The Care Quality Commission
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Archived: Holly House Care Home

Overall: Good read more about inspection ratings

24 Queen Anne's Place, Enfield, Middlesex, EN1 2PT (020) 8360 7622

Provided and run by:
John Holland

All Inspections

3 December 2015

During a routine inspection

This inspection took place on 3 December 2015 and was unannounced. At our last inspection on 24 September 2014 the service was meeting all the standards we looked at.

Holly House Care Home is a care home for older adults. The maximum number of people they can accommodate is 16. On the day of the inspection there were 16 people living at the home.

There was a registered manager in post. 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 told us they felt safe and had no concerns about how they were being cared for at the home. They told us that the staff were kind and respectful and they were satisfied with the numbers of staff on duty so they did not have to wait too long for assistance.

The registered manager and staff at the home had identified and highlighted potential risks to people’s safety and had thought about and recorded how these risks could be reduced.

Although people’s care plans were being reviewed monthly, we saw that these did not always take into account risks that people faced, medical conditions or include important events that might trigger a reassessment of a person’s needs.

We saw that environmental risk assessments, audits and checks regarding the safety and security of the premises were taking place on a regular basis and were being reviewed and updated where necessary.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and told us they would presume a person could make their own decisions about their care and treatment in the first instance. Staff told us it was not right to make choices for people when they could make choices for themselves. The registered manager was following appropriate guidance regarding the associated Deprivation of Liberty safeguards (DoLS).

People had access to healthcare professionals such as doctors, dentists, chiropodists and opticians and any changes to people’s needs were responded to appropriately and quickly.

People told us staff listened to them and respected their choices and decisions.

People using the service and staff were positive about the registered manager. They confirmed that they were asked about the quality of the service and had made comments about this. People felt the registered manager took their views into account in order to improve service delivery.

24 September 2014

During an inspection in response to concerns

We conducted this inspection after receiving concerning information about the workplace culture of the home, and a safeguarding adults' alert from the local authority. As such, we did not speak with people who used the service or their representatives during our visit. We spoke with care workers, the care manager, the registered manager and the proprietor of the home. We also reviewed people's personal care and support records, minutes of residents' meetings, minutes of staff meetings, staff personnel records and incident records. We looked at information provided by the local authority.

The service was previously inspected on 9 April 2014, and was found to be meeting essential standards relating to care and welfare of people who use services, meeting nutritional needs, cooperating with other providers, supporting workers, and assessing and monitoring the quality of service provision.

During this visit, on 24 September 2014, we found that staff were appropriately supported in their roles, through training, regular supervision meetings, and annual appraisals. Staff spoke highly of the service managers, and told us they were free to raise any issues or concerns and these would be appropriately addressed.

We saw that people who used the service were protected from the risk of abuse, and the provider had systems in place to ensure that staff were aware of their responsibilities to keep people safe. We also found that the service managers were knowledgeable about the Deprivation of Liberty Safeguards (DoLS) and had used these appropriately to ensure people's safety and welfare.

9 April 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer the five key questions; is the service safe, effective, caring, responsive and well led? Below is a summary of what we found. The summary describes what people using the service and their relatives and staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People are treated with respect and dignity by the staff. Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve. All people in living in the service had capacity to make decisions about their care and treatment.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said that they had been involved in writing them and they reflected their current needs. Staff were supported through regular supervision an training to meet people's needs.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People commented, "the staff are very good here, they help me when I need it and they look out for me." A relative said, "when I go home I have peace of mind that my loved one is cared for. It's a real home they cannot do enough to help."

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People knew how to make a complaint if they were unhappy. We looked at how these complaints had been dealt with, and found that the responses had been open, thorough, and timely. People can therefore be assured that complaints are investigated and action is taken as necessary. The service was responsive to the changing needs of residents and people's care plans reflected changes.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. The service had a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving. Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

6 August 2013

During a routine inspection

People who use the service and their relatives were very positive about Holly House. One person told us, 'it's like a home from home. They tell you this is your home.' Most people we spoke with told us the home had been recommended to them. A relative told us, 'I looked at several places before choosing this one.' People we spoke with confirmed that staff communicated well with them and asked for their permission before any care or treatment took place. One person commented 'I find them very helpful.'

We observed staff supporting people in a friendly, patient and professional manner. Staff understood how people expressed their needs and preferences and responded appropriately. One person commented, 'staff are very kind, some are excellent but on the whole they are all pretty good.' Another person told us, 'it's as friendly as it can be and they are professionals.'

People told us they had good access to health care professionals such as doctors, dentists and chiropodists. One person commented, 'they are very good at sending for the doctor.'

People who use the service told us that they felt safe. They said they had no concerns or complaints about their care but would speak with their relatives, the manager or the care worker if they needed to. One person commented, 'I trust them.' Another person told us, 'I feel absolutely safe here.'

Effective recruitment and selection processes where in place and appropriate checks were undertaken before staff began work.

14 November 2012

During a routine inspection

On the day of the inspection there were sixteen people using the service. We were able to speak with the majority of people living at the home. The home was warm, clean and had a relaxed and friendly atmosphere.

People who use the service told us that staff were kind and respected their privacy.

They told us they could talk with the manager or staff about any issues in the home.

We observed staff supporting people in a friendly and professional way and saw that

people were being offered choice with regard to menus, activities and care preferences.

People who use the service were positive about the care and treatment they received at

the home. They confirmed that staff assisted them when they needed support with their care and that staff were very helpful.

People also told us they had good access to health care professionals such as doctors, district nurses, dentists and chiropodists.

People who use the service indicated to us that they felt safe at the home. They told us

they had no concerns about their care but would speak with a relative or the staff if they did.

14 February 2012

During a routine inspection

On the day of the inspection there were sixteen people using the service.

We were able to speak with the majority of people living at the home.

The home was warm, clean and had a relaxed and friendly atmosphere.

There were two care staff on duty with a care manager supervising. The registered manager was also on duty and in addition there was a domestic and a cook.

People who use the service told us that staff were kind and respected their privacy.

They told us they could talk with the manager or staff about any issues in the home.

We observed staff supporting people in a friendly and professional way and saw that people were being offered choice with regard to menus, activities and care preferences.

People who use the service were positive about the care and treatment they received at the home.

They confirmed that staff assisted them when they needed support with their care and that staff were very helpful. People also told us they had good access to health care professionals such as doctors, district nurses, dentists and chiropodists.

People who use the service indicated to us that they felt safe at the home. They told us they had no concerns about their care but would speak with a relative or the staff if they needed to.