CQC report explained · a residential care home
What the CQC found at Holm Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2023
Rated Good overall; inspectors found safe, kind care, but the home’s leadership and quality checks require improvement.
This was an unannounced focused inspection on 10 July 2023. Inspectors spoke with people, staff, relatives and professionals. They looked at seven care plans, medicines records, staff recruitment, audits and infection control.
The home was clean, had enough staff and managed medicines safely overall. People said they felt safe. Staff knew people well and supported them to make choices. Relatives and professionals spoke positively about the managers and staff.
Inspectors found weaknesses in the way the home checked its own quality. Some risk assessments conflicted, accident patterns were not analysed, kitchen concerns were missed and feedback was not consistently collected or acted on. This breached Regulation 17. The overall rating improved from Requires Improvement to Good, but the well-led rating remained Requires Improvement.
Safe and clean environment
Inspectors found the home clean, with communal areas cleared of stored items. Staff followed infection prevention processes and there were no unpleasant odours.
“The service was clean throughout and staff followed safe infection prevention and control processes.” from the report
Enough staff
There were enough staff to respond to call bells and requests for help. Staff also had time to talk with people and support activities.
“There were enough staff employed at the service to meet people's support needs.” from the report
People felt safe
People and relatives said people were safe. Staff had safeguarding training and knew what to do if they suspected harm.
“People lived safely at the service and were protected from harm.” from the report
Warm, familiar care
Staff spent time with people and knew their needs well. Relatives described the home as welcoming and said staff had a positive effect on people.
“The registered manager had fostered a positive culture at the service and there was a homely feel to the service during our inspection.” from the report
Conflicting risk information
seriousSome care plans and risk assessments did not match. This could make it harder for staff to rely on the records when supporting someone.
“Some risk assessments contained conflicting information.” from the report
Weak quality checks
seriousAudits did not always identify problems or explain what had been checked. The home missed kitchen concerns and did not identify patterns in accidents and falls.
“Auditing processes were not always effective and had failed to identify trends with accidents and incidents and concerns raised relating to the kitchen.” from the report
Feedback was inconsistent
needs fixingPeople and staff were not consistently asked for their views. The home could not show how survey information had been used to improve care.
“There was no record of how the information provided in these surveys was used to improve the service.” from the report
Missing as-required medicine protocols
minorSome records and protocols for as-required medicines were missing. The manager put these in place during the inspection.
“There were some gaps in 'as required' (PRN) medicine records and protocols regarding these medicines were missing from some care plans.” from the report
- 01How are you making sure that risk assessments and care plans contain matching, up-to-date information?
- 02How do you now review falls and other accidents to identify patterns, especially incidents happening in bedrooms at night?
- 03What changes have you made to kitchen checks after the concerns identified by the Food Standards department?
- 04How often are residents, relatives and staff asked for feedback, and how do you show what has changed as a result?
- 05Have all as-required medicine protocols now been added to the relevant care plans?
This was an unannounced focused inspection of Safe and Well-led only; ratings for Effective, Caring and Responsive were carried over from the previous inspection. This explanation was written from the published report of 17 August 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, September 2022
Rated Requires Improvement; inspectors found kind care and improved staffing, but cleaning and management checks were not reliable.
This was an unannounced inspection. Two inspectors visited on 23 August 2022 and looked at infection control, staffing, medicines, care records, the building and how the home was managed. They spoke with four people and five staff, and reviewed four care plans and medication records.
The home was rated Requires Improvement overall. Safe and Well-led were both rated Requires Improvement. Inspectors found that bedrooms, bathrooms and communal areas were not always clean. Clutter, strong smells and a lack of maintenance oversight also needed attention.
There were enough staff, and recruitment and medicines were handled safely. People told inspectors they felt safe, and staff were kind and respectful. Care plans, risk assessments and falls analysis had improved since the previous inspection.
The home breached Regulation 15 because premises and equipment were not kept clean. CQC asked for an action plan and said it would monitor progress.
Improved staffing
There were enough staff to support people safely, including an additional evening staff member. People said staff were available and responded quickly at night.
“There were enough staff to support people safely. Staff did not appear rushed and were able to spend meaningful time with people throughout the day.” from the report
Kind and respectful care
People appeared happy, and staff spent time talking with them, reassuring them and supporting activities they chose.
“Staff interacted with people in a positive and friendly way and we saw staff make people smile and laugh.” from the report
Medicines managed safely
Medicines were stored and managed safely. Staff had training and checks before administering medicines.
“Staff received training before administering medication. This included a practical session and competency check to ensure that staff understood the process” from the report
Improved care planning
Care plans and risk assessments were updated monthly and when people's needs changed. Falls were also analysed more effectively than at the previous inspection.
“At this inspection, improvements had been made and care plans and risk assessments were updated monthly and when things changed for the person.” from the report
Cleaning and infection control
seriousBedrooms, bathrooms and communal areas were not always clean. Some bathrooms had calcium build-up, and parts of the home had strong odours.
“Areas of the home which included people's bedrooms and bathrooms were not clean on the day of our inspection.” from the report
Clutter and maintenance
seriousCardboard boxes and other items made cleaning difficult. Some items were in front of fire exits and stairwells before inspectors asked for them to be removed.
“Some items were found in front of fire exits and stair wells. These items were removed immediately upon us raising this concern.” from the report
Weak management checks
needs fixingAudits had not identified the cleaning, storage and decoration problems. Cleaning records were missing for some bedrooms, and there was no clear plan for decorating rooms.
“Recent issues with cleanliness and lack of storage had not been identified through infection control audits.” from the report
Inconsistent incident records
needs fixingAccidents and incidents were not always recorded consistently. A bruise had been noted on a body check chart but not recorded on an incident form.
“Although accidents and incidents had been recorded by staff, we found that this was not always consistent.” from the report
- 01What cleaning and deep-cleaning work has been completed in bedrooms, bathrooms and communal areas since the inspection?
- 02How are daily cleaning checks now recorded, and who reviews them?
- 03What has been done to remove clutter and keep fire exits and stairwells clear?
- 04What is the timetable for replacing carpets and decorating bedrooms?
- 05How are bruises, injuries and other incidents now recorded and reviewed for patterns?
This was an unannounced focused inspection of Safe and Well-led, with particular attention to infection prevention and control; it did not give new ratings for Effective, Caring or Responsive. This explanation was written from the published report of 24 September 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 Holm Lodge
6 rated inspections over 7 years: the service has held its Good rating throughout.
- August 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2022Requires improvementSafe: Requires improvementWell-led: Requires improvement
- February 2022Inspected but not ratedSafe: Inspected but not rated
- September 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2021Requires improvementstayed Requires improvementSafe: Inspected but not ratedWell-led: Inspected but not rated
- October 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 25 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.
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Most charge £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
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