Archived: Hollycroft Care Home

A registered manager was in post, but had recently stepped down from the role. We reminded them of the need to correctly deregister with the Commission. An interim manager was in place whist the service recruited another registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection in July 2016 we rated the service ‘requires improvement’ overall and identified two breaches of regulation. This was because there was a lack of evidence the service was acting within the legal framework of the Mental Capacity Act (MCA) and medicines were not safely managed. We found improvement had been made at this inspection.

People and relatives spoke positively about the overall standard of care provided. They said care was appropriate and met people’s individual needs. They said staff were friendly and knew them well.

Medicines were safely managed. People received their medicines as prescribed and clear records were maintained.

People told us they felt safe living in the home. Safeguarding procedures were in place which were understood by staff. Risks to people’s health and safety were assessed and regularly reviewed to help ensure people were kept safe.

Although on the day of the inspection, staffing levels were reduced due to last minute sickness, we concluded that overall, there were enough staff deployed to ensure people received timely and appropriate care. Safe recruitment procedures were in place to ensure people were of suitable character to work with vulnerable people.

The premises was safely managed. A full time maintenance worker was employed to ensure the premises was kept safe and suitable for its intended purpose.

People and relatives praised staff and said they had the right skills to care for them. Staff received a range of training and supervision relevant to their role.

People’s consent was sought before care and support was offered. The service was acting within the legal framework of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity to make decisions, best interest processes were followed.

People had access to a choice of food and risk and appropriate action was taken where people were at risk of malnutrition.

We observed care and found staff were kind, caring and treated people well. Staff demonstrated they knew people well and had formed positive relationships with them.

People’s care needs were assessed and clear and person centred care plans were put in place. These were subject to regular review and demonstrated the service responded to people’s changing needs.

Although a dedicated activities co-ordinator was not employed we saw staff provided people with a number of activities to ensure their social needs were met.

We found a number of improvements had been made to the service over recent months. We would need evidence these were sustained over time to be assured the service was well led. A range of audits and checks were undertaken to identify and rectify any issues that arose.

People’s feedback was sought and used to make improvements to the service.

At the last inspection in April 2015 the home was found to be compliant with all of the legal requirements inspected at that time.

We inspected the service on 12 July 2016. On the date of the inspection 18 people were living in the home.

A registered manager was in not place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A new manager had been recruited who told us they would be applying for the registered manager’s post.

People and relatives provided positive feedback about care at the home. They said that staff were kind and caring and treated people well. They praised the nicely decorated and homely feel of the building and said the small size of the home helped the home to retain a personalised approach to care and support.

Medicines were not safely managed. People did not always get their medicines as prescribed and appropriate protocols were not always in place to instruct staff when to provide “as required” medicines.

People told us they felt safe living in the home. Safeguarding procedures were in place which were understood by staff. Risks to people’s health, safety and welfare were assessed and appropriate plans of care put in place to help keep people safe.

There were sufficient quantities of staff deployed to help ensure safe care. However there were sometimes inconsistencies in the number of care staff deployed from day to day. Recruitment procedures were in place, however they had not been sufficiently robust around the transition period when the home had changed registered providers.

The premises was well maintained with a good number of communal areas for people to spend time. Checks were undertaken on the premises to ensure it was safe.

People spoke positively about the food provided at the home. We saw the mealtime experience was a positive experience, although we identified one person was not always offered a sufficient meat free alternative.

Appropriate Deprivation of Liberty Safeguard (DoLS) applications had been made where the service thought it was depriving people of their liberty. However staff did not have an understanding of DoLS or who had one in place. The service was not consistently acting within the legal framework of the Mental Capacity Act as best interest processes were not always followed where people lacked capacity.

People’s healthcare needs were assessed by the service and plans of care put in place. People were supported to maintain good health by a multi-disciplinary team.

Staff were kind and compassionate towards people and treated them with dignity and respect. Staff knew people well and their individual likes, dislikes and preferences.

People’s views were listened to and acted on both informally and formally by the staff and management team.

People’s needs were assessed and plans of care put in place for staff to follow. These were largely appropriate, although we identified a lack of end of life care plans in place.

An activities co-ordinator was employed who provided people with a varied range of activities which were well received by people who used the service.

A complaints policy was in place which was displayed within the home. People told us complaints were appropriately dealt with, although there was a lack of systems in place to robustly record informal and verbal complaints and the action taken.

People spoke positively about the way the home was managed and said the manager was friendly and approachable.

Systems were in place to assess and monitor the quality of the service. We saw examples where these were successful in identifying and rectifying issues although this was not consistently the case as systems to assess, monitor and improve medicines management were not sufficiently robust.

People’s feedback was regularly sought and acted on through a variety of formal and informal mechanisms.