CQC report explained · a residential care home
What the CQC found at Hollymount Residential and Dementia Care Centre
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines were not always given or recorded safely, and storage problems were found. Staff views about staffing levels were mixed, although people said call bells were answered quickly.
- Effective?
- Good
- People's needs and dietary requirements were assessed and supported. Staff had training and supervision, and the Mental Capacity Act was being applied.
- Caring?
- Good
- People and relatives said staff were caring. Inspectors observed staff treating people patiently, with dignity and respect, and supporting their choices.
- Responsive?
- Good
- Care plans reflected people's preferences and social history. Activities, end of life planning and complaint arrangements were in place.
- Well-led?
- Requires improvement
- Audits did not identify important medicines and infection control risks. Staff gave mixed views about management, although surveys, meetings and partnership working were taking place.
What inspectors found, January 2023
Rated Requires Improvement; inspectors found kind, personalised care but unsafe medicines management and weak oversight.
This was an unannounced inspection on 3 November and 8 December 2022. Inspectors spoke with people, relatives and staff. They reviewed medicines, care records, staff records and management information, and toured the building.
The home was rated Good for Effective, Caring and Responsive care. People said they felt safe, were treated with dignity, enjoyed the food and could choose how they spent their time. Care plans, activities, healthcare support and complaint arrangements had improved.
The overall rating fell from Good to Requires Improvement. Medicines were not always given or recorded safely, including one person missing six days of a medicine. Audits had not found these problems. The home was also rated Requires Improvement for Safe and Well-led.
Kind and respectful care
People and relatives were positive about the care. Inspectors saw staff being patient and caring, and staff understood people's preferences.
“People were treated with dignity and respect and had choices over their care.” from the report
Personalised care plans
Care plans included people's likes, dislikes, social history and relationships. This was an improvement since the previous comprehensive inspection.
“They reflected likes and dislikes of people and important social history and relationships.” from the report
Choice and wellbeing
People had choices about their routines, meals and activities. The home worked with health professionals and planned for end of life care.
“People were supported to have maximum choice and control of their lives” from the report
Activities and relationships
Activities were taking place in the home and in the local community. People could choose whether to join in.
“During the inspection, the activity worker was supporting residents to participate in events in the local community.” from the report
Medicines were not safe
seriousMedicines were sometimes given late or not as prescribed. Records had gaps, one person missed six consecutive days of a medicine, and staff competency checks were not recorded.
“Medicines were not managed safely. This placed people at risk of harm.” from the report
Staffing pressures
needs fixingStaff gave mixed views about staffing. One concern was that people sometimes missed breakfast because there were not enough staff available at the time.
“It's not good at the minute. Staff ring in sick last minute and there isn't enough staff… some people miss breakfast because we haven't got around to them.” from the report
Weak quality checks
needs fixingManagement audits did not identify problems with medicines and infection control. The provider said a new electronic auditing system was being introduced.
“Systems and audits were in place although they were not always effective at identifying risks.” from the report
Infection control and repairs
needs fixingSome items were stored in ways that could increase cross-contamination. Parts of the building needed repair, although the provider said immediate action and renovation work were underway.
“Infection Prevention and Control practices were not robust.” from the report
- 01What changes have you made to ensure every medicine is given at the prescribed time and recorded correctly?
- 02How do you check that every member of staff who gives medicines is competent?
- 03What staffing tool do you now use to take account of the building layout and people's changing needs?
- 04What has the new electronic audit system found since the inspection, and what actions have followed?
- 05Have all the reported repairs, storage changes and flooring work been completed?
This unannounced inspection looked at all five CQC questions and included medicines, care, staffing, infection control, the building and management systems; the previous comprehensive inspection was on 15 April 2020. This explanation was written from the published report of 20 January 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, April 2022
Hollymount Residential and Dementia Care Centre is rated Good; inspectors found people felt safe and received kind, effective care, while some safeguarding and engagement work still needed.
