CQC report explained · a residential care home
What the CQC found at Holly House Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2023
Rated Good; inspectors found safe, compassionate care, but some records needed more regular review.
This was an unannounced focused inspection. Inspectors visited on 15 August 2023 and carried out inspection activity until 21 August 2023. They spoke with people, relatives, staff and managers, and checked care records, medicines records, recruitment files and management records.
The home was rated Good for Safe and Well-led. Inspectors found enough staff overall, safe medicines systems, suitable risk assessments, good infection control and appropriate recruitment checks. They found people were cared for safely and compassionately.
Inspectors saw that staffing reduced after 7pm while some people were still in communal areas. The provider reviewed this and increased evening staffing. Some mental capacity assessments had not been reviewed for a long time, although the records inspected contained accurate information.
The overall Good rating remained unchanged from the previous inspection. The inspection looked only at Safe and Well-led, so the other three ratings were carried forward from the previous inspection.
Risk management
The home used personal risk assessments and care plans for issues such as falls, skin integrity and eating and drinking. Staff followed the plans seen by inspectors.
“Risks to people were identified and managed safely.” from the report
Medicines
Medicines records were complete and regularly checked. Staff had training and competency checks before supporting people with medicines.
“An electronic medicines recording system was in place, medicine administration records (MAR) were fully completed and regularly audited.” from the report
Staffing and recruitment
Inspectors found enough staff overall and appropriate checks were completed before staff started work. People and relatives said they did not usually have to wait for care.
“People were supported by sufficient numbers of staff who knew them well and understood how to meet their needs.” from the report
Open management
People, relatives and staff said managers were approachable and listened to concerns and feedback. The home used meetings, surveys and audits to identify improvements.
“The service had a positive ethos and an open culture.” from the report
Evening staffing
needs fixingStaffing levels fell after 7pm while many people were still in communal areas. The provider reviewed this during the inspection and decided to increase evening staffing.
“During the inspection we observed staffing levels reduced after 7pm when many people were still up in communal areas.” from the report
Mental capacity records
needs fixingSome mental capacity assessments had not been reviewed for a prolonged period. Inspectors said this could mean changes in people's abilities and needs were not identified promptly.
“Some mental capacity assessments had not been reviewed for a prolonged period.” from the report
- 01What evening staffing levels are now in place after the review during the inspection?
- 02How do you make sure mental capacity assessments are reviewed regularly when people's abilities or needs change?
- 03What action was taken after the serious injury incident mentioned in the report?
- 04How are falls, skin damage and pressure ulcer risks monitored for my relative?
- 05How can relatives raise concerns and see what action has been taken in response?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their ratings were carried forward from the previous inspection. This explanation was written from the published report of 5 October 2023 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, November 2022
Rated Good overall, but inspectors found that care was not always effective, especially at mealtimes and when recording daily care.
This was an unannounced follow-up inspection on 13 October 2022. Inspectors spoke with people living in the home, relatives, staff and visiting professionals. They reviewed care records, medicine records, staff files, training records and quality checks.
The home was rated Good overall. Safe, Caring, Responsive and Well-led were rated Good. Effective was rated Requires Improvement. Inspectors found that people were generally safe, treated kindly and supported according to their needs and preferences.
Some improvements were still needed. People living with dementia were not always shown their meal choices, and the response to people eating in their bedrooms was not always good. Pre-admission assessments and daily records also needed strengthening.
The home had improved since the previous inspection in December 2021. The previous breaches and Warning Notices had been addressed, and the provider was no longer in breach of regulations at this inspection.
Staffing and safety
Inspectors found there were consistently enough staff to meet people's care needs. The home also used safer recruitment checks and seldom used agency staff.
“At this inspection we found there were consistently enough staff to ensure people received safe care.” from the report
Medicines
Medicines were given safely by trained staff and records had improved. An electronic system and regular audits helped reduce the risk of errors.
“People received their medicines safely and in the way they preferred.” from the report
Kind and respectful care
Staff knew people well and treated them with patience and respect. Inspectors saw that privacy, dignity and independence were promoted.
“Throughout the inspection we saw staff were patient and caring in their interactions with people.” from the report
Personalised support
Care plans included people's routines, preferences, personal histories and cultural or religious needs. People were supported to take part in activities that mattered to them.
“People had personalised care plans which included information about their personal needs, choices and preferences.” from the report
Improved management
The home had strengthened its quality checks and management systems since the last inspection. Improvements were recorded, tracked and supported by an improvement plan.
“A comprehensive range of audits had been implemented and embedded.” from the report
Mealtimes
needs fixingPeople were not always shown what food choices were available. A person eating in their bedroom was left with cold porridge after a request for a fresh bowl was not acted on.
“People who dined in their bedrooms did not always receive a responsive mealtime service.” from the report
Pre-admission assessments
needs fixingPeople's needs sometimes differed from their pre-assessment when they arrived. This could mean staff were not fully prepared for specialist care or equipment needs.
“On occasion people's needs differed when they arrived in the service to their pre-assessed needs.” from the report
Daily care records
needs fixingDaily notes did not always explain what had happened or how staff had tried to support someone before giving medicine to ease distress.
“Daily notes to record and monitor people's care and wellbeing were written by staff but could be improved.” from the report
Dementia-friendly signs
minorSome signs were small and discrete. Inspectors found that a person was unsure where the lounge was, and additional signs were being commissioned.
“Extra dementia friendly signage may support people to navigate around the service better.” from the report
- 01How are people now shown their meal choices, especially if they live with dementia?
- 02What checks make sure people eating in their bedrooms receive hot, suitable meals and prompt help when they ask?
- 03How do you make sure a person's needs on arrival match their pre-admission assessment?
- 04How are daily records checked to show what support was tried before medicine is given to ease distress?
- 05What dementia-friendly signs are now in place to help people find communal rooms?
This was an unannounced follow-up inspection checking previous Warning Notices and an action plan, with all five key questions rated and infection prevention and control also reviewed. This explanation was written from the published report of 15 November 2022 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 House Residential Home
6 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- October 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Holly House Residential Home →
- November 2022Goodup from Requires improvementSafe: GoodWell-led: Good
Read what inspectors found at Holly House Residential Home →
- December 2021Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2021Inspected but not ratedSafe: Inspected but not rated
- May 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- January 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 31 January 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
At least 100 live-in carers within about an hour of West Northamptonshire
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 £1,280 a week. 87 can care for a couple. 12 years' experience on average.
“We can all fully relax around Nyarai and she feels like part of our family, which is no mean feat!”
“If you bump into her in the night on her way to the bathroom she will still inquire how you are and if everything is alright.”
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.