The Hollies

Updated 7 October 2021

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 Care Act 2014.

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

This inspection was carried out by two 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

The Hollies 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 registered with the Care Quality Commission. 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.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. We visited the office location on 16 June.

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, local safeguarding team and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We observed the delivery of care and support in communal areas to help us understand the experience of people who were unable to talk with us. We spoke with staff including the nominated individual and registered manager. We reviewed a range of records during and after our visit to the home. This included five people's care records and three people’s medication records.

The nominated individual is responsible for supervising the management of the service on behalf of the provider.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

We spoke with various professionals over the telephone including two health professionals who regularly visit the service, and we spoke with six members of staff who work at The Hollies. We also spoke with five people who used the service and five relatives about their experience of the care provided.

Updated 7 October 2021

About the service

The Hollies is a residential care home providing personal care to people aged 65 and over, some of whom are living with dementia. At the time of the inspection there was 28 people using the service. The service can support up to 28 people.

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

We found the staffing levels were not adequate. There were limited activities organised for people however, the service is in the process of recruiting an activity co-ordinator.

The service reported a high number of unwitnessed falls over the previous 12 months. We were not assured that systems were always in place to take action to reduce these. Equipment such as stair safety gates and handrails had been fitted to improve safety in the environment.

There was a lack of effective governance systems. We found some policies were out of date or had no review date, the registered manager stated this would be actioned.

We found risks were not always managed in the least restrictive way. We recommend the provider works within the principles of the Mental Capacity Act 2005 (MCA) to determine whether alternatives could have been considered rather than using restrictive practices.

During our inspection we found issues with medicines storage and administration. We were not assured the service reviewed medicines and records were not always complete. People at the service felt supported to take their medicines, one person told us, “I feel supported to take my tablets on time.”

People told us they felt safe living at The Hollies. The provider had effective safeguarding systems in place. Staff demonstrated a good understanding of how to raise safeguarding concerns.

People and staff provided us with positive comments about the management team “if I need help, I know I can ask”. Staff said they felt supported. We found the management team had taken steps to improve the service.

The service had established good working relationships with health professionals, one health professional told us “the staff are always friendly and approachable”.

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

Rating at last inspection

The last inspection was not rated and there were no breaches (published 27 November 2020). At the last comprehensive inspection the service was rated requires improvement overall published 28 January 2020.

Why we inspected

This was a planned inspection and was prompted in part by notification of a specific incident. Following which a person using the service sustained a serious injury. The information CQC received about the incident indicated concerns about the management of falls from stairs. This inspection examined those risks.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.

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.

We have found evidence the provider needs to make improvements. Please see the Safe and Well led sections of this full report.

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.

We have identified breaches in relation to management of risks, medicine management, governance and

staffing at this inspection.

You can see what action we have asked the provider to take at the end of this full 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.