The Hollies Residential Home

Although people and relatives were happy with the care and support, we found some concerns about people's safety. Improvements to safety had been made in relation to building related risks and risks relating to people's assessed health needs. Some risks relating to skin integrity and constipation to people had not always been properly managed.

Medicines had not always been given as prescribed, however one medicine had not been given as per the prescriber's instructions, as it had been given at the same time as other medicines. Medicated patches which can cause irritation to the skin if they are placed in the same position after removal were not always sited in a different place on people's skin, which increased the risks of a reaction and discomfort. We found no evidence that people had been harmed. This is an area for improvement. Medicines were stored safely in a locked medicines room. Medicines had been stored at the correct temperature to ensure they were safe to use. Staff were trained to administer medicines and we observed good practice when staff were completing the medicines round.

Management oversight of the service had improved. The provider and registered manager had systems in place to check and audit the care and support as well as monitoring health and safety risks and building related risks. Actions were completed swiftly when the management team identified concerns. The provider had changed the electronic care planning system and this was mainly working well. However, some improvements were required to help the management team have better oversight of repositioning, constipation, medicines, and fluid intake.

Enough staff were deployed to keep people safe. Staff had been recruited safely to ensure they were suitable to work with people. People were supported by regular staff who they knew well. Staff were well supported by the management team.

The provider had improved the environment and further redecoration and renovation was taking place, during the inspection a new shower room was being installed. There was signage in place to support people living with dementia (as well as new people to the service) to orientate themselves.

People were assessed to check their capacity to make particular decisions when this was in doubt. Records showed how decisions were made in people's best interest. Mental capacity assessments were in place, these were decision specific, some had some conflicting information, which is an area for improvement. People told us they made choices about their lives. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The provider had effective safeguarding systems in place to protect people from the risk of abuse. Safeguarding concerns had been identified and reported to the local authority appropriately. Staff knew and understood their role in keeping people safe.

The service was clean; the provider was promoting safety through the layout and hygiene practices of the premises. Staff used personal protective equipment when providing care to people in line with infection control guidance.

Prior to people moving into the service their needs were assessed. These assessments were used to develop the person's care plans and make the decisions about the staffing hours and skills needed to support the person.

Meals and drinks were prepared to meet people's preferences and dietary needs. People told us they liked the food.

People were treated with dignity and respect. People's views about how they preferred to receive their care were listened to and respected. People and relatives told us staff were kind and caring.

People had access to a range of different activities throughout the week. People told us that they took part in these.

People received good quality care, support and treatment including when they reached the end of their lives. People had been involved in planning and discussions about their wishes and preferences in relation to their end of life care.

When people needed medical attention, this was quickly identified, and appropriate action was taken. For example, if people were losing weight referrals were made to dieticians.