Background to this inspection
Updated
11 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 completed by one inspector.
Service and service type
Holywell House Care Centre 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. Holywell House Care Centre 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 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 not a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since it was registered. We sought feedback form the local authority commissioning and safeguarding teams. 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 of this information to plan our inspection.
During the inspection
We spoke with six people using the service and two relative about their experience of Holywell House Care Centre. We spoke with 13 members of staff including the manager, care workers, senior care workers, ancillary staff, the consultant director and the nominated individual who was also the provider. The nominated individual is responsible for supervising the management of the service.
We viewed seven people's care plans and a range of medicine records. We observed staff using PPE and observed interactions between staff and people on each floor. We reviewed recruitment records for three staff and looked at a range of records relating to the management of the service, including policies and procedures, safeguarding information and information on the safe management of infection control.
We emailed four members of staff for feedback and received two replies. We contacted a further four relatives of whom one provided feedback.
Updated
11 June 2022
About the service
Holywell House Care Centre is a residential care home providing personal care for up to 47 people in one purpose-built building over three floors. The service provides support to younger adults and older people, some of whom may be living with a dementia. One floor is dedicated to supporting men only. At the time of our inspection there were 42 people using the service.
People’s experience of using this service and what we found
Government guidance in relation to the wearing of face masks was not always followed. We have made a recommendation about this. Previous concerns had been raised about infection control at Holywell House Care Centre. The management team had been responsive however observations during the inspection evidenced that the systems used to elicit improvements had not been effective. We have made a recommendation about monitoring of infection prevention and control practices.
Safe recruitment practices were followed. Agency staff were being used whilst the manager completed pre-employment checks for staff who had been offered posts.
The manager was not registered with the Commission. They had begun the process to register but had not yet submitted a completed application form.
Risks had been assessed and control measures were in place to minimise the impact on people. Medicines were managed safely. Safeguarding procedures were in place and any allegations of abuse were investigated and addressed.
People’s needs were assessed, and staff worked alongside other health and social care professions to make sure people received appropriate and effective care and support. 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. Staff were well supported and completed relevant training to make sure they could meet people’s needs.
People, and their relatives if appropriate, were included in decision making. People were treated well by staff who were kind and caring. Dignity and privacy was respected. People were encouraged and supported to maintain their independence where possible.
People’s choices and preferences were reflected in care records. Communication plans were in place which supported staff to communicate appropriately with people. Concerns and complaints were investigated and responded to. Relationships with family and friends were encouraged and maintained.
People. relatives and staff were supportive of the manager’s approach and felt communication and morale had improved since they had been in post.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 9 December 2020 and this is the first inspection.
The last rating for the service under the previous provider was good (published on 2 March 2015).
Why we inspected
The inspection was prompted in part due to concerns received about infection control and staffing. A decision was made for us to inspect and complete a five domain inspection as the service had not had a ratings inspection with the current provider. 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.
Recommendations
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 action was necessary and proportionate to keep people safe as a result of this inspection. We made two recommendations. Please see the safe and well-led sections of the report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.