CQC report explained · a residential care home
What the CQC found at Holmlea
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Staffing and training had improved, medicines were managed safely, and infection control arrangements were in place, although vacancies remained.
- Effective?
- Good
- Care plans, staff training, food and drink support, healthcare arrangements and consent processes were generally effective. The manager acted immediately when inspectors identified the need to link risk assessments more clearly to care plans.
- Caring?
- Good
- This question was not inspected during this visit. The previous Good rating was used to calculate the overall rating.
- Responsive?
- Good
- People had personalised care plans, communication support and access to activities and family contact. However, an outside professional said staff were not always consistent in helping one person use a communication aid.
- Well-led?
- Good
- The manager and provider had improved training checks, communication with relatives and quality monitoring. The home still relied heavily on agency staff, and staff said recruitment could take up to three months.
What inspectors found, June 2023
Dannsa House is Rated Good; inspectors found improved care and management, but staffing still relied heavily on agency workers.
This was a focused inspection on 24 and 26 May 2023. One inspector observed care, spoke with staff, relatives and outside professionals, and checked care, medicines, recruitment, training and management records.
The home was rated Good overall. Safe, Effective, Responsive and Well-led were rated Good. The Caring question was not inspected during this visit, so its previous Good rating was used.
Inspectors found that staffing, training, recruitment records and management had improved since the previous inspection. People were supported with individual care, communication, health needs, activities and family contact.
The home still had staff vacancies and relied significantly on agency workers. Inspectors also heard that communication support was not always consistent and that the recruitment process was slow.
Improved staffing arrangements
The provider had improved staffing and training since the last inspection. Regular agency staff were used to help them understand people's individual needs.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 18.” from the report
Personalised support
Care plans reflected people's individual needs, preferences and ways of communicating. Staff supported people to make choices and take part in activities.
“People had individualised care plans in place as a guide for staff on how to meet people's care needs and preferences.” from the report
Safe medicines and infection control
Inspectors found that medicines were administered, recorded and stored safely. The home was generally clean and had arrangements to prevent and manage infections.
“Medicines were safely managed. People were supported by staff who followed the provider's systems and processes to administer, record, and store medicines safely.” from the report
Learning from incidents
The provider reviewed safety arrangements after a scalding incident and worked with the local authority to investigate what happened. Learning was shared with other services.
“The provider also shared the learning from this incident with their other care homes and services, which should help to reduce the likelihood of recurrence.” from the report
Positive management
Inspectors found improved quality monitoring and better communication with relatives. Staff described the manager as supportive and responsive.
“The provider had considered the findings of our previous inspection report, and local authority quality audits, and had made improvements to the service.” from the report
Reliance on agency staff
needs fixingThe home still had staff vacancies and relied heavily on temporary agency workers. Relatives were concerned about consistency and whether staffing would be enough if another person moved in.
“Relatives told us that although the staffing situation had improved a little since our last inspection, they were still concerned that the service relied heavily on temporary agency staff.” from the report
Inconsistent communication support
needs fixingAn outside professional said staff did not always consistently help one person use a communication aid. The home tried to reduce this risk with individual communication plans.
“We feel that staff are not consistent in supporting this.” from the report
Slow recruitment process
minorStaff said the provider's recruitment process could take up to three months. This may make it harder to move agency workers into permanent roles.
“They need a new recruitment process. It can take up to three months here, and people wanting a job can't afford to wait that long.” from the report
Long one-to-one shifts
needs fixingOne relative said some staff worked long shifts providing one-to-one support, which they felt was too much for one person to manage.
“Staff often work long shifts with [person] on a 1:1 which is too much for any staff member to cope with.” from the report
- 01How many permanent, bank and agency staff currently work in the home?
- 02How do you make sure agency staff understand each person's care and communication needs?
- 03What progress has been made in reducing staff vacancies and speeding up recruitment?
- 04How will you make sure communication aids are used consistently?
- 05How are long one-to-one shifts arranged and checked to make sure staff can provide safe support?
This was a focused inspection of Safe, Effective, Responsive and Well-led, mainly to check the previous staffing Warning Notice; Caring was not inspected and its previous Good rating was carried forward. This explanation was written from the published report of 28 June 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, October 2022
Dannsa House was rated Requires Improvement; inspectors found kind care and safe medicines, but serious gaps in staff training and leadership.
Inspectors visited unannounced on 15 and 17 August 2022. They observed staff supporting four residents, spoke with 11 staff members, reviewed care, medicine and staff records, and received feedback from relatives and a healthcare professional.
The home met people's basic care needs and staff were kind, respectful and generally caring. Medicines were managed safely, risks were assessed, and the home was generally clean. However, most care staff were from agencies and had not received the specialist training needed for people's complex care and communication needs.
The provider's systems had not fixed the staffing and training problems. The home also did not have a registered manager at the time of the inspection. The overall rating changed from Good at the previous inspection to Requires Improvement, with Safe and Well-led also rated Requires Improvement.
Kind and respectful care
Staff provided kind and compassionate care and respected people's privacy and dignity. They understood people's basic physical care needs.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Medicines managed safely
Inspectors found that medicines were administered, recorded and stored safely. People received their medicines as prescribed and reviewed by their GP.
“Medicines were safely managed. People were supported by staff who followed the provider's systems and processes to administer, record, and store medicines safely.” from the report
Safeguarding arrangements
Staff had safeguarding training and knew how to recognise and report abuse. The provider had policies and processes to support this.
“People were kept safe from the risk of abuse or neglect because staff worked regularly with them and understood how to protect them.” from the report
Good healthcare links
The manager and staff worked with external healthcare professionals. This helped people receive the healthcare support they needed.
“The manager had good links with external health agencies.” from the report
Heavy reliance on agency staff
seriousMost care staff were agency workers. Regular agency staff had not received documented supervision, formal management support or competency assessments from the provider.
“The majority of care staff working at the care home at the time of the inspection were agency staff.” from the report
Activities and communication support were limited
needs fixingPeople were not always supported to pursue their individual interests outside the home or to have their say about their care. Inspectors linked this to the lack of specialist communication training.
“People were not always able to be supported by staff to pursue their individual interests outside of the care home.” from the report
- 01What specialist training have permanent and agency staff completed to support residents' complex care and communication needs?
- 02How do you check the competency of regular agency staff before they provide care?
- 03What action has been taken to reduce the reliance on agency staff and fill vacancies?
- 04Who is the registered manager now, and has their application been submitted to the CQC?
- 05How are residents being supported to take part in activities and pursue their individual interests outside the home?
This inspection rated Safe and Well-led, and included infection prevention and control; the report does not give ratings for Effective, Caring or Responsive. This explanation was written from the published report of 19 October 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 Holmlea
3 rated inspections over 3 years: the service has held its Good rating throughout.
- June 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- March 2020GoodSafe: GoodEffective: GoodResponsive: GoodWell-led: Good
- February 2019
Registered with the Care Quality Commission on 25 February 2019.
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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