Hollie Hill provides accommodation for people with nursing and personal care needs. The home can accommodate up to 61 people. At the time of our inspection there were 58 people using the service. The home is on two floors and is divided into four units including a nursing unit and residential care. This inspection took place on 16 and 17 February 2017and was unannounced.
At the last inspection in November 2014, we rated the service as overall “Good” and found the home was meeting the regulatory requirements.
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.
People who used the service and their relatives told us they felt safe in the home. We saw there were regular checks to ensure the building was a safe place to live. Where a person’s individual risks had been identified then actions had been put in place to mitigate those risks.
We could not be reassured that people’s prescribed topical medicines (creams applied to the skin) had been applied in the manner they were prescribed. A new audit had been introduced by the registered provider had had been used by the registered manager. It showed action needed to be taken to improve the use of topical medicines in the home and reduce the risks to people where they were not receiving their topical medicines as prescribed.
The registered manager showed us the, “CHESS” tool; this is designed to enable the registered manager to calculate the number of staff hours required. They demonstrated to us they were providing more hours that required. However people in the home and their relatives experienced the need for more staff. We therefore recommended the home review the level of dependency needs.
We found appropriate checks were carried out on staff before they started working in the home. This meant people were being cared for by staff who were able to do the work and had been considered safe to work with people living in a home.
People told us they liked the food in the home and we observed staff offering to support people to eat. We found the catering staff understood about people’s dietary needs.
We found the service adhere to the principles of the Mental Capacity Act 2005 and where people were unable to make decisions for themselves best interests’ decisions had been put in place. These had involved family members and other professionals.
Staff were supported to carry out their duties through supervision, training and appraisal.
People living in the home and their relatives during the inspection told us staff were caring. We saw thank you cards and letters from people which thanked staff for their levels of care. Some of these were from relatives who had experienced the loss of a family member whilst being a resident at Hollie Hill.
We saw examples throughout our inspection of people being treated with respect and dignity. Staff closed people’s bedroom doors before attending to people’s personal care needs.
Staff were able to give us detailed information about people’s needs, backgrounds likes and dislikes. This meant staff knew and understood the people for whom they were providing care.
We found people had detailed care plans in place which guided staff on what actions to take to meet people’s care needs. These were reviewed on a regular basis to ensure they were up to date. Staff had also completed care documents required by the commissioners for people requiring intermediate care. These were for people who had been discharged from hospital who required a period of further care before they went home or alternative accommodation was found.
People were given a choice about being involved in activities. We observed people making Easter cards and two people were taken out to a luncheon club. Other activities in the home included bingo and knit and natter. We saw one person had taken up exercise and people had been supported to attend a local swimming session for people with dementia care needs.
The service constantly gathered feedback on the home through electronic systems. We saw the registered manager had access to the feedback outcomes and was able to analyse the information at any given point. We found this feedback was largely positive.
Audits were carried out in the home by the registered manager to look at the quality of the service. We saw actions had been put in place to improve the service.
Staff felt supported by the registered manager. Although one relative felt unhappy with one response they had received from the registered manager the majority of relatives felt they had experienced a positive working relationship and were complementary about the registered manager’s skills and abilities to manage the home.
The registered manager had developed positive relationships with local community groups. This had enabled the home to receive funding for activities and a group of young people had transformed the garden making it more suitable for people to use.
During our inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of the report.