Hollybank Care Home

Updated 24 June 2022

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

The inspection was carried out by three inspectors 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

Hollybank 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. Hollybank is a care home registered for nursing care, however this is currently not being provided. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post for the regulated activity of Accommodation for people requiring nursing or personal care.

A separate manager application had been submitted for the regulated activity of Treatment for disease, disorder and injury.

Notice of inspection

We gave a short period notice of the inspection because of a recent COVID-19 outbreak at the home. Inspection activity started on 6 April 2022 and ended on 20 April 2022. We visited the service on 11 April 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority quality monitoring team who work with the service. 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 five people who used the service and seven members of staff. These included the registered manager, operations manager senior care staff, carers, kitchen staff and the volunteer. We also spoke with a visiting district nurse and the Expert by Experience contacted five relatives by telephone to seek their feedback about the service.

We reviewed a range of records. This included care records for three people, medication management, four staff files in relation to recruitment, audits and monitoring systems and health and safety checks.

After the inspection

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

Updated 24 June 2022

About the service

Hollybank is a residential and nursing care home providing care and support for up to 49 older people some of whom are living with dementia. No nursing care was being provided by the service at the time of this inspection. Accommodation and support were provided on two floors which were accessible by passenger lifts. At the time of the inspection there were 40 people living at the home.

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

The service had a range of audits and checks to help monitor standards within the home. However, these were not sufficiently robust in helping to identify the shortfalls found at the inspection. Records also showed where shortfalls had been identified, action required had not been identified and implemented.

Good staffing levels were provided. However, not all information and checks were completed prior to new staff commencing employment. Staff spoken with felt supported in their role and the team worked well. Staff were able to demonstrate a good knowledge and understanding of the people’s individual needs and wishes, interactions were respectful and caring.

Servicing and maintenance checks were carried out to ensure the premises and equipment were kept safe. Outstanding checks regarding gas safety and profiling beds were being addressed. Suitable aids and adaptations were available to aid people's mobility and promote their safety.

People were provided with spacious, comfortable accommodation. The home was clean and well-maintained. Immediate action was taken with regards to the storage of slings and pressure aids to help minimise the risk of cross infection. We received mixed feedback about visiting arrangements due to COVID-19. We were assured that open visiting in and away from the home had resumed.

The management and administration of people’s oral medicines were managed safely. Improvements needed to the records for topical creams, when required medication and fridge temperatures were addressed immediately following the inspection visit.

Positive feedback was received from people, their relatives and third parties about the care and support provided. People told us they were happy living at Hollybank and were seen to enjoy a good rapport with staff. People followed routines of their own choosing and were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Further activities and opportunities were being explored following the lifting of COVID-19 restrictions.

Good systems in place with regards to safeguarding people, end of life care, handling of complaints and concerns and care planning.

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 17 October 2019).

Why we inspected

We received concerns in relation to staffing levels, medication and risk management. As a result, we undertook a focused inspection to review the key questions of safe, responsive 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 good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hollybank Care Home 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 monitor the service and will take further action if needed.

We have identified breaches in relation to quality monitoring systems and staff recruitment at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.