CQC report explained · a residential care home
What the CQC found at Holkham House
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Outstanding
- People were protected by strong safeguarding and risk-management systems. Staff supported people to understand risks and take positive risks, and medicines, staffing, infection control and emergency arrangements were found to be safe.
- Effective?
- Good
- People received care from trained and supported staff. Their nutrition, health appointments and individual needs were supported effectively, although the building was not designed in line with Registering the Right Support guidance.
- Caring?
- Outstanding
- People were treated with kindness, dignity and respect. Communication methods such as easy-read information, videos and Braille helped people be involved in decisions.
- Responsive?
- Outstanding
- Care was highly personalised and adapted to changing needs. People were supported with activities, holidays, relationships, work experience and community involvement.
- Well-led?
- Good
- The home was consistently managed, with approachable leadership, regular audits and good communication between staff. The report identified no current plans to change the building's layout or design.
What inspectors found, March 2020
Rated Outstanding; inspectors found exceptionally safe, kind and personalised care, although the building was not designed in line with current best-practice guidance.
This was an unannounced inspection on 21 and 22 October 2019. The inspector met all 10 people living at the home, spoke with staff, the manager and a professional, received feedback from relatives, and checked care, medicine, recruitment and management records.
The home was rated Outstanding overall. Safe, caring and responsive care were rated Outstanding. Effective and well-led were rated Good. Inspectors found people were supported to make choices, build independence, communicate in ways that suited them, access activities and stay connected with their communities.
The home had safe systems for medicines, safeguarding, staffing and emergencies. Staff were trained and knew people's needs. One medicine allergy detail was not initially recorded in the correct records, but the home checked this immediately and updated the records.
The building was a large group setting and had not been designed or updated in line with Registering the Right Support guidance. The report says this did not stop people receiving care based on choice, control and independence. The previous overall rating was Good in a report published on 28 September 2016.
Choice and independence
People were supported to understand risks rather than being unnecessarily restricted. They could take part in training, safety checks and everyday decisions.
“Many people were supported to understand risk and take positive risks to promote their independence.” from the report
Kind and respectful care
Staff took time to listen and used communication methods suited to each person. Relatives were positive about the care provided.
“We observed people being supported in a kind, patient and sensitive manner through appropriate communication methods but also with time.” from the report
Personalised support
Staff adapted support around people's goals, health needs and behaviour. The report gives examples of people becoming more independent and accessing work or community activities.
“People were supported by a truly person centred culture created by a motivated and skilled registered manager and staff” from the report
Communication and involvement
Information was made accessible through pictures, easy-read formats, audio and Braille. People were involved in meetings, complaints, menus, holidays and decisions about the home.
“The registered manager and staff had been creative in ensuring all of the information available to people about the home was fully accessible” from the report
Activities and community life
People had a wide range of activities, trips, holidays and relationships. Staff supported people to take part in local groups and community events.
“People received plenty of opportunities to participate in a wide range of social, recreational and pastoral activities.” from the report
Monitoring and learning
The home used audits, feedback and reviews of accidents and incidents to identify improvements. Staff roles and communication arrangements were clear.
“There were established systems for monitoring the delivery of the service.” from the report
Building design
needs fixingThe home was a large group setting and had not been designed or updated in line with Registering the Right Support guidance. Inspectors said there were no current plans to change the layout or design.
“The premises had not been designed in line with the guidance and had not been updated to comply with the principles.” from the report
Medicine allergy information
minorA possible medicine allergy was recorded in a hospital document but not initially in the person's medicine record or health action plan. The manager checked this with health professionals and updated the records immediately.
“However, this information was not recorded onto their individual medicine record or health action plan.” from the report
- 01What plans, if any, are now in place to improve the building layout in line with Registering the Right Support guidance?
- 02How do you make sure medicine allergies and other important health information are recorded consistently in all relevant records?
- 03How would you find out how my relative communicates pain, anxiety or distress if they cannot explain it verbally?
- 04What activities, work opportunities and community visits could my relative take part in, and how much choice would they have?
- 05How would you support my relative to build independence while managing risks safely?
This was an unannounced planned inspection that looked at all five key questions, including the care provided and the premises; the report also noted that the home was not designed in line with Registering the Right Support guidance. This explanation was written from the published report of 4 March 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, September 2016
Holkham House rated Good; inspectors found safe, kind and personalised care, with all five areas rated Good.
This was an unannounced inspection on 22 July 2016. The inspector spoke with people living at the home, relatives, staff, managers and a health and social care professional. They also observed care and checked care plans, medicines records, policies and staff files.
Inspectors found the home was safe and well staffed. Risks were assessed, medicines were managed safely, and recruitment checks were completed. Staff had suitable training and support, and people were helped with food, healthcare and decisions about their care.
People were treated kindly and with respect. Their care plans reflected their needs, interests and wishes. People were supported to take part in activities at home and in the community, and there were systems for complaints and quality checks.
The overall rating was Good, with Good ratings for Safe, Effective, Caring, Responsive and Well-led. At the previous inspection in February 2014, the provider was meeting the regulations covered by that inspection.
Safe staffing and medicines
Inspectors found enough staff to meet people's needs and support outings. Medicines records, training and checks were in place.
“Medicines were safely stored and administered. Staff were familiar with the provider's medicines policy and procedure and records showed that staff had received medicines training and competency checks.” from the report
Kind and respectful support
Staff understood people's individual communication methods, needs and wishes. They respected privacy, dignity and preferred routines.
“Staff consistently responded in a friendly and supportive way, which demonstrated they had a very good understanding of people's individual personalities, needs and wishes.” from the report
Personalised activities
People were supported to follow their interests both at home and in the community. Inspectors found that activities helped people enjoy themselves and develop skills.
“People were supported to access a broad range of activities and entertainments that provided enjoyment and opportunities to develop new skills and interests.” from the report
Good management checks
The provider used care plan, medicines, safety and other audits. Quality monitoring visits identified improvements and checked them later.
“There were ongoing arrangements for monitoring and improving the quality of the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How many staff are usually available now, and can people still go out for activities and appointments when they wish?
- 02How are medicines administration records checked today, and how are staff's medicines skills assessed?
- 03How often are each person's care and support plans reviewed, and how are people and relatives involved?
- 04Which current Deprivation of Liberty Safeguards authorisations are in place, and how are they reviewed?
- 05How are complaints and people's views collected now, and what improvements have followed from them?
This was an unannounced inspection of all five key questions, based on conversations, observations and checks of care, medicines, policies and staff records. This explanation was written from the published report of 28 September 2016 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 Holkham House
2 rated inspections over 3 years: the service has improved, from Good to Outstanding.
- March 2020Outstandingcurrent ratingup from GoodSafe: OutstandingEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Good
- September 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 9 April 2011.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
77 live-in carers within about an hour of Surrey
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,250 a week. 66 can care for a couple. 11 years' experience on average.
“Without his support we wouldn't have been able to navigate bringing and keeping Dad at home.”
“Not only has she looked after him beautifully, she has also been great company for him with lively conversation, kindness and humour.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.