CQC report explained · a nursing home
What the CQC found at Hollyfields
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2023
Hollyfields is Rated Good; inspectors found safe, kind and personalised care, with minor gaps in records and infection control.
This was an unannounced, focused inspection on 30 August 2023. Inspectors examined Safe, Responsive and Well-led after concerns about care needs, unexplained bruising and cleanliness. They spoke with people, relatives and staff, and checked care, medicines, staffing, cleanliness and management records.
The home was rated Good overall. Safe, Responsive and Well-led were each rated Good. Inspectors found people were protected from abuse, risks were assessed, medicines were given safely, staffing was sufficient and relatives felt welcomed. Care plans had improved since the previous inspection, and staff knew people's needs and preferences.
There were some small shortfalls. One repositioning support record was not completed at the time care was given. Staff had left items in a communal bathroom and further checks were being introduced for some medicine patches. Inspectors did not find evidence of the concerns that had prompted the inspection.
People felt safe
Staff understood how to recognise and report abuse. Relatives said staff knew people well and maintained their safety.
“People were protected from abuse and harm. Staff received training on, and understood, their individual responsibility to remain alert to and report abuse or neglect.” from the report
Staffing and teamwork
Inspectors found enough staff to meet people's needs without unreasonable waits. Staff worked together, and agency staff used to cover shortages knew people well.
“We saw there were enough staff and they worked as a team to ensure people did not have to wait unreasonable periods of time for assistance.” from the report
Personalised care improved
Care plans had been improved since the previous inspection, giving staff more consistent guidance about people's individual needs.
“The management team had made continual improvements to people's care plans following our last inspection.” from the report
Activities and relationships
People were supported to take part in varied activities and maintain relationships with family and friends. Relatives said they were welcome to visit whenever they wanted.
“People had support to participate in fun and interesting things.” from the report
Open management
Managers and staff worked as a team and used audits, meetings and feedback to improve the service.
“There was a positive and open culture at the home, where staff and the management team alike wanted people to receive the best outcomes in their care.” from the report
Care records were not always completed immediately
needs fixingStaff gave repositioning support to a person but did not record it at the specific time it was provided. Managers addressed this with staff.
“However, they had not documented this at the specific time the support was provided on the day of our inspection.” from the report
Some infection control practices needed strengthening
needs fixingItems including skin cream and towels had been left in a communal bathroom and shower area. They were removed immediately.
“For example, staff had not removed items such as, skin cream and towels in a communal bathroom and shower area.” from the report
Further medicine patch checks were being introduced
minorThe home had records for applying and removing medicine patches, but additional checks were still being implemented because patches can fall off.
“Further checking systems were also being implemented to monitor patches as they can be prone to falling off.” from the report
- 01How do you now make sure repositioning and other care records are completed at the time care is given?
- 02What changes have you made to stop items such as skin cream and towels being left in communal bathroom and shower areas?
- 03How are medicine patches checked after they are applied, and what happens if a patch falls off?
- 04How will you keep care plans up to date when a person's mental or emotional health needs change?
- 05How do you decide staffing levels, and how often are agency staff used?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and the overall rating partly used ratings from the previous inspection. This explanation was written from the published report of 11 October 2023 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, February 2019
Rated Good overall; inspectors found safe, kind care, but personalised care records and activities for people in their rooms needed improvement.
This was an unannounced inspection on 13 December 2018. Inspectors spoke with people living at the home, relatives and staff. They observed care and checked care records, medicines, safety records and quality checks.
The overall rating was Good. Safe, Effective, Caring and Well-led were rated Good. Responsive was rated Requires Improvement because some care records did not give staff enough detail, some monitoring records were incomplete and more sensory activities were needed for people staying in their rooms.
The home had improved its staffing arrangements since the previous inspection, so the Safe rating rose from Requires Improvement to Good. The report says there was no evidence of serious risks or concerns.
Improved staffing
Inspectors found enough staff to meet people's needs without unreasonable delays. This was an improvement from the previous inspection.
“At this inspection, although staff were busy they were available to assist people with their needs safely and without any unreasonable delays.” from the report
Kind and respectful care
Staff knew people well and supported their dignity, privacy, choices and independence.
“Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes.” from the report
Positive leadership
Relatives and staff described open communication and good teamwork. The management team used quality checks and action plans to support improvements.
“The registered manager was supported by their staff team and the provider.” from the report
Mattress checks were not consistently recorded
needs fixingStaff did not always record the actual mattress settings for two people who needed pressure-relieving mattresses. The nurse took immediate action to address this.
“Staff had not detailed the actual mattress settings to show these were being monitored and continued to meet both people's needs.” from the report
Limited sensory activity in bedrooms
needs fixingMore could have been done to provide sensory stimulation for people who mainly stayed in their rooms because of choice or health reasons.
“However, for people who mainly stayed in their rooms through choice or health reasons we found more could be done to provide people with sensory stimulation.” from the report
Medicine cream labelling
minorSome prescribed creams did not consistently show opening dates or use-by dates. Nurses reminded staff of their responsibilities.
“However, staff had not consistently ensured creams had use by dates and or dates of when they were opened.” from the report
Odour in the home
minorInspectors noticed an odour. The registered manager was aware and said action was being taken, including cleaning the carpet.
“However, there was an odour which the registered manager was already aware of and assured us they were taking actions to deal with this, such as cleaning the carpet.” from the report
- 01What changes have you made to care plans for people whose behaviour can be challenging?
- 02How do you now record and check the settings of pressure-relieving mattresses?
- 03What sensory activities can people receive in their rooms, and how are these matched to their preferences?
- 04How do you make sure prescribed creams show both their opening date and use-by date?
- 05What action was taken about the odour, and has it been checked since the inspection?
This was an unannounced inspection that considered all five CQC questions, including care, records, medicines, staffing, safety and management. This explanation was written from the published report of 16 February 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.
Every inspection of Hollyfields
4 rated inspections over 8 years: the service has held its Good rating throughout.
- October 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2019Goodstayed GoodSafe: GoodResponsive: Requires improvementWell-led: Good
- April 2017Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 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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