We carried out a review of the data available to us about Holly Tree Lodge Residential Home Derby on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Holly Tree Lodge Residential Home Derby, you can give feedback on this service.
Holly Tree Lodge Residential Home Derby is registered to provide personal care and accommodation for up to 27 people. The service is provided across two floors. At the time of the inspection 23 people were living at the home.
We found the following examples of good practice.
COVID-19 screening was undertaken before people were able to enter the home and personal protective equipment (PPE) was provided and required to be worn.
During the COVID-19 outbreak at the home, the provider and registered manager had closed the home to non-essential visitors. People were supported to contact their relatives and friends through video calls and telephone calls.
Government guidelines were being followed to enable essential care givers and the families of people receiving end of life care to continue to visit.
Enhanced cleaning schedules included regular cleaning of touch areas such as handrails and door handles. This reduced the risk of cross infection.
Staff had received training in infection prevent and control and the use of PPE. Staff were observed wearing PPE appropriately.
Staff and people living at the home accessed regular testing for COVID-19, so that action could be taken swiftly if anyone developed symptoms or had a positive test result.
The infection prevention and control policy was up to date.
Proactive measures were in place to keep people and staff safe. People and staff had risk assessments in place to identify their individual risks associated with COVID-19.
Holly Tree Lodge is a care home providing personal care for up to 27 people aged 65 and over. At the time of our inspection there were 22 people using the service. The home is a large adapted property located over two floors.
People’s experience of using this service and what we found
Moving and handling practices were not always safe, we found that not all equipment was tailored to the person it was being used for. This was in relation to equipment used to transfer people and also walking aids. The provider took swift action to rectify this and ensure safe practice.
People were protected from the risk of infection. Government guidance on the use of personal protective equipment (PPE) was being followed and staff were wearing appropriate PPE and washing their hands regularly.
The registered manager was working closely with health care professionals to implement current moving and handling practice within the service and make improvements where needed.
Rating at last inspection
The last rating for this service was good (published 05 February 2020).
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
The inspection was prompted in part due to concerns received about safe moving and handling of people using the service. A decision was made for us to inspect and examine those risks.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We found evidence, during this inspection, that people were at risk of harm from these concerns. However, this was rectified swiftly to ensure people’s safety.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Please see the safe section of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Holly Tree Lodge Residential Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Holly Tree Lodge Residential Home Derby is a residential care home providing personal care to 23 people aged 65 and over at the time of the inspection. The service can support up to 27 people.
The service is provided across two floors in a purpose-built premises.
People’s experience of using this service and what we found
People received safe care. Staff knew how to recognise and report abuse or avoidable harm, and managers took action to safeguard people. Staff followed safe medicines management protocols. The service deployed sufficient number of staff to meet people needs. They followed safe recruitment practices.
Staff support people as required by law. They had the relevant training and experience required to fulfil the responsibilities of their role. They promptly referred people to health care services and worked with other professionals to ensure people received consistent care which met their needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff were kind and compassionate. They developed positive relationships with people and treated people like they mattered. The service promoted people’s independence, dignity and rights to privacy. Staff supported people to be involved in decisions about their care.
People’s care was tailored to their individual needs. Staff supported people to maintain relationships with people that mattered to them. The service had robust end of life protocols which supported delivery of comfortable and dignified care.
There was a visible and supportive leadership at the service. People were kept at the centre of care delivery. Staff felt engaged and valued. The provider had systems in place to monitor and improve the quality of care they delivered.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 27 January 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
This inspection took place on 15 and 19 December 2016. The inspection was unannounced and was carried out by one inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert for this inspection had experience of the care of older people and older people living with dementia.
A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
People using the service and their representatives we spoke with said they thought the home was safe. Staff had been trained in safeguarding (protecting people from abuse) and generally understood their responsibilities in this area.
People's risk assessments provided staff with information of how to support people safely.
Staffing levels were, in the main, sufficient to ensure people were safe.
People using the service and relatives told us they thought medicines were given safely and on time.
There were systems in place to ensure that the premises were safe for people to live in.
Staff were subject to checks to ensure they were appropriate to work with the people who used the service.
Most staff had been trained to ensure they had the skills and knowledge to meet people's needs though more training was needed on relevant issues in order there was assurance to meet all the needs of people.
Staff generally understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have an effective choice about how they lived their lives, and the service had obtained legal approval for limiting people's choices when necessary for their best interests.
People had plenty to eat and drink, everyone told us they liked the food served and people were assisted to eat when they needed help.
People's health care needs had been protected by referral to health care professionals when necessary.
People and their representatives told us that staff were friendly and caring and we saw many examples of staff working with people in a kind and compassionate way.
There was some evidence that people and their representatives were involved in making decisions about their care, treatment and support, though evidence was lacking in some care plans.
Care plans were individual to the people using the service and covered their health and social care needs.
There were sufficient numbers of staff to ensure that people's needs were responded to in good time.
Activities were organised to provide stimulation for people, though activities tailored to people's needs had not been frequently provided.
People and relatives told us they would tell staff if they had any concerns and were confident they would be followed up to meet people's needs.
People, their relatives and staff were satisfied with how the home was run by the registered managers.
People, their representatives and staff all said that this was a well led and well run service.
Management carried out audits and checks to ensure the home was running properly to meet people's needs.
There were 24 people using the service on the day of our visit. Due to people's level of dementia the majority of people were unable to give us their views on the care provided. However people that were able to give their views told us that they were happy with the support they received from staff. Comments included, 'the staff are very good, lovely people.' And 'I like them all, they are lovely.'
We saw that staff were responsive to people's needs and wishes, for example we observed staff offering choices at the lunch time meal and supporting people with their meal in a caring and patient manner.
We found the home was well led by the acting manager and comments from people also confirmed this. A visiting professional told us, 'the care here is very good, including end of life care, we know if we get a call from the staff the information we get will be accurate and there's a good relationship between staff and residents.'
Visitors spoken with also confirmed they were happy with the care their relatives received. One visitor told us, 'I'm more than happy with this home, the staff here are very caring.'
Sufficient numbers of staff were on duty to ensure people's needs were met effectively.
An on-going maintenance programme was in place to ensure a safe and comfortable environment was maintained.
Peoples care plans now contained personal information about the person who used the service. There was also evidence that families had been involved with decisions about care. One person we spoke with told us that they were very happy with the care provided.
The provider had revised their recruitment and selection policy to ensure that all staff would be subject to full pre employment checks before they commenced work.
One relative stated "Everyone's very welcoming. Staff take an interest in you, as well as the person and other resident's". Another stated that their relative was "treated very well". One person told us that "they do care, they really do care".
All the people we spoke with felt that the staff were very helpful. One person told us that staff are "very considerate" and show "true dedication to their job". A person using the service stated 'anything you want you either get, or they (staff) will give you a reason why you cant get it'.
One family member told us that their relative's room was "lovely".
One person told us that they liked the way people who used the service could walk about in the home and that residents spoke with each other and also visitors.
We found that there was some concern with care plans and pre-employment checks on staff members.
One relative told us that she leaves some money for her mother each week and that they were happy the money is correctly managed. This person also said "I feel mum is safer here than before."
"I do think the residents are bored, fed up. She has told me she's fed up and that it's a long day. I think she gets up and wanders around for a change."
One visitor told us "I find the home clean, the domestics clean when the residents go for their meals."