CQC report explained · a nursing home
What the CQC found at Little Holland Hall
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Recruitment checks, risk assessments, medicines systems and infection-control arrangements were found to be effective.
- Effective?
- Good
- Staff received relevant induction and training, and people were supported with nutrition, swallowing needs and access to health professionals. Staff said they wanted more substantial training and that supervision was not regular.
- Caring?
- Good
- Inspectors observed warm, respectful relationships. People were involved in choices about their routines, care and meals, and their privacy and independence were respected.
- Responsive?
- Good
- Care was planned around people's needs, communication and preferences. The home supported activities, family relationships and end-of-life care, although some staff raised concerns about having enough time for social contact.
- Well-led?
- Good
- The home had a positive, person-centred culture and systems for checking quality and learning from incidents and feedback. The manager used meetings, surveys and an open-door approach to involve people and staff.
What inspectors found, January 2020
Little Holland Hall was rated Good; inspectors found kind, safe and personalised care, with some staff concerns about activity time, training and supervision.
Inspectors visited on 30 October and 19 November 2019. The visit was unannounced and included speaking with people, relatives and staff, as well as checking care, medicine and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were treated with kindness, received personalised care, had their medicines managed safely and were supported to keep relationships and access health services.
There were some areas to watch. Staff said there was not always enough time for activities and social contact, some wanted more substantial training, and supervision was not regular. Inspectors also noted limited storage and that some bedrooms were small for moving equipment.
The overall Good rating means the inspectors found the home was meeting the expected standards at the time of this inspection. The previous inspection, published in April 2017, was also rated Good.
Kind and respectful care
People and relatives were consistently positive about staff. Inspectors observed compassionate relationships and found that people's privacy, dignity and choices were respected.
“Staff had developed positive and caring relationships with people and they showed them warmth, understanding and kindness.” from the report
Safe medicines support
Medicines were stored securely, records were completed correctly and staff were trained and checked as competent. A new electronic system supported daily checks.
“People received their prescribed medicines as they should.” from the report
Good mealtime support
People were offered choices and supported to eat at their own pace and with dignity. Staff responded to nutritional and swallowing risks with advice from health professionals.
“The meal time experience was a very calm social event.” from the report
Personalised end-of-life care
The home worked with hospice, palliative care and GP services. People's end-of-life wishes and family involvement were recorded, and families were given bereavement information.
“The service had developed a bereavement guide for families which held information for relatives following a death of their family member.” from the report
Time for activities and social contact
needs fixingSome staff said there was not always enough activity time to meet everyone's social needs each day. This could leave people who spent much of their time in bed at risk of isolation.
“There was not always enough time to spend talking and reading to them.” from the report
Staff development and supervision
needs fixingStaff said they wanted more substantial training, including end-of-life care training. They also said formal supervision was not regular, although the manager said regular supervision was being introduced.
“Staff told us, supervision or formal support was not a regular arrangement and was mostly received if they had done something wrong.” from the report
Storage and bedroom space
minorThe home did not have enough storage, making it difficult to keep areas uncluttered. Some bedrooms were small, which made it harder to move equipment.
“There wasn't enough storage facilities and staff told us it hard to declutter the home.” from the report
- 01How do you make sure people who spend much of their time in bed receive enough conversation, reading and activities each day?
- 02What substantial training, including end-of-life care training, have staff received since the inspection?
- 03How often do staff now receive formal supervision and support?
- 04Have storage problems and difficulties moving equipment in smaller bedrooms been addressed?
- 05How are the new electronic medicines records checked and any medicine errors followed up?
This was an unannounced, planned inspection covering all five CQC questions, including both the care provided and the premises. This explanation was written from the published report of 1 January 2020 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 2017
Rated Good; inspectors found safe, kind and personalised care, but shared lounge and dining spaces felt crowded.
This was an unannounced inspection carried out on 16 December 2016 and 13 January 2017. Inspectors spoke with people living at the home, relatives, staff and managers. They reviewed care records, medicines records, risk assessments, staff files, complaints and quality checks.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough suitably recruited staff, safe medicines systems, appropriate care planning and staff who understood people's needs and preferences.
People were treated kindly and with dignity. They were supported to make choices, take part in activities and keep in touch with family and friends. Inspectors also found an open management team that listened to feedback and used audits and meetings to make improvements.
The main issue raised was that the lounge and dining room were small for the number of people using them, particularly people using wheelchairs or specialist chairs. The provider was asked to consider how the shared spaces could be made more comfortable.
Enough skilled staff
Inspectors found enough staff and safe recruitment processes. Staff had the training, induction and support needed for their roles.
“There were sufficient staff who had been recruited safely and who had the correct skills and knowledge to provide care and support in ways that people preferred.” from the report
Safe medicines
Medicines were stored securely and records showed that administration procedures were followed. Checks and guidance were in place for medicines needing extra care.
“Systems and procedures for supporting people with their medicines were followed, so people received their medicines safely and as prescribed.” from the report
Kind and respectful care
Staff knew people well and responded to distress in a caring way. Inspectors saw friendly interactions and found that privacy and dignity were respected.
“During our inspection we observed that staff were kind, polite and helpful.” from the report
Personalised activities and choices
The home recorded people's histories, interests and preferences to guide activities and daily support. People could make requests and were supported to maintain important relationships.
“Staff understood people's interests and encouraged them to take part in pastimes and activities that they enjoyed.” from the report
Open management
Managers were visible and approachable. The home collected views through meetings and surveys, then used audits and improvement plans to act on issues.
“There were systems in place to monitor the quality of the service, to obtain people's views and to use their feedback to make improvements.” from the report
Crowded shared spaces
minorThe lounge and dining room were considered too small for the number of people using them. Wheelchairs and specialist chairs made movement difficult and created a crowded atmosphere.
“The provider should consider how they could improve the environment so that people wishing to use communal areas had a better and more comfortable experience.” from the report
- 01What has been done to make the lounge and dining room less crowded and easier to use for people with wheelchairs?
- 02How do you check that there are enough staff when people's needs change or new people move in?
- 03How are relatives involved in monthly care plan meetings and decisions about their family member's care?
- 04How do you make sure activities reflect each person's interests, history and preferences?
- 05How are concerns, complaints and suggestions recorded and followed up?
This was an unannounced comprehensive inspection of the overall service, covering all five CQC questions, on 16 December 2016 and 13 January 2017. This explanation was written from the published report of 28 April 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 Little Holland Hall
2 rated inspections over 3 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 6 December 2010.
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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