CQC report explained · a residential care home
What the CQC found at Hollin Knowle Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that medicines and risks linked to people's health, equipment and surroundings were managed safely. Falls prevention had been strengthened after an increase in falls, although ongoing monitoring was still being developed.
- Effective?
- Good
- People received support with their health, nutrition and access to health professionals. Inspectors noted that one person's care plan and some staff training and guidance needed further development.
- Caring?
- Good
- Staff treated people with kindness and respect and promoted their dignity, privacy, choices and independence. People and relatives said they were happy with the care and relationships with staff.
- Responsive?
- Good
- Care was individualised and timely, and staff adapted how they communicated with people. People were supported to take part in activities, community life and family relationships, and were told how to complain.
- Well-led?
- Requires improvement
- Managers were visible and approachable, and the home had made important improvements. However, the provider had not yet shown that it could consistently identify, act on and sustain improvements through its own monitoring systems.
What inspectors found, October 2018
Hollin Knowle Residential Care Home is rated Good overall; inspectors found safe, kind and responsive care, but the home needed to improve its leadership and oversight.
This was an unannounced, comprehensive inspection on 31 July 2018. Two inspectors visited the home, where 16 people were living. They spoke with people, relatives, staff and community professionals, and checked care records, medicines, staffing, complaints, safeguarding and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found that medicines, risks, recruitment and care were generally managed safely. People were treated with kindness and dignity, received individualised care, and were supported with their health, food, activities and contact with family.
Well-led was rated Requires Improvement. The provider had made improvements since the previous inspection, including staffing, cleanliness and falls prevention. However, some improvements were made only after concerns were raised by others, and some records were not accurate or complete. The overall rating was Good, but inspectors wanted the provider to show that improvements would be found and maintained proactively.
Safe medicines management
Inspectors observed medicines being given safely and found that medicines were stored correctly. Records showed people received their medicines consistently.
“Records kept of medicines received into the home and given to people by staff, showed people received their medicines in a safe and consistent way.” from the report
Kind and respectful care
Staff supported people's dignity, privacy, independence and choices during personal care and everyday activities.
“Staff were kind, caring and promoted people's dignity, choice, independence and rights when they provided care.” from the report
Individual communication
Staff knew people well and adapted their communication to help people express choices and remain involved in daily life.
“People received individualised, timely care from staff who knew how to communicate with them in the way they understood.” from the report
Improved falls prevention
The home introduced revised falls prevention measures with help from health professionals after an increase in falls. Inspectors were told that falls had reduced.
“They [provider and staff] have been very receptive; They have followed my suggestions and instigated better checks, risk assessment and ongoing liaison with us.” from the report
Management oversight
needs fixingThe provider did not always identify problems through its own monitoring. Inspectors wanted evidence that improvements would be timely, consistent and sustained.
“However, the provider had not yet demonstrated their ability to proactively and consistently ensure sustained, timely and continued service improvement.” from the report
Incomplete records
needs fixingCleaning schedules were not always recorded accurately. Supervision records also did not accurately reflect the support staff said they had received.
“However, we found these were not always accurately maintained by staff responsible.” from the report
Further care guidance
needs fixingSome staff needed more training and guidance to support one person's emotional and behavioural needs. The person's care plan did not fully guide care in line with recognised practice.
“However, some staff felt they needed further training and guidance to ensure a more consistent approach to one person's care, relating to their emotional and behavioural needs associated with their mental health condition and type of visual impairment.” from the report
- 01How do you now check that cleaning schedules and staff supervision records are completed accurately?
- 02How are falls monitored for trends, and how does this information affect staffing and care plans?
- 03What extra training and guidance have staff received for mental health, visual impairment and dementia care?
- 04Have the broken furniture and potential trip hazard identified during the inspection been fully dealt with?
- 05How do you make sure new service improvements are identified by your own checks rather than only after concerns are raised?
