked relaxed, happy and comfortable with staff supporting them. Staff were caring and spent time chatting with people as they moved around the service. A relative told us, “My relative is safe here and well looked after.”

Records were accessible and up to date. The management and staff knew people well and worked together to help ensure people received a good service.

Staff were recruited safely in sufficient numbers to ensure people’s needs were met. There was time for people to have social interaction and there was a designated activities staff member to assist people. Staff knew how to keep people safe from harm.

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.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. One visiting professional said, “The staff are very quick to ask for advice and support.”

Records of people's care were individualised and reflected each person’s needs and preferences. Risks were identified, and staff had guidance to help them support people to reduce the risk of avoidable harm. People’s communication needs were identified, and where they wanted, people had end of life wishes explored and recorded.

Staff told us the registered manager and provider were available and assisted them. They went onto say how they were approachable and listened when any concerns or ideas were raised. A staff member said, “We are like one big family.”

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

Rating at last inspection and update

The last rating for this service was requires improvement overall (published 2 November 2021).

Why we inspected

We carried out this inspection to follow up on the breaches of regulation from the previous report.

As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Hollies on our website at www.cqc.org.uk

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 COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.