Hollin Knowle Residential Care Home

Updated 26 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive, unannounced inspection, which took place on 31 July 2018. The inspection team consisted of two inspectors.

Before our inspection the provider sent us their completed Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We spoke with local authority care commissioners for people’s care at the service. We also looked at all the key information we held about the service. This included written notifications about changes, events or incidents that providers must tell us about.

We spoke with four people, three relatives and three community professionals. We also spoke with four care staff, including the deputy manager, a cook, a domestic and the registered provider who is also the registered manager for the service. We looked at four people’s care records and other records relating to people’s care and the management of the service. This included, staffing, medicines, complaints and safeguarding records; the provider’s checks of the quality and safety of people’s care and related service improvement plans. We did this to gain a representation of views of people’s care and to check that standards of care were being met.

Updated 26 October 2018

Hollin Knowle 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. Personal care is provided in one adapted building for up to 19 older people.

This inspection was unannounced and carried out by two inspectors. There were 16 people living at service and receiving personal care.

There was a registered manager for the service at the time of this inspection, who is also one of the registered partners [care providers]. A registered manager is a person who has registered with the Care Quality Commission. They are responsible for the day to day management of the regulated activity of personal care at the service. Like providers, as a registered person they have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection in February 2017 we rated the service as Requires Improvement. At that time the provider had made improvements to ensure people’s medicines were safely managed. However, staffing arrangements were not always sufficient to ensure timely care or adequate environmental cleanliness, to protect people from the risk of an acquired health infection. We also found the provider did not operate effective management systems to inform and ensure related service improvements when required. These were respective breaches of Regulations18 and 17 of the HSCA (Regulated Activities Regulations) 2014. Following that inspection, the provider told us what actions they were taking to address this.

At this inspection we found the required action taken by the provider was to rectify the breaches. Resulting care and service improvements were made to an overall standard of Good. However, further improvement was needed in relation to how the service is led. As the provider now needs to demonstrate their ability to proactively and consistently ensure sustained, timely and continued service improvement.

Overall, people, relatives and staff felt people received safe care. Revised staffing, safe recruitment and environmental cleanliness and hygiene measures, were either made or in progress, to ensure this.

The provider had responded to local authority concerns to ensure people’s safety at the service, following an increase in people’s falls there. Revised falls prevention, reduction and management strategies were introduced in consultation with relevant external health professionals, to ensure people’s safety at the service.

Staff supported people safely when they provided care. Risks to people’s safety associated with their health conditions, medicines needs or, any care equipment used, were assessed before people received care, safely accounted for and regularly reviewed. People’s medicines were safely managed.

Environmental upgrade, adaptations and repairs were either made or in progress. Emergency contingency planning and related risk management arrangements helped to ensure people’s safety.

People received effective care. People and relatives were happy with the care and meals provided.

Overall, people were supported to maintain or improve their health in consultation with relevant external health professionals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff were trained and supported to help ensure this.

Action was taken when required, via relevant health professionals, to review and inform people’s care in their best interests. Important care and medicines information was shared with relevant external care providers, in the event of any transfer of people’s care from the service.

People and relatives were happy with the care and had good relationships with staff. Staff understood and followed people’s care and daily living choices; and promoted people’s dignity, independence and rights when they provided care.

People received individualised, timely care from staff who knew how to communicate with them in the way they understood. People were supported to engage in home and community life and with family as they chose.

The provider complied with the Accessible Information Standard (AIS). They had begun to introduce and make sure people with a disability or sensory impairment were provided with care and service information in a way they could understand.

People and relatives were informed to make a complaint and the provider regularly sought their views about the service. Feedback and findings obtained from this were used to inform and make care changes or improvements.

Staff understood their role and responsibilities for people’s care. The providers operational procedures; communication and reporting systems helped to ensure this.

Management were visible, accessible and worked closely with people, relatives and external care partners. A range of service improvements made, or in progress at this inspection, helped to better ensure the safety, quality and timeliness of people’s care, to their benefit.

Records relating to management of the service, people’s care and staff employed were often accurately maintained and they were securely stored and handled. People and visitors at the service were informed about the latest CQC inspection report.