This was an unannounced comprehensive inspection covering all five key questions, with ratings given for Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 26 October 2018 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, May 2017
Requires Improvement; inspectors found kind care and safer medicines, but staffing, food, activities and management needed improvement.
The inspection took place on 6 and 14 February 2017. It was unannounced on the first day and announced on the second. An inspector and a nutrition specialist spoke with people, relatives and staff, observed care, and checked care plans, medicines, training and management records.
The home was caring, and staff were kind, respectful and knew people well. Medicines were now managed safely, following problems found at the previous inspection. People were supported with their health, food and drink, but care was not always timely.
Inspectors found that staffing was not always enough for 19 people across three floors. This affected cleanliness, activities, independence, choice and personal routines. Food was sometimes delayed or not hot enough, and quality checks did not always lead to improvements.
The overall rating was Requires Improvement. Caring was rated Good. Safe, Effective, Responsive and Well-led were all rated Requires Improvement. Two regulations were breached.
Kind and respectful staff
Staff treated people with dignity and compassion. They knew people's routines, preferences and what mattered to them.
“Throughout of inspection we observed that staff were consistently kind, courteous and respectful towards people.” from the report
Medicines had improved
Problems with medicines found at the previous inspection had been addressed. Records and staff training showed medicines were given safely and as prescribed.
“This meant people's medicines were safely managed and consistently given to them as prescribed.” from the report
Support for health needs
Staff understood people's health conditions and helped them access health professionals. They followed professional advice about care, nutrition and screening.
“People were supported to access external health professionals when they needed to and staff followed any related instructions for people's care when required.” from the report
People were involved
People and relatives were consulted about care and daily routines. People could make choices about when to get up, go to bed and spend time with family.
“People and their relatives were involved and informed in the care provided.” from the report
Not enough staff at busy times
seriousThree care staff supported 19 people across three floors, while also doing other tasks. This led to delays and meant staff could not always provide individualised care.
“We found that sufficient numbers of suitably qualified, competent, skilled and experienced staff were not always deployed to ensure people's timely care.” from the report
Cleanliness was inconsistent
needs fixingInspectors found dust, debris and cleanliness problems in some shared areas, bathing facilities and bedrooms. Immediate action was taken during the inspection.
“On day one of our inspection we observed that some areas of the home were not always kept clean, well-lit or free from dust and debris.” from the report
Delays and cold food
needs fixingSome people waited too long for meals or help to eat. Food was carried on an open, unheated trolley, so it was not always at the right temperature.
“This meant people received sufficient amounts of food and drink; but not always at the correct temperature or in the manner they preferred.” from the report
Activities and independence were limited
needs fixingSome people did not receive the support they wanted to go out, attend church or take part in daily tasks. The home did not always find alternative ways to meet these wishes.
“This meant people's care was not always individualised or responsive to their assessed needs or expressed wishes.” from the report
Quality checks did not drive improvement
seriousThe home's monitoring systems did not always identify problems or make sure they were fixed. This included cleanliness, consent processes and people's choices and routines.
“We found the provider did not have wholly effective arrangements to monitor or fully ensure the quality and safety of people's care.” from the report
- 01How many care staff are now working at busy times, especially during meals, and how is this based on people's changing needs?
- 02How do you make sure meals reach people promptly and stay hot, including for people eating in their rooms?
- 03What activities and outings can my relative join, and how will you support their individual hobbies, church visits or daily living tasks?
- 04What changes have been made to improve dementia-friendly lighting, signs and the home environment?
- 05How do your quality checks now identify problems and make sure they are fixed?
This was a comprehensive inspection covering all five CQC questions, including observations, discussions with people and staff, and checks of care and management records. This explanation was written from the published report of 17 May 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 Hollin Knowle Residential Care Home
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- October 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Hollin Knowle Residential Care Home →
- May 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Hollin Knowle Residential Care Home →
- February 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 December 2010.
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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