Archived: Holland House

Updated 13 July 2016

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 inspection took place on 11 May 2016 and was unannounced. The inspection team consisted of an inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care home.

Before the inspection we reviewed the information we held about the home. This included any incidents the provider was required to tell us about by law and concerns that had been raised with us by the public or health professionals who visited the home. We also reviewed information sent to us by the local authority who commission care for some people living at the home. Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the home, what the home does well and improvements they plan to make.

During the inspection we spoke with three people who lived at the home, a visitor to the home and spent time observing care. We also spoke with a nurse, a care worker and the manager.

We looked at three care plans and other records which recorded the care people received. In addition we examined records relating to how the home was run including staffing, training and quality assurance.

Updated 13 July 2016

The inspection took place on 11 May 2016 and was unannounced.

Holland House Nursing Home is registered to provider residential and nursing care for 10 older people, some of whom may be living with a dementia. It is on the same site as Rose Lodge another of the provider’s homes. Both the homes share their staff and facilities.

At the time of our inspection the manager on our register was no longer working at the home and did not have any managerial oversight. There was a new manager at the home but they were not yet registered with the CQC. We discussed with them the need to register. 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.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS were in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect themselves. The manager had made appropriate requests for people to be assessed under the DoLS and all the care provided minimised the restriction on people.

The manager assessed people’s needs and ensured that there were enough staff available to meet those needs in a calm and unhurried manner. Staff received training when they first started to ensure that they had the skills needed to provide safe effective care for people and were supported by ongoing training to maintain a high skill level. Staff had received training in how to keep people safe from harm and knew how to raise concerns and were confident to do so.

Risks to people had been identified and care was planned and equipment was in place to keep people safe. Where people had capacity and chose to not follow the advice and guidance from health care professionals this was respected and staff worked with them to achieve compromises which supported their choices and managed the ongoing risks. People’s dietary needs were assessed and again care was planned to keep people safe and support their independence. People’s medicines were ordered, stored and administered in a methodical way to reduce the risk of infection.

There was a warm and loving relationship between staff and people living at the home. Staff worked beyond their contracted hours to enable people to access the community and to support colleagues. Staff were really knowledgeable about people’s needs and how care could be provided in a person centred way to encourage independence. Staff continually sought the consent of people when providing care to ensure people were happy with what was happening and were involved in their care.

People’s care needs were assessed and reassessed at regular intervals or whenever their needs changed. People were involved in developing their care plans and they contained information on how care was personalised to meet individual needs. People were supported with a varied activity programme which supported them to access the community and to be entertained.

People and staff told us that the manager was often not visible in the home but that they felt supported as they could always raise concerns with the nurse. The provider had effective systems in place to monitor the quality of care people received and to seek the views of people using the home and their relatives.

The provider ensured the manager and staff were supported to provide good care by employing staff at head office who kept up to date with any changes in how care should be provided. This enabled the provider to disseminate the latest guidance around best practice and any changes in legislation effectively and consistently. In addition the provider’s culture was that of an open organisation with a no blame culture which supported learning across their care homes as well as within each home.