CQC report explained · a residential care home
What the CQC found at Holt Road
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found effective systems to reduce risks, enough staff, suitable recruitment checks and safe medicines processes. Earlier concerns about hot water and liquid medicines had been addressed.
- Effective?
- Good
- Care was personalised and based on people's needs, choices and communication methods. Staff had appropriate training, people received health support, and nutritional needs were met.
- Caring?
- Good
- This question was not rated in this report. The report describes staff supporting people's choices, communication, independence and community involvement.
- Responsive?
- Good
- This question was not rated in this report. The report says activities, communication methods and support plans were tailored to each person.
- Well-led?
- Good
- Inspectors found a clear management structure, visible leaders, regular staff meetings and systems for monitoring incidents, staff practice and service quality.
What inspectors found, October 2022
Holt Road rated Good; inspectors found safe, person-centred support and said earlier concerns about water, medicines and behaviour management had been acted on.
This was an unannounced inspection on 27 September 2022. Two inspectors visited the home, looked around the premises and some bedrooms, spoke with managers and support workers, and reviewed care files, medicine records, recruitment records, policies and audits.
The home supported four people with learning disabilities and autistic people. Inspectors found enough trained staff, personalised support plans, safe medicines systems, suitable risk assessments and a clean, well-maintained environment. People were supported to communicate, make choices, take part in activities and use local services.
The inspection followed concerns about hot water temperatures, medicines and staff understanding of distressed behaviour. Inspectors found the home had acted on these concerns. The overall rating was Good, and Safe, Effective and Well-led were each rated Good. The previous Good rating from 2018 remained unchanged.
Support for independence
Support plans included strategies to build independence and considered each person's longer-term hopes and goals.
“Positive behaviour support plans promoted strategies to enhance independence and demonstrated evidence of planning and consideration of the longer-term aspirations of each person.” from the report
Communication
Staff understood people's individual communication needs. Picture aids, gestures and communication cards helped people understand what was happening and express choices.
“People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.” from the report
Health and wellbeing
People were supported to attend health checks and use different health professionals. Inspectors also found that meals and food choices involved the people living at the home.
“People were supported to attend annual health checks, screening and primary care services.” from the report
Positive leadership
Managers were visible in the home and staff said they felt supported and able to raise concerns. Quality checks and learning systems were in place.
“Management and staff put people's needs and wishes at the heart of everything they did.” from the report
Medicines management
Medicine records were completed and audited, and staff were trained and checked as competent. Inspectors said earlier concerns about liquid medicines had been acted on.
“Medicine administration records (MAR) were completed appropriately and regularly audited.” from the report
Occasional staffing pressure
minorAlthough inspectors found enough staff to keep people safe, one staff account said there could occasionally be short staffing. The report says agency staff were used when needed.
“Most of the time there are enough staff around, on the occasion we can be short but we get help from agency staff if this is needed.” from the report
Some DoLS reviews still in progress
minorThe home had applied for authorisations where needed and was monitoring progress, but the service manager was still reviewing some existing arrangements.
“Records showed the service manager was in the process of reviewing people's DoLS and had contacted the local authority.” from the report
- 01How do you make sure staffing remains sufficient when people need one-to-one or two-to-one support?
- 02How often are liquid medicines audited, and what happens if an error or shortfall is found?
- 03Which DoLS authorisations are currently being reviewed, and what is the progress with the local authority?
- 04How will you support my relative's preferred way of communicating and building independence?
- 05How are positive behaviour support plans updated when a person's needs or behaviour changes?
This was an unannounced inspection focused on the risks that had been raised, and it rated Safe, Effective and Well-led; Caring and Responsive were not rated in the report. This explanation was written from the published report of 13 October 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.
What inspectors found, May 2018
Rated Good; inspectors found safe, kind and personalised care, with some further work needed on accessible information.
This was a comprehensive, announced inspection on 21 March 2018. The inspector observed care, spoke with relatives, staff and managers, and checked care records, staff files, training records, complaints and quality checks. The people living in the home could not communicate verbally with the inspector, so observations were important.
All five areas were rated Good: safe, effective, caring, responsive and well-led. Inspectors found enough staff, safe recruitment, accurate medicines records, detailed risk plans and a clean, well-maintained home. Staff received training and specialist support to meet people's complex needs.
People were supported to make choices, stay independent and take part in activities. Care was tailored to individuals and relatives were involved. The home had improved since the previous inspection in 2016, including how people chose meals and how settled they appeared. The report found no serious risks or concerns and no breaches of regulations.
Detailed safety planning
People had detailed care plans and risk assessments. These helped staff support independence while managing known risks.
“People had detailed plans of care and risk assessments to guide staff in maintaining their safety.” from the report
Kind and respectful care
Staff knew people's histories, likes and dislikes. Inspectors saw kind interactions and found that privacy and dignity were respected.
“Staff interactions with people were kind and respectful.” from the report
Personalised choices
Care plans reflected each person's strengths, interests, communication needs and goals. People and relatives were involved in reviews.
“Care plans were person centred and comprehensive, identifying people's background, preferences, communication and support needs.” from the report
Good behaviour support
The home worked with specialist teams and relatives to support people whose behaviour could be difficult to manage. Inspectors saw that people appeared more settled than at the previous inspection.
“We noted improvements from our last inspection in particular how settled people were and how positively they related to staff they clearly knew, respected and liked.” from the report
Meaningful activities
People were supported with life skills, leisure and community activities, including walks, shopping, swimming and visits to a day centre.
“Each person had an activity plan that included support with life skills and leisure and recreational activities.” from the report
Deputy manager vacancy
minorThe home did not have a deputy manager in post at the inspection. The registered manager was recruiting for the vacant role.
“The registered manager told us that she was currently in the process of recruiting a new deputy manager to fill the vacant post.” from the report
Further accessible information needed
minorThe home had started using pictures to make information easier to understand, including picture menu cards. The manager acknowledged that more improvement was still needed.
“The registered manager showed us good examples of work already been done, for example the picture menu cards, but acknowledged that there was further room for improvement.” from the report
- 01Has the deputy manager post now been filled, and how is management cover arranged when the registered manager is absent?
- 02What further improvements have been made to provide information in ways each person can understand?
- 03How are families involved in reviewing care plans, behaviour support plans and people's goals?
- 04How do staff make sure medicines given when required are used only when the person's guidelines say they are needed?
- 05How have the activities and community routines described in the report continued for each person?
This was a comprehensive inspection covering all five CQC questions, with the overall Good rating unchanged from 31 March 2016. This explanation was written from the published report of 9 May 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.
Every inspection of Holt Road
3 rated inspections over 6 years: the service has held its Good rating throughout.
- October 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2018Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015
Registered with the Care Quality Commission on 16 December 2015.
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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At least 100 live-in carers within about an hour of Brent
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. 74 can care for a couple. 11 years' experience on average.
“The quality of life that she's given my parents has been priceless. The peace of mind she's given my sisters and I, through a very difficult time, has been invaluable.”
“I can truly say that Peter always put Dad at the centre of everything and I know that they found a great friendship in difficult times.”
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.