Hollie Hill Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The service was safe and has been rated good. We received mixed feedback about the level of staffing at the service. Some staff felt staffing levels at times were unsafe. We discussed with the management team about deployment, use of agency and recruitment and they confirmed they would review this immediately and feedback to the staff team. During our visits, we observed care wasn’t rushed, peoples’ needs were met, and we did not hear call bells ringing for long periods. People told us they received their medicines on time and we saw medicines were managed and administered safely. The service was clean, well maintained and staff followed good infection control practice. Recruitment was carried out safely and staff supervision and training were in place. Due to changes in home management, the supervision programme was not up to date but an action plan was in place to address this.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People we spoke with said they felt safe living at Hollie Hill. One relative told us their relation was moved from their room as there was a problem with the wall and then moved back without delay.

Professionals we spoke with told us the service was responsive and responded to concerns or safeguarding issues raised without delay. Staff members we spoke to told us how incidents were recorded on the system and any learning or actions for the service were communicated via handover and in communication books.

Systems were in place to identify any lessons learnt and take appropriate action. We tracked an incident and saw it had been reported to CQC and safeguarding. There was communication for staff to increase their observations and records reflected this had taken place. We saw that forums such as clinical governance and health and safety committees were in place but had not run consistently during 2024 due to management changes. There was a plan in place to re-establish these going forward.

People told us they felt safe. Relatives we spoke with also said they felt their relations received safe care. Relatives told us the provider contacted them immediately if there were any issues with their relations.

All staff we spoke with confirmed they knew how to raise a concern and were confident to do so. One staff member told us the manager was responsive to issues, “She's been quick to react to things though. A SALT assessment was done that a lady needed to be at 90 degrees for eating, her chair was not suitable and she was slipping out. The manager dealt with it immediately and a suitable chair was delivered the next day. Anything I have asked for she hasn't hesitated."

We spoke with four professionals who visited the service regularly and all said they had confidence the service responded positively to safeguarding. One social worker said, “I have known that safeguardings have been raised in the past, but they have been dealt with and addressed.”

We saw that safeguarding incidents were actioned and managed appropriately. We saw in one person’s care records they had an unexplained bruise. We saw the service recorded this on their incident reporting system, a photo was taken, the concern was reported to the family and a safeguarding alert was raised. We also spoke with a family member who confirmed this had taken place and they were very happy with how this had been managed.

People we spoke with said they felt safe and that that staff were kind towards them. One person told us, “The staff are very caring and always very mindful in how they move me carefully.”

Staff had completed training in safeguarding and mental capacity and were aware of how to identify and report any concerns. Staff said they were confident the management team would take the appropriate action in relation to any concerns.

Staff were caring and spoke with people in a respectful and dignified manner. They had a good understanding of people’s needs and how to promote and maintain their safety, for example by using appropriate equipment to ensure people safely mobilised.

Systems and processes were in place to safeguard people from the risk of harm. Relevant policies and procedures were in place including safeguarding, raising concerns, freedom to speak up and mental capacity. Appropriate applications and authorisations were in place in relation to Deprivation of Liberty Safeguards (DoLS).

People we spoke with told us they were supported to make choices about risk and that their wishes were respected.

Staff raised with us that they felt agency staff were not always aware of risk factors relating to people with specific dietary needs. We reviewed this with the home’s management and saw of 3 incidents which had taken place, one was from an agency staff who immediately recognised they had not followed the person’s food passport instructions and reported this to management and safeguarding. We did see food passports detailing peoples' nutritional needs were in place in people’s rooms and one of the nursing team told us how new agency staff were inducted regarding emergency procedures.

We observed that risks were managed well and people were encouraged to do tasks for themselves where they were able.

Risk assessments were generally in place. For changes in people’s needs, communication was good regarding handovers but records did not always reflect risk and how the service was supporting people to remain safe.

People we spoke with said their rooms were kept clean and were well maintained. People also told us that their equipment was checked to ensure it was working safely.

Staff had received training around adopting safe working practices and following best practices guidance. Staff told us they had access to all the appropriate equipment they needed.

We observed staff using equipment safely and confidently and ensuring people were moved gently and with care.

The manager made sure staff had received training to support people with equipment, which included how it was cleaned, calibrated and safe. They understood what risk assessments were needed to make sure staff followed health and safety guidance. As the home provided 10 beds to people on short stay who were coming from hospital for rehabilitation before going home, the staff team worked closely with OT and physio support to encourage people to regain their independence with the use of equipment where needed.

People we spoke with stated they sometimes felt there wasn’t enough staff. One person said, “There are a lot of agency staff and if someone is off then its agency. There isn’t always enough staff. I don’t really need to wait a long time if I ring my buzzer. It’s not a great problem.” Relatives also raised concerns and comments included, “The agency staff are a nightmare as they don’t know what they are doing” and “There isn’t enough staff on this floor.”

Staff all raised with us that the use of agency had an impact on how care and support was provided. One staff said, “It’s very difficult at times. If you're supporting someone and they need to be supported with food, you have to tell people you can't take them to the toilet or they have to just wait.” Staff said they felt that at times people were at risk as staff didn’t know people’s needs well enough. We discussed this with the management team who stated they had reviewed incidents and near misses at the home and only one incident had occurred with agency staff. The agency staff member themselves recognised their mistake and reported it immediately following the correct procedure.

We visited the service on 3 occasions including one visit at night time. During our visits there were enough staff to meet people’s needs as we saw that staff were deployed safely and mainly permanent staff were on duty.

We discussed the views of people and staff with the management team. There was a dependency tool in place which the service was working to, based on people’s needs. This was a highly moveable tool due to the 10 intermediate care beds which impacted on staffing needs. The regional manager told us, “The rota is produced with skill mix in mind and any agency team members are allocated to work with regular team members.” Robust and safe recruitment practices were in place, and these made sure staff were suitably experienced, competent and able to carry out their role. Recruitment, disciplinary and capability processes were fair and were reviewed to ensure there was no disadvantage based on any specific protected equality characteristic. Staff received the support and training they needed to deliver safe care. We saw supervision meetings and appraisals had lapsed due to management changes at the home but there was a plan to deliver these going forward. Staff received training around all aspects of care including condition specific needs.

People told us they felt the home was clean and well maintained. One person told us they had even replaced his pull cord for his bathroom light so it was cleanable.

Staff confirmed they received training on infection control procedures. They had all the equipment they needed to reduce the risk of spreading infections. One of the housekeeping team told us, “When I first started, we had an outbreak of D&V, so we segregated the home. We worked changing our PPE for every room and changing the trolley between units or completely stripping it down. We work well as a team.”

The service was clean, tidy and free from clutter. We observed housekeeping staff knew their role and responsibilities well.

The provider had systems in place to mitigate the risks of people and staff from catching and spreading infections. We saw evidence to confirm staff had received infection prevention and control training and their practices were regularly checked.

People they told us they received their medicines safely and on time. One person told us, “I get my meds on time. I take them myself and creams and inhalers as I am able to administer them myself.” A visiting social worker told us, “Staff are respectful, they support people to manage their own medicines safely with our community pharmacist following their risk assessment and policy.”

Staff told us that they received training in how to safely administer medication.

People were supported to manage their own medicines where this was safely assessed to do so. The manager completed regular checks to ensure medicines had been given as prescribed and records were accurate. Staff were trained in medicines management and processes were in place to assess whether staff were competent to administer people’s medicines.