Clayton-le-Moors: The Hollies Nursing Home rated inadequate

The CQC undertook an unannounced inspection at Hollies Nursing and Residential Home to look at whether it is safe and well-led, following concerns in relation to staffing and the management of the home, medicines, and safeguarding issues.

The inspection was also prompted by the death of a resident. Due to this incident, inspectors also looked at how the Clayton-le-Moors home manages choking.

The service, which was previously rated as good, is now inadequate overall and has been placed into special measures to focus the Hollies leadership team on the areas where rapid improvements are needed.

The CQC has also rated the service as inadequate for being safe and well-led.

At the time of inspection, there was a formal suspension on admissions to the home until commissioners were assured improvements had been made. The provider had drawn up an action plan, for improvements designed to ensure the safe running of the service.

Hollies provides personal care and nursing care for up to 31 people, some of whom have dementia. When CQC inspected there were 29 people in the home.

Hayley Moore, CQC’s head of adult social care inspection, said: “When we inspected Hollies Nursing and Residential Home Limited, we were very concerned people were exposed to the risk of harm due to poor processes and systems. This is why we have placed them into special measures and downgraded their rating from good to inadequate.

“Our inspectors saw risks around choking, weight loss and dehydration. Someone at risk of weight loss wasn’t being weighed regularly. Also, falls weren’t always being identified, meaning there weren’t any plans in place to reduce the risk of them happening.

“We had other concerns around people’s safety. A high number of safeguarding allegations, including unexplained bruising on one resident, had been made by external organisations but had been missed by the home and not referred to the safeguarding team for further investigation. The interim manager immediately actioned this during the inspection.

“It was also very worrying staff felt unable to speak up about these issues, where they could have provided valuable insight for management to learn from. They also told us there was a culture of bullying and leaders weren’t addressing this or promoting a positive culture. This must be urgently addressed.

“However, within a short space of time the new interim manager had started to build a supportive culture for staff, and was providing clear and effective leadership.

“We will monitor the home closely and will not hesitate to take further action if we feel people are not safe and at risk of harm.”

Inspectors found the following: • Staffing levels weren’t always sufficient to meet people’s needs.

• The provider’s quality assurance systems and audits were ineffective.

• Individual’s risks including the risk of falls, choking and the deterioration of people’s conditions were not routinely identified.

• There were significant gaps in the reporting and management of accidents and incidents and medicines were not always managed safely. Systems and processes to safeguard people from the risk of abuse were poorly developed.

However: • People were protected from the risks associated with the spread of infection, including from COVID-19.

• The provider had recently brought in an external interim manager who had experience of supporting homes to improve. They had prioritised a number of areas for improvement, including reviewing people’s needs to ensure they received safe care and treatment.

A spokesperson for the home said: "Prior to the most recent Care Quality Commission inspection we had already identified issues that required urgent action and had appointed a new specialist interim manager to oversee substantial changes, and recruited new staff to help implement them.

"We have urgently reviewed procedures and activities throughout the home and developed an action plan to address the concerns raised by the CQC. We have begun sharing that plan and changes to our procedures with residents and their families, and are working closely with the local Clinical Commissioning Group, Lancashire County Council and the CQC on our recovery plans.

"Our new specialist interim manager has within a short space of time given staff the support they need with clear and effective leadership. Staff welcomed the new support structure telling the CQC: "Its onwards and upwards now," while another commented: "We are pulling together better as a team to get back to the glory days."

"At The Hollies we have always sought to provide a compassionate and caring environment for elderly residents and those suffering from debilitating medical conditions, and both family members and residents have appreciated our efforts.

"In common with many other care and nursing homes across the UK, The Hollies and its staff have been under intense pressure since the COVID-19 outbreak began but, as the CQC report recognises, we have maintained infection control and protected residents.

"Our overall rating was previously ‘Good’. In the latest report The Hollies is still rated by the CQC as ‘good’ for two categories; our caring approach and the way we respond to residents. But our rating overall is ‘Inadequate’, and for that we must sincerely apologise. That rating is simply not good enough, but we are working hard to regain the standards of which we have been so proud – the standards our residents and their families deserve."