This inspection took place on 16 and 17 October 2018 and was unannounced. We last inspected the service in June 2017 and rated the service overall as ‘requires improvement’.

Hollycroft Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Hollycroft Nursing Home accommodates 37 people in one adapted building. People using the service have a range of needs which include dementia, physical disability or old age. Whilst some people lived there permanently, the service also provides care to people on a short-term rehabilitation basis, often following discharge from hospital. On the day of the inspection, 14 of the 31 people living at the service were living there on a short term basis.

There was a registered manager. 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.

Quality assurance checks in place were not always effective and there continued to be no analysis of accidents, incidents that could improve people’s experience of the service. Staff competencies were not routinely checked. Audits had failed to identify a number of areas that came to light on the inspection, including care records and risks assessments inconsistently kept up to date and information missing in recruitment files.

People felt safe. Staff were aware of their responsibilities to report any concerns and of the risks to people on a daily basis.

Staffing levels were determined by the dependency levels of the people living in the home, but the deployment of staff at mealtimes, remained a concern.

People were supported to take their medicines as prescribed by staff who had received training in this area.

People were happy with the care they received and considered the staff who supported them to be well trained. Staff felt supported and listened to by management and described the registered manager as ‘approachable’.

People said staff were kind and caring. Staff treated people with dignity and respect and supported people to regain their independence, where appropriate.

People said they were involved in the planning of their care, but there was little documented evidence of this. Activities took place but did not always take into consideration people’s choices and preferences.

There was a system in place to record complaints and people were confident if they raised any concerns they would be acted on.

There had been, and continued to be a programme of refurbishment across the home which had a positive impact on the environment.

This is the first rating inspection under this provider. The service was last inspected under Leyton Healthcare (No7) Ltd in November 2014. Since then the service has changed hands on a further three occasions, the latest being in January 2017. This is the first inspection of the service under this ownership.

Hollycroft Nursing Home is registered to provide accommodation, nursing or personal care for up to 37 people. At the time of our inspection 31 people were living at the home. People using the service have a range of needs which include dementia, physical disability or old age. Whilst some people lived there permanently, the service also provides care to people on a short term rehabilitation basis, often following discharge from hospital. On the day of the inspection, 20 of the 31 people living at the service were living there on a short term basis.

There was a registered manager. 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 felt safe and were supported by staff who were aware of their responsibilities to act on and report any concerns they may have.

Staff were aware of the risks to people on a daily basis and worked closely with physiotherapists and occupational therapists in order to ensure people’s needs were met.

Staff were safely recruited and new systems were in place to ensure all appropriate employment checks were complete and in place prior to staff commencing in work.

Staffing levels were assessed by a dependency tool, but deployment of staff across the home was not as effective as it could be which impacted directly on people’s experience of the service.

People were supported to take their medicines but protocols for ‘as required’ pain relief were not in place and medication audits had not highlighted this.

People were happy with the care they received and considered staff to be well trained and able to meet their needs. Staff felt well trained and supported by management and able to raise any concerns they may have.

People said staff were kind and caring and treated them with dignity and respect. People were supported to regain their independence where appropriate, by staff who followed guidance provided by visiting healthcare professionals.

People said they were happy with the care they received and had no complaints, but were not involved in the planning of their care. Where complaints had been received, there was little evidence to demonstrate how they had been responded to and acted upon.

People said they had not been asked their opinion of the home or asked for feedback on the service provided.

People were complimentary about the registered manager and the care they received. Staff felt supported but supervision sessions were inconsistent and there were no staff meetings taking place to enable staff to discuss any issues or concerns they may have.

The new provider had commenced a programme of refurbishment across the home which was welcomed by staff. The registered manager and staff group felt supported by the new provider.

Quality assurance audits in place were not always effective and there was no analysis of accidents, incidents or complaints that would improve people’s experience of the service.