CQC report explained · a residential care home
What the CQC found at Holly Cottage
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Staff understood safeguarding and risk management, staffing levels were sufficient, and medicines were administered safely. Some PRN medicine protocols were missing from care plans but were corrected during the inspection.
- Effective?
- Good
- People had assessed care needs, trained staff support, help with food and drink, and access to health appointments. Some information about medical procedures was not in an accessible format, and consent was not always clearly recorded.
- Caring?
- Good
- People were treated with warmth, respect and equality. Staff supported independence, listened to people's views and protected privacy and dignity.
- Responsive?
- Good
- Care plans reflected individual needs, wishes and changing goals. People were supported with activities, independence, family contact, complaints and discussions about end of life care.
- Well-led?
- Requires improvement
- The home had been without a registered manager for more than six months, and staff supervision and appraisals had not always taken place. A new manager had started and provided an action plan, but the improvements had not yet become established.
What inspectors found, September 2018
Rated Good overall; inspectors found safe, kind and personalised care, but the home was not always well-led.
Inspectors made an unannounced comprehensive inspection visit on 24 and 25 July 2018. They spoke with people, families, staff, managers and other professionals. They also checked care plans, medicines records, staff files, audits and other documents.
The home was rated Good for Safe, Effective, Caring and Responsive. People were protected from abuse, received medicines safely and had enough staff support. Inspectors saw respectful care, personalised activities, support with health needs and encouragement to make choices.
The home was rated Requires Improvement for Well-led. There had been no registered manager for more than six months, and staff supervision and appraisal had not always taken place. A new manager had been in post for three weeks and had sent CQC an action plan.
The overall rating remained Good, as inspectors found no serious risks or concerns. However, the lower well-led rating means the home's management systems needed to become more consistent and established.
Safe staffing and risk support
Staffing was planned around people's activities, appointments, holidays and sickness. Staff had clear risk assessments and understood how to keep people safe.
“Staffing levels provided safe care and were sufficient to meet people's needs.” from the report
Medicines handled safely
Trained staff gave medicines on time and used medicine records. Medicines were stored securely and checked regularly with support from the local pharmacist.
“People received their medicines safely when they needed them.” from the report
Respectful, kind care
Inspectors found people relaxed with staff. Staff listened, supported independence and respected privacy, dignity and personal choices.
“People continued to be treated with warmth, respect and equality by staff.” from the report
Personalised support
Care plans reflected people's individual needs, interests, health and goals. People were supported to develop independence through cooking, activities, travel and community involvement.
“People's care had been planned responsively and personalised to their individual needs.” from the report
Management continuity
needs fixingThe home had no registered manager for more than six months. During this period, staff supervision and appraisals were not always completed, leaving some staff feeling unsupported.
“However, in the absence of the registered manager, supervisions and appraisals had not been completed.” from the report
Recording choices and consent
needs fixingAlthough people's choices were sought and respected, the records did not always clearly show consent and decisions in line with the Mental Capacity Act principles.
“The staff had demonstrated that they had discussed matters with people but consent obtained had not always been clearly recorded.” from the report
Accessible health information
minorSome information about medical procedures had not been provided in a format that people could easily understand. Inspectors made a recommendation about this.
“Some information about medical procedures had not been provided in an accessible format.” from the report
- 01What progress has been made with the action plan for staff supervision, appraisals and competency development?
- 02How do you now make sure people's choices, consent and Mental Capacity Act decisions are recorded clearly?
- 03How will medical information be provided in a format that each person can understand?
- 04Who is currently responsible for the home while the new manager applies for registration?
- 05What further training will staff receive to support discussions about end of life care?
This was an unannounced comprehensive inspection covering the home, the care provided and all five CQC questions; the overall rating remained Good from the previous inspection. This explanation was written from the published report of 15 September 2018 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, May 2017
Rated Good overall; inspectors found the home had fixed earlier medicines and recruitment problems, and rated safe Good.
This was an unannounced focused inspection on 29 April 2017. One inspector spoke with all three people living at the home, staff and managers, observed the morning routine, and checked records.
The inspection looked only at whether the home was safe. Inspectors found that medicines were managed safely, staffing was planned around people's needs, risks were managed without unnecessary restrictions, and people felt safe.
The home had improved since the previous inspection. Earlier breaches about medicines management and recruitment had been met, so the safe rating improved from Requires Improvement to Good. The overall rating remained Good.
Medicines management
The home had updated guidance for medicines taken when needed and for applying creams. Records were accurate and staff had regular medicines training.
“Medicines were stored safely and medicine records were clear and up to date.” from the report
Staffing and recruitment
Staffing was arranged around people's appointments and activities. Recruitment files had been checked and contained the required information.
“People said that staff were always around when they needed them.” from the report
Managing risks
Inspectors found that risks were reviewed without unnecessarily limiting people's lives. People were supported to take part in activities and experiences.
“Risks to people continued to be creatively managed so that people were enabled to take part in a variety of activities and were not restricted.” from the report
Feeling safe
People told inspectors they felt safe. Staff understood abuse and safeguarding procedures, and information about raising concerns was displayed.
“Staff we spoke with knew about different types of abuse and knew who they could report any concerns to.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you keep the guidance for medicines taken when needed and creams up to date?
- 02How do you make sure staffing remains sufficient when people have different appointments and activities?
- 03How are staff recruitment files checked after the improvements found in this report?
- 04How are people's risk assessments reviewed while still supporting them to take part in activities?
- 05What were the ratings for Effective, Caring, Responsive and Well-led at the last comprehensive inspection?
This was a focused inspection of Safe only, to check earlier breaches; the report says the other areas were not inspected. This explanation was written from the published report of 19 May 2017 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 Holly Cottage
3 rated inspections over 3 years: the service has held its Good rating throughout.
- September 2018Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2017Goodstayed GoodSafe: Good
- October 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 December 2010.
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.
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39 live-in carers within about an hour of Kent
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 £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
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.