This was an unannounced focused inspection on 9 and 10 March 2022. Inspectors looked at Safe, Effective and Well-led. They spoke with seven people, four staff and a visiting professional, and checked care, medicine, recruitment and management records.
The home was rated Good in all three areas inspected. People said they felt safe and were happy. Staff were available, medicines were managed safely, staff had suitable training, and people were supported with meals and healthcare.
The inspection followed concerns about safeguarding incidents. Inspectors found no evidence that people were at risk of harm from this concern during the inspection. The manager had identified common themes and was taking action, but one skin-check record had not been completed effectively.
The overall rating stayed Good, as the two key questions not inspected carried over their previous ratings. Inspectors also identified work to improve dementia-friendly stimulation, regular meetings and the use of survey results.
People felt safe
People told inspectors they felt safe and were happy living in the home.
“People told us they felt safe living in the home and were happy living there.” from the report
Safe medicines
Medicines were administered by trained staff, with suitable records and guidance where medicines were given covertly.
“Medicines were safely managed. Staff responsible for administering medicines were competent and had received appropriate training.” from the report
Staff support
Staff said they received inductions, training, supervision and appraisals, and felt supported by the manager.
“Staff told us they felt well supported by the registered manager and that she was visible and approachable within the service.” from the report
Food and nutrition
People enjoyed the meals, were offered choices and received support with their nutritional needs.
“People told us they enjoyed the meals and there was a calm relaxed atmosphere in the dining room.” from the report
Learning from incidents
The manager recorded learning from accidents and incidents and shared it with staff to reduce the chance of repeat problems.
“The registered manager had learned lessons from incidents where things had gone wrong.” from the report
Safeguarding follow-up
needs fixingThe inspection was prompted by concerns about several safeguarding events. The manager had identified themes and was taking action, but inspectors were told that investigations still needed to be completed.
“Concerns had been raised around the number of recent safeguarding events at the service and the local authority had convened meetings to discuss these.” from the report
Skin-check records
needs fixingOne incident involved a staff member not recording skin-integrity checks effectively. The manager agreed to make staff responsibilities clearer.
“However, we were made aware that of one incident where a staff member had not effectively documented skin integrity checks.” from the report
Dementia stimulation
minorThe environment had improved, but inspectors said more could be done to adapt it for people living with dementia and provide stimulation.
“The provider had made some improvements to the environment to meet the needs of people in the home, including those living with dementia and agreed to further develop this so that people were more stimulated.” from the report
Regular meetings and surveys
needs fixingResident and staff meetings had not always happened regularly. Quality survey results had not yet been collated into action plans.
“However, regular resident and staff meetings had not always been taking place and this was raised as an issue with the registered manager who assured us that these would be re-instated on a more regular basis.” from the report
Comfort and repositioning
needs fixingOne person had been sitting in an uncomfortable chair for several hours. The manager acted promptly after inspectors raised it, and the electronic system had flagged the issue.
“We spoke to one person who told us they had been sitting in an uncomfortable chair for several hours.” from the report
- 01What action has been completed in response to the recent safeguarding events, and how are investigations and learning now recorded?
- 02How do you check that staff complete skin-integrity checks properly and act on any changes?
- 03What dementia-friendly changes and activities are now available to provide more stimulation?
- 04Have regular resident and staff meetings restarted, and how can my relative raise concerns between meetings?
- 05What actions resulted from the latest quality survey findings?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward into the overall rating. This explanation was written from the published report of 1 April 2022 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 Hollymount Residential and Dementia Care Centre
6 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- January 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Hollymount Residential and Dementia Care Centre →
- April 2022Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
Read what inspectors found at Hollymount Residential and Dementia Care Centre →
- July 2021GoodSafe: GoodEffective: GoodWell-led: Good
- November 2020Inspected but not ratedSafe: Inspected but not rated
- April 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 13 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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