Background to this inspection
Updated
19 January 2015
The inspection team consisted of one inspector and a specialist advisor. A specialist advisor is someone who has clinical experience and knowledge of working with people living with a learning disability.
Prior to our inspection we asked the provider to complete a Provider Information Return (PIR) which gave us information we had asked the provider to send to us prior to this inspection. This is key information about the service where the provider told us what the service does well and improvements they plan to make. We also spoke with the local authority contracts monitoring team and commissioners of the service to obtain their views.
On the day of this inspection, we spoke with three staff members, the manager and the provider. We spoke with five people who lived at the service. However, due to their limited ability to verbally communicate with us they were unable to give us detailed feedback regarding the care they received. Therefore our specialist advisor spent time over a period of three hours observing how care and support was provided to them.
Following this inspection we spoke with two social care professionals and one relative to gain their views on the care provided by the service.
We looked at the care records for three of the eight people who used the service, medication records and staff recruitment and training records. We also looked at records relating to how the service monitored quality and safety.
Updated
19 January 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2012 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 2012 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
This inspection was unannounced. Our last scheduled inspection of this service was on the 25 October 2013 where we found no breaches of the regulations we inspected.
The Hollies Residential Care Home provides accommodation for up to 10 older people with physical and learning disabilities. Some people as a result of the ageing process had also been diagnosed with dementia. On the day of our inspection there were 8 people living at the service.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. At the time of our inspection a registered manager was employed at the service. The registered manager and the provider were present during this inspection.
Risks to people’s health, safety and wellbeing had been assessed. However, the provider did not take steps to notify the Care Quality Commission (CQC) of notifiable incidents which affected the welfare, health and safety of people so that, where needed, investigations could take place and action could be taken.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS), and to report on what we find.
We looked at whether the service was applying the Deprivation of Liberty Safeguards (DoLS) appropriately. These safeguards protect the rights of adults using services by ensuring that if there are restrictions on their freedom and liberty these are assessed by professionals who are trained to assess whether the restriction is appropriate and in the best interest of the person. Staff had received training and demonstrated their knowledge and understanding of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. However, the provider had failed to notify the Care Quality Commission (CQC) of an application to the authorising body to deprive a person of their liberty.
We were not assured that that the provider had considered the design, layout and access arrangements effectively to take into account the needs of people with physical disabilities.
The gardens were unkempt, insecure and not adequately maintained. Steps had not been taken by the provider to enable people easy access to safe and well maintained gardens.
There were systems in place to monitor the quality of the service. The provider told us they carried out monthly quality monitoring visits to the service. However, reports following these visits were brief and ineffective as the process had not identified the concerns we found and had not led to the necessary improvements required to ensure people’s safety and wellbeing needs were met.
The provider had not taken steps to assess and provide personalised social and leisure opportunities appropriate for people with a learning disability and those living with dementia. This did support people in relation to promoting their autonomy, independence and community involvement.
The provider was not fully meeting the requirements of the Deprivation of Liberty Safeguards as CQC had not been informed of the application to deprive one person of their liberty as is required by law.
People were treated with dignity and respect. They communicated to us that they felt safe and that staff were always kind and respectful to them.
People’s healthcare needs were assessed and access to healthcare professionals was provided where appropriate.
Medication practices at the service were robust and ensured that people’s medicines were managed safely.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and one breach of the Health and Social Care Act 2008 (Registration) Regulations 2009. You can see what action we have told the provider to take at the back of the full version of the report.