CQC report explained · a nursing home
What the CQC found at Holly Lodge Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2019
Holly Lodge Nursing Home was rated Good; inspectors found safe, kind and personalised care, with improvements in food and nutrition since the previous inspection.
This was an unannounced inspection on 30 November 2018. Inspectors spoke with people living in the home, relatives and staff. They observed care and mealtimes, and checked care plans, staff records, medicines and quality checks.
The home was supporting 57 people, including people living with dementia and physical health needs. Inspectors found suitable staffing, safe medicines systems, regular risk checks and clean surroundings. Staff were described as kind, respectful and knowledgeable about people's needs.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. At the previous inspection, Effective had needed improvement because dietary needs and preferences were not always met. Inspectors found this problem had been addressed.
Safe staffing
Inspectors saw enough staff on duty and found that requests and call bells were answered promptly. Recruitment checks and staff training were also in place.
“We observed there were enough staff on duty and deployed throughout the home to meet people's care and support needs promptly.” from the report
Kind and respectful care
Staff knew people well and supported their dignity, privacy, independence and choices. Relatives were involved and welcomed.
“Throughout our inspection we observed people were treated with kindness and respect and received compassionate emotional support from staff when required.” from the report
Improved nutrition
The earlier shortfall in meeting dietary needs had been addressed. People were offered choices and received special diets and support when needed.
“At this inspection we found that people's dietary needs and preferences were met and respected and people received their meals and support where required promptly.” from the report
Personalised care
Care plans covered people's health, preferences, routines and communication needs. Staff used up-to-date information to respond to changes.
“Staff used portable electronic devices to update people's care plans and we saw that care plans were updated instantly and accurately to reflect people's needs at that time.” from the report
Strong leadership
The home had an open culture, good teamwork and regular checks on care, medicines, training, accidents and other areas.
“There were well-led governance arrangements in place to monitor, assess and improve the quality of the service.” from the report
Mattress condition
needs fixingInspectors found two foam mattresses that were damaged and had a bad smell. The home replaced them immediately and introduced regular checks afterwards.
“We conducted a random check of foam mattresses and found that two mattresses were breached and malodorous.” from the report
Accessible toilets
needs fixingTwo communal toilets labelled as accessible had limited turning space and no handrail on the back of the door. The home said refurbishment was planned.
“There was little turning space and no handrails on the back of the toilet door which made it difficult to close once inside.” from the report
- 01What regular checks are now carried out on all mattresses, and how are problems recorded and acted on?
- 02Has the planned refurbishment made the two communal toilets fully suitable for wheelchair users?
- 03How will you record and review my relative's food preferences, allergies and any special diet?
- 04How are relatives involved when a person's care needs or care plan changes?
- 05What activities and communication support would be available for a person living with dementia?
This was an unannounced comprehensive inspection covering all five CQC questions and the overall quality of the home. This explanation was written from the published report of 24 January 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
Holly Lodge Nursing Home was rated Good overall; inspectors found safe, kind care, but food support was not consistently suitable.
Inspectors made an unannounced visit on 7 November 2016. They spoke with people, relatives, staff and a healthcare professional. They also observed care and checked care plans, medicines, risk assessments, complaints and recruitment records.
The home was rated Good for Safe, Caring, Responsive and Well-led. Inspectors found enough staff overall, safe medicines systems, kind and respectful care, detailed care plans, activities and systems for handling complaints.
Effective was rated Requires Improvement. Some people were given food that did not match their dietary needs or preferences. Some people also waited for up to, or over, an hour for meals. The report records one breach relating to person-centred care.
Kind and respectful staff
Inspectors saw staff speaking gently, showing patience and supporting people's choices and independence. People were treated with dignity and privacy.
“Individual staff interacted with people in a kind, caring and compassionate manner.” from the report
Safe medicines
Medicines were stored securely and administration records had no gaps. Guidance was available for medicines given when needed.
“Safe medicines management systems were in place and people received their medicines in line with their prescriptions.” from the report
Personalised care
Care plans recorded people's preferences, histories and support needs. Staff were able to describe people's interests and routines.
“People's care plans recorded people's likes, dislikes and preferences.” from the report
Health support
People could see doctors and other healthcare professionals when needed. Staff acted when people's health or mobility changed.
“People were supported with their healthcare needs and had access to a range of healthcare professionals.” from the report
Food did not always match needs
seriousSome people received pureed food when their records said they needed a soft diet. One person was given food they did not like, and the report says dietary needs and preferences were not always met.
“People's dietary needs and preferences were not respected by staff.” from the report
Long waits for meals
needs fixingSome people waited for up to, or over, an hour for their meals because staff were helping others. Inspectors also saw people eating cold food or waiting without support.
“We observed people waiting for up to and over an hour to receive their meals, well after others had finished, as staff were assisting other people.” from the report
Records were difficult to rely on
needs fixingSome care records were hard to read, difficult to navigate or not fully completed. This made it harder to identify the most up-to-date care instructions.
“Records were not always maintained accurately and when changes were recorded or reviews undertaken it meant it was not always easy to identify the most up to date information in relation to people's care needs.” from the report
Some capacity decisions lacked detail
needs fixingCapacity assessments were not always linked to specific decisions, such as bed rails or a wheelchair lap belt. Some best-interest decisions were not recorded.
“However there was no evidence of best interest decisions being discussed for this person.” from the report
- 01How do you make sure each person's required food texture, dietary needs and food preferences are followed at every meal?
- 02What staffing arrangements are now used at lunchtime, and how do you monitor waiting times for meals?
- 03How are specific capacity assessments and best-interest decisions recorded for equipment, restrictions and medicines given covertly?
- 04How have care records been made easier to read, navigate and keep up to date?
- 05How do you check that staff supervision takes place at the intervals set out in your policy?
This was an unannounced inspection covering all five CQC questions and the overall rating; the previous inspection in February 2014 had found no concerns. This explanation was written from the published report of 25 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 Holly Lodge Nursing Home
2 rated inspections over 2 years: the service has held its Good rating throughout.
- January 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2017GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 5 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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