Updated 20 February 2024
Date of assessment 6 March to 21 March 2024 Holly Lodge Nursing Home provides care to older people with physical and health related support needs, some of whom also live with dementia. We assessed a total of 4 quality statements from the safe and well-led key questions and found areas of concern. The scores for these areas have been combined with scores based on the key question ratings from the last inspection. Though the assessment of these 5 quality statements indicated areas of concern since the last inspection, our overall rating remains good. There were enough competent staff to provide timely care to people and people were supported safely, for example, with their mobility. People had personalised care plans in place. Staff felt well-supported by the management and knew how to raise concerns to protect people when required. However, staff did not always follow provider’s choking management policy which could put people at risk. Staff did not always ensure least restrictive support measures were considered and decisions were made in the best interests of people who could not consent to have their diet modified. The provider did not always recognise when complaints and incidents included safeguarding concerns. This put people at risk of harm and of their rights and liberties not being respected, although staff took some action to protect people following incidents. Audits and checks did not identify referrals to healthcare professionals were not always completed when needed and people’s records were not always reflective of the individual risk of choking, and that not all safeguarding concerns were appropriately identified, reported and investigated. The registered manager did not always notify CQC about events in the home as required. The provider took immediate action to address those shortfalls following the site visit. We have asked the provider for an action plan in response to the concerns found at this assessment.