Holly Bank Care Home

Updated 8 September 2023

The inspection

This was a targeted inspection to check whether the provider had met the requirements of the specific concerns about the support for people during hot weather and the suitability of the environment. We will assess all of the key question at the next comprehensive inspection of the service.

Inspection team

This inspection was undertaken by and inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Holly Bank Care 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 who was in the process of registering with the Care Quality Commission. Registered managers 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 inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection. We had requested information from the provider prior to the inspection and this information was used as part of the inspection plan.

During the inspection

We spoke with 5 members of staff including the manager and provider representative. we also spoke with 5 people who use the service and 1 relative.

After the inspection

We continued to seek clarification from the provider and manager to validate evidence found.

Updated 8 September 2023

About the service

Holly Bank is a residential care home registered to accommodate up to 31 people in need of personal care. Accommodation is provided over three floors with rooms including some with en-suite facilities. On the days of the inspection there were 13 people living in the home.

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

The provider needed to review their recruitment processes. They did not always meet current legislation and guidelines. There were issues around management oversight. Other senior staff were providing this cover in the absence of a manager. In these circumstances, we noted some shortfalls with staffing levels. We have made recommendations about staffing levels and safe recruitment in the 'Safe' section of the report.

People's care records and risk assessments required some improvements. They did not always reflect people's current position and mental capacity status. These issues were resolved during the inspection.

People did receive their medicines as prescribed by their health care professionals.

Infection, Prevention and Control (IPC) processes were generally appropriate. We had some concerns about the robustness of processes when professional visitors attended the home. This was corrected during the inspection and we were assured about the service's ability to mitigate the transmission of infections.

Staff were competent with safeguarding processes and knew how to protect people from abuse. A relative said their loved one felt safe in the home and were trusting of staff and management. We observed good practices and interactions between staff, the provider representative and people during the inspection. The service's safeguarding processes were robust.

Staff supported people to have access to healthcare professionals and specialist support and the service worked well with external professionals. Healthcare professionals were particularly complementary about the care and support people received at the home.

People told us they felt cared for and were happy with the service they received. Relatives said staff were kind and caring and treated their loved ones well. At inspection, we noted good interactions between people, management and staff.

People and staff were happy with the way the service was managed. People's views and opinions of the service were sought and acted on.

In part, the inspection was as a result of concerns around an environmental issue and the subsequent temporary re-location of people. It was established the service could not have foreseen these issues. Maintenance processes were in place and could not have expected to warn of the likelihood of a concern in this area.

The provider acted during and immediately after the inspection to address the issues we found. This included increasing the staffing team and implementing improved checks and reviews.

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 'Good' (published 15 July 2019).

Why we inspected

We received concerns following a water leak in the home and the subsequent relocation of people. Residents were temporarily relocated to another home. It was accepted relocation was only used as a last resort and in the best interests of people in these particular circumstances. These issues raised questions of the provider's preparedness to deal with emergencies and the general maintenance of the home. As a result, we undertook a focused inspection to review the key questions of 'Safe' and 'Well-led' only. 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.

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.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

Follow up

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