CQC report explained · a nursing home
What the CQC found at Hollybank House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found enough staff, safe medicines systems, regular risk reviews and effective infection control.
- Effective?
- Good
- This area was not rated in this inspection report. Inspectors did record that staff worked with health and social care professionals to manage people's health.
- Caring?
- Good
- This area was not rated in this inspection report. People, relatives and professionals gave positive feedback about the kindness of staff and the person-centred approach.
- Responsive?
- Good
- This area was not rated in this inspection report. Inspectors said people's needs and preferences were considered, and feedback was used to make improvements.
- Well-led?
- Good
- The home had a positive culture, open communication and effective quality checks. People, relatives and staff felt able to raise concerns and suggestions.
What inspectors found, January 2024
Hollybank House is rated Good; inspectors found safe, caring and well-managed support, with no registered manager in post at the time.
This was an unannounced inspection on 28 and 29 November 2023. Inspectors spoke with people, relatives, staff and health and social care professionals. They observed care and checked care records, medicines, staff training and quality checks.
The home was rated Good overall. Safe and Well-led were both rated Good. Inspectors found enough staff, safe medicines practice, clean surroundings and suitable checks for risks. People and relatives said they felt safe and listened to.
The service had a positive and caring culture. Staff knew people well and worked with other professionals to support their health. The inspection only gave ratings for Safe and Well-led. The other three areas were not rated in this report.
Enough staff
Inspectors found enough staff to meet people's needs, including when people needed help with eating, reassurance or activities. Staff turnover was described as low, helping staff know people well.
“There were enough staff to keep people safe.” from the report
Safe medicines
Medicines were stored, given and recorded safely. Staff were trained and checked as competent, including in the use of medicines given when needed.
“People received their prescribed medicines safely.” from the report
People felt safe
People and relatives said they felt safe. Staff knew how to recognise and report abuse and felt able to speak up.
“People felt safe living at Hollybank House, and relatives also felt their family members were supported safely.” from the report
Open management
People, relatives and staff felt able to raise concerns or suggest improvements. The provider used audits and feedback to identify and act on changes.
“People and relatives told us they felt able to raise concerns or make suggestions for improvement and felt confident they would be listened to.” from the report
End of life care
Inspectors noted a team approach to end of life care and positive feedback from professionals. The provider had received a local award recognising this work.
“The whole staff team approach to end of life care meant people and their relatives could be assured of a compassionate person-centred approach at this most difficult time.” from the report
No registered manager
minorThere was no registered manager in post when inspectors visited. The manager had applied to register, and the application was still being assessed.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01Has the manager's application to become registered been approved, and who is currently responsible for the service?
- 02How are staffing levels reviewed when people's needs change?
- 03What actions have been taken to reduce falls and the risk of pressure sores?
- 04What refurbishment work has been completed since the June 2023 feedback about the décor?
- 05How are relatives involved in care planning and decisions about end of life care?
This inspection rated Safe and Well-led only; Effective, Caring and Responsive were not rated in this report. This explanation was written from the published report of 26 January 2024 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, October 2017
Rated Good; inspectors found kind, safe care, but consent arrangements and some records needed improvement.
Inspectors visited on 7 and 12 September 2017. The first visit was unannounced. They spoke with people, relatives, staff and health professionals, observed care, and checked care, medicine, staffing and quality records.
The home was rated Good in all five areas. People were described as safe, cared for with dignity, supported by trained staff, helped to access healthcare, and offered activities suited to their interests.
There were important shortfalls. The home could not always show that relatives had the legal authority to consent for people who lacked capacity. Checks and records for pressure mattresses, fluid intake and topical medicines were also not always reliable. The manager took immediate action during the inspection.
The home had previously been rated Requires Improvement in May 2016. Inspectors found that improvements had been made and that the service met the requirements of the regulation breached at that time.
Kind and respectful care
Staff knew people well and treated them in a patient, friendly and respectful way. Inspectors saw staff protect people's dignity and privacy.
“During our inspection, staff supported people in a caring, friendly and respectful way.” from the report
Safe staffing and risk management
Inspectors found enough staff to provide personal and nursing care. Individual risks were assessed, reviewed and managed.
“People were protected from the risk of avoidable harm.” from the report
Skilled staff and healthcare
Staff received training and supervision, and people were supported to access health and social care professionals when needed.
“This enabled staff to monitor people's health and ensure they accessed health and social care services when required.” from the report
Meaningful activities
The home supported people to continue their hobbies and interests through group and individual activities.
“This meant people were supported to remain active and participate in activities that were meaningful to them.” from the report
Improvement since the previous inspection
The home had been rated Requires Improvement in May 2016. Inspectors found that the earlier regulatory problems had been addressed.
“On this inspection, we found that improvements had been made, and the service now met all requirements of the relevant regulation.” from the report
Consent and legal authority
seriousThe home could not consistently show that relatives had the correct legal authority to consent for people who lacked capacity. The manager took action during the inspection, but people's rights were at risk before this was addressed.
“The provider could not demonstrate the relatives had the correct legal authority to consent on behalf of people.” from the report
Pressure mattress checks
seriousTwo pressure mattresses were set at the wrong pressure for people's weight. Staff said there were no regular checks to ensure the settings were correct.
“We found two pressure mattresses which were not set at the correct pressure for people's weight.” from the report
Incomplete care records
needs fixingFluid intake was not always recorded where monitoring was needed. Records for prescribed topical medicines were also not consistently completed.
“We also identified that record keeping for people's prescribed topical medicines were not consistently completed.” from the report
Care review discussions not recorded
minorPeople and relatives said they were involved in care discussions, but the home did not always record that involvement. This created a risk that people's views and wishes were not documented.
“We found this involvement was not always recorded.” from the report
- 01How do you now check that consent decisions for people who lack capacity are made lawfully?
- 02How often are pressure-relieving mattress settings checked, and where are those checks recorded?
- 03How do you make sure fluid intake is recorded whenever a person's care plan says monitoring is needed?
- 04How are topical medicines recorded and checked for completion?
- 05How do you record people's and relatives' involvement when care plans are reviewed?
This was an overall inspection covering all five CQC questions, following a Requires Improvement rating in May 2016. This explanation was written from the published report of 14 October 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 Hollybank House
3 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- January 2024Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2017Goodup from Requires improvementSafe: GoodWell-led: Good
- September 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- February 2012
Registered with the Care Quality Commission on 9 February 2012.
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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