CQC report explained · a residential care home
What the CQC found at Hoylands House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2023
Requires Improvement; inspectors found staffing, training and management weaknesses that increased the risk of harm.
This was an unannounced inspection after concerns were received about staffing, training and management. Inspectors visited on 22 November and 1 December 2022. They spoke with relatives, staff and professionals, observed care, and checked care, medicine, recruitment and management records.
The home was not always safe or effective. There were periods when too few staff were available, which limited people's activities and opportunities to go out. Some staff had not completed required training, including training linked to first aid and supporting autistic people.
Inspectors found good practice in medicines, infection control, safeguarding, health support and the home environment. However, management systems had not made sure improvements happened quickly enough. The overall rating fell from Good at the previous inspection to Requires Improvement.
Safeguarding
Staff knew people well and understood how to protect them from abuse. Risks were assessed and managed, with restrictions used only as a last resort.
“People were kept safe from avoidable harm. Staff knew them well and understood how to protect them from abuse.” from the report
Health support
Staff worked with health professionals and made referrals when needed. Health action plans and communication support assessments were in place.
“Staff supported people to stay healthy and referred people to other healthcare professionals as required.” from the report
Not enough staff
seriousRotas showed that staffing was below the assessed level at times. This limited people's activities and meant some people had to wait before going out.
“There was not always enough staff to keep people safe.” from the report
Gaps in training
seriousSome staff lacked required training. One agency worker involved in restraint had not completed the required training, although the provider took immediate action afterwards.
“Training records showed gaps in staff training. For instance, 5 staff had not completed training in first aid” from the report
Weak management checks
seriousThe systems used to monitor safety and make improvements were not robust enough. Inspectors said this placed people at risk of harm.
“Systems were either not in place or robust enough to demonstrate safety was effectively managed. This placed people at risk of harm.” from the report
Limited choices at times
needs fixingStaff supported people to make choices, but staffing shortages and a lack of specialist training sometimes reduced the choices and activities available.
“People were involved in decisions about what to do throughout the day, although their choices were sometimes limited due to low staff numbers.” from the report
- 01How many staff are normally on duty for each part of the day, and how often has the home been below that level recently?
- 02What training has every permanent and agency worker completed, especially in autism, positive behaviour support, restraint, first aid and communication?
- 03What has changed since the inspection to make sure people can attend planned events and go out when they want to?
- 04How does management now check that safety problems are identified and fixed promptly?
- 05What action was taken after the restraint incident involving an agency worker, and how is this checked now?
This was a focused inspection of Safe, Effective and Well-led; the Caring and Responsive ratings were not inspected and the overall rating changed from Good to Requires Improvement. This explanation was written from the published report of 12 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, December 2018
Rated Good; inspectors found safe, kind and person-centred care, but the rating fell from Outstanding and some cultural and best-interest decisions needed attention.
This was an unannounced inspection on 23 and 31 October 2018. Inspectors observed care, looked around the building, checked records and staff recruitment files, and spoke with relatives, staff and managers.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough suitably recruited staff, safe medicines arrangements, detailed care plans, kind support and a wide range of activities.
There were two notable shortfalls. A best-interest decision had not been reviewed after a relative asked for cultural and religious needs to be considered. One person's religious dietary needs had also not been provided. The service was given recommendations about these issues.
At the previous inspection in December 2015, the service was rated Outstanding. This inspection found a good standard, but not enough consistent evidence to keep the higher rating in Caring and Responsive.
Enough trained staff
Inspectors found staffing levels were based on people's needs. Staff had relevant training, regular supervision and support to carry out their roles.
“There were enough staff to provide people with the care and support they needed and to keep the home clean.” from the report
Safe medicines and risk management
Medicines were stored and given safely. Risk assessments gave staff guidance on supporting people consistently and reducing identified risks.
“Medicines were stored, managed and administered safely.” from the report
Kind, respectful care
Staff knew people well and supported them with patience and respect. Inspectors saw privacy and dignity being maintained.
“We saw staff treated people with kindness and patience and knew people well.” from the report
Personalised support and activities
Care plans described people's communication, preferences, triggers and goals in detail. People had access to activities at the home and in the community.
“Each person's care plan was specifically designed around their needs, goals and aspirations and reviewed regularly by the managers and support staff.” from the report
Supportive leadership
Families and staff spoke positively about the management team. The home had regular meetings, handovers and quality checks.
“We found the registered manager open and committed to making a genuine difference to the lives of people living at the service.” from the report
Best-interest decisions not fully reviewed
needs fixingOne best-interest decision from 2013 had not been updated after a relative raised cultural and religious needs in 2015. Inspectors recommended seeking guidance on when these decisions should be reviewed.
“However, best interest decisions were not kept up to date.” from the report
Religious dietary needs missed
needs fixingOne person's request for food linked to their religion had not been taken into account, and the person had not been provided with halal food. Inspectors said the home needed to improve how it promoted religious rights.
“We found one person's diet which has restrictions due to his religion had not been provided as this person should only have halal food.” from the report
Audits missed these issues
minorThe home's monitoring systems had not picked up the problems with best-interest decisions and cultural needs.
“However, we found the audits had not identified the issues around best interest decisions and meeting cultural needs.” from the report
- 01How are best-interest decisions reviewed now, and how will you involve the person and their relatives?
- 02How do you record and check each person's religious, cultural and dietary requirements?
- 03What action did you take to make sure the person who needed halal food received it?
- 04How do your audits now check that cultural needs and best-interest decisions are being followed?
- 05How will you support my relative to choose activities, outings and ways to communicate their preferences?
This was an unannounced inspection of all five quality areas, including the building and care provided; inspectors reviewed three people's care records and three staff recruitment files. This explanation was written from the published report of 11 December 2018 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 Hoylands House
3 rated inspections over 7 years: the service has slipped, from Outstanding to Requires improvement.
- January 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2018Gooddown from OutstandingSafe: GoodEffective: GoodWell-led: Good
- March 2016OutstandingSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Good
- July 2013
Report published without a new overall rating.
- December 2012
Registered with the Care Quality Commission on 13 December 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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At least 99 live-in carers within about an hour of Barnsley
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 82 can care for a couple. 12 years' experience on average.
“Carla has been a god send with the implementation of bringing mum back home from respite care.”
“Ivy was very kind and gentle in all her dealings with my late mother. They got on very well and were able to share a joke and a laugh.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.