CQC report explained · a residential care home
What the CQC found at Holland House
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- People said they felt safe. Inspectors found individual risk plans, suitable staffing, safe recruitment and systems for medicines, infection control and learning from incidents.
- Effective?
- Good
- People's physical, mental and social needs were assessed. Staff followed specialist guidance for Prader-Willi Syndrome, supported personalised diets and worked with healthcare professionals.
- Caring?
- Good
- Inspectors saw a warm and relaxed atmosphere. Staff supported people's choices, privacy, dignity, communication and independence.
- Responsive?
- Outstanding
- Care plans and daily activities were highly individualised. People were supported to pursue interests, relationships, community activities and personal dreams.
- Well-led?
- Outstanding
- Inspectors found strong leadership, an open culture, experienced staff and effective quality checks. People, relatives and staff were involved in improving the service.
What inspectors found, December 2019
Rated Outstanding; inspectors found highly personalised care, excellent activities and strong leadership, with Safe, Effective and Caring rated Good.
The inspection took place at the home on 23 October 2019. The inspector spoke with all four people living there, staff and relatives, and checked care, medicines, recruitment and management records. Further telephone interviews with four relatives took place on 8, 11 and 12 November.
The home supports up to four adults with Prader-Willi Syndrome and learning disabilities. Inspectors found care was personalised to people's specialist needs. People were supported to manage food and weight, attend health appointments, build skills and live more independently.
The home was rated Good for Safe, Effective and Caring. It was rated Outstanding for Responsive and Well-led. The overall rating was Outstanding. Responsive and Well-led had improved from Good at the previous inspection, published on 7 January 2017.
Personalised specialist care
Care and support were tailored to each person's specialist needs. Staff had significant experience of supporting people with Prader-Willi Syndrome.
“Without exception the care and support people received was specifically personalised to meet people's specialist needs.” from the report
Health and weight support
People followed personalised calorie-controlled diets and were supported to manage food choices, activity and health appointments. Inspectors linked this to improvements in health and wellbeing.
“People were supported to manage their weight and food choices.” from the report
Activities and independence
People had individual activity programmes and were supported to develop skills, maintain relationships and take part in community life. Staff also helped people achieve personal dreams.
“Each person had a daily activity programme that was individualised to meet their specific preferences and wishes.” from the report
Strong leadership
The report describes a committed management team, experienced staff and a culture focused on choice, independence and better outcomes.
“There was a strong commitment to promoting independence and social inclusion.” from the report
Quality monitoring
The home used audits, incident reviews and action plans to monitor care and make improvements. Staff were encouraged to question practice and share concerns.
“Effective quality assurance systems were used to continually monitor all aspects of the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you adapt the personalised calorie-controlled diet and food controls to my relative's needs and wishes?
- 02What staffing support would my relative receive outside the home, including any one-to-one support?
- 03How would you identify and support my relative's personal goals, activities, relationships and independence?
- 04How would my relative be involved in their care plan and in decisions about restrictions such as kitchen access?
- 05How do you currently check care quality, review incidents and act on any improvements needed?
This was a planned comprehensive inspection covering all five key questions, with a home visit on 23 October and telephone interviews with relatives on 8, 11 and 12 November 2019. This explanation was written from the published report of 20 December 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, January 2017
Holland House was rated Good; inspectors found safe, caring and personalised support with effective management systems.
This was an unannounced inspection on 1 December 2016. The inspector visited the home, spoke with two people and two relatives, and spoke with four staff members, including the manager. They reviewed care records, recruitment and training records, quality checks, the building and staff interactions.
The home supported three people, with space for up to four. It had reopened in September 2016 and specialised in supporting adults with complex needs and behaviours linked to Prader-Willi Syndrome. Inspectors found enough staff, safe medicines arrangements, suitable training and detailed risk plans.
All five areas were rated Good: safe, effective, caring, responsive and well-led. This means inspectors found the home was meeting the relevant standards at the time of this inspection. It does not describe how the home is operating now.
Detailed risk planning
Risk plans gave staff clear guidance while allowing people to remain as independent as possible. They covered risks linked to Prader-Willi Syndrome and everyday activities.
“Risk assessments were in place and were continually reviewed and managed in a way which enabled people to safely pursue their independence and receive safe support.” from the report
Relevant staff training
Staff received training about Prader-Willi Syndrome, nutrition, conflict management and other areas needed for the people living there. New staff completed training and shadow shifts before working alone.
“Additional training relevant to the needs of the people they were supporting was also provided; this included training in PWS, conflict management, nutrition and healthy eating.” from the report
Respectful relationships
Inspectors saw positive relationships between staff and residents. People were involved in choices and their privacy, dignity and cultural needs were respected.
“Staff supported people in a kind and caring way and involved them as much as possible in day to day choices and arrangements.” from the report
Personalised activities
People were supported to follow their interests, work towards goals and build independence. Activities included community outings, hobbies and practical tasks.
“People were supported to take part in activities that they enjoyed and staff were knowledgeable about people's preferences and hobbies.” from the report
Quality monitoring
The manager and provider carried out audits and followed up actions. People, relatives and staff had opportunities to give their views.
“There were arrangements in place to consistently monitor the quality of the service that people received, as regular audits had been carried out by the provider and manager.” from the report
Manager registration was pending
minorA manager was in post, but their application to register with the CQC was still being processed when inspectors visited. Ask whether this has since been completed.
“The manager had applied to the Care Quality Commission to register as the manager of the service and this application was being processed.” from the report
- 01Has the manager's application to register with the CQC since been completed?
- 02How will you manage my relative's food access, meal plans and nutritional needs if they have Prader-Willi Syndrome?
- 03How are risk assessments and care plans reviewed when a person's needs or behaviour changes?
- 04What activities and opportunities for independence would be available for my relative?
- 05How would my relative or our family raise a concern or complaint, and how would it be followed up?
This was an unannounced inspection covering the overall service and all five CQC questions, including care records, staffing, medicines, quality monitoring and the home environment. This explanation was written from the published report of 7 January 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Holland House
2 rated inspections over 3 years: the service has improved, from Good to Outstanding.
- December 2019Outstandingcurrent ratingup from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Outstanding
- January 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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