CQC report explained · a residential care home
What the CQC found at The Holt
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2019
The Holt is rated Good; inspectors found kind, person-centred care, with some cleaning and storage issues.
The inspection was unannounced and took place on 20 August 2019. One inspector reviewed care records, medicines records, staff recruitment and supervision records, and management documents. They also observed care, spoke with staff, a relative and visiting professionals.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from abuse, medicines were managed safely, staff were skilled, and people's healthcare and nutrition needs were supported.
People were treated with kindness, dignity and respect. Care plans were personalised and people were supported to make choices, maintain relationships and take part in activities. Inspectors did identify that some areas were not clean and that some rooms were being used for storage inappropriately.
Kind and respectful care
Inspectors saw warmth and kindness in staff interactions. People appeared relaxed and were treated with dignity and respect.
“People were supported by staff who were kind, caring and treated them with dignity and respect.” from the report
Safe medicines support
Medicines were stored, given, disposed of and checked safely. Staff had training and regular competency checks.
“People's medicines were managed safely. This included storage, administration, disposal and stock control.” from the report
Personalised support
Care plans described people's individual needs, choices and preferences. They were reviewed and updated when needed.
“People's care plans were person-centred and reflected each person's individual needs.” from the report
Cleaning was not always effective
minorInspectors found that not all areas were clean. The issues were addressed immediately, and the manager said a domestic assistant had recently been employed.
“Effective cleaning practices were not always in place. Not all areas of the service were clean.” from the report
Limited and unsuitable storage
minorThe home needed further improvement to its storage arrangements. Cleaning materials were stored in the laundry room and a domestic fridge was kept in the medication room.
“The home did not have a lot of storage space and areas were being used inappropriately” from the report
- 01What changes have been made to ensure all areas of the home are cleaned properly?
- 02Where are cleaning materials and medicines stored now, and how is access controlled?
- 03How are people's risk assessments and care plans reviewed when their needs change?
- 04How will my relative be supported to choose activities and maintain independence?
- 05How can relatives be involved in care plan reviews and raise concerns?
This inspection looked at all five key questions and the care and premises provided to six people living in the home at the time. This explanation was written from the published report of 9 October 2019 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 2018
Rated Requires Improvement; inspectors found kind, personalised care, but staffing, medicines processes and management needed attention.
This was an unannounced, comprehensive inspection on 5 June 2018. Inspectors spoke with the manager, care staff and the area manager. They observed care and reviewed care records, staffing, training and quality checks.
People were treated with kindness, dignity and respect. Their care was personalised, communication was adapted to their needs, and people were supported with food, healthcare, activities and choices. Risks were assessed and managed, and safeguarding arrangements were in place.
However, there were not always enough staff. Some staff worked excessive hours, which could make them tired. PRN medicines are medicines given when needed, and one protocol was missing while protocols were not kept with the medicine records. Areas of the home needed refurbishment, 13 staff had not received supervision since January 2018, and quality checks did not always lead to completed actions.
The overall rating fell from Good to Requires Improvement. Caring and Responsive were rated Good. Safe, Effective and Well-led were rated Requires Improvement. The report says the manager was later registered with CQC after the inspection.
Kind and respectful care
Staff understood people's preferences and supported their privacy, dignity and independence.
“People's privacy, dignity and independence were respected and promoted.” from the report
Personalised support
Care plans recorded what mattered to people and were reviewed when their needs or wishes changed.
“We found that people received personalised care that was responsive to their needs.” from the report
Support with health
People were helped to access doctors and other healthcare professionals, including specialist services.
“People were supported to live healthy lives by receiving on-going healthcare support.” from the report
Safety systems
Risks were assessed and monitored. Staff knew how to recognise and report abuse, and lessons were learned from accidents and near misses.
“We found that risks to people's safety had been assessed, monitored and managed so that people were supported to stay safe while their freedom was respected.” from the report
Staffing levels
seriousThere were not consistently enough staff to meet people's needs. Some staff worked excessive hours, creating a risk of tiredness, and community activities were sometimes affected.
“The provider had not ensured there was consistently enough staff on duty to provide safe care to people.” from the report
PRN medicine information
seriousOne PRN protocol was missing, and protocols were not kept with the medicine records. This meant instructions were not always available at the point medicines were given.
“This meant they were not available at the point of administration for staff to use to ensure PRNs were administered appropriately.” from the report
Building maintenance
needs fixingParts of the home needed redecoration and repairs. Work in the refurbishment plan was behind schedule.
“This meant the home was not maintained to a good standard.” from the report
Staff supervision
needs fixingSupervision had not been provided consistently. Records showed that 13 staff had not received supervision from January 2018.
“Arrangements were not in place to ensure all staff received one to one support.” from the report
Quality follow-through
needs fixingThe home carried out checks, but actions were not always given completion dates or completed. Staff also lacked confidence that concerns would be taken seriously.
“Despite this we found issues had not been consistently addressed.” from the report
- 01How many staff are now on duty for each shift, and how do you ensure there are enough male staff when this is required for a person's care?
- 02How do you monitor staff working additional hours and prevent tiredness from affecting people's safety?
- 03Are all PRN protocols now complete and kept with the medicine administration records?
- 04What refurbishment and maintenance work has been completed since the inspection, and what remains outstanding?
- 05How often does each staff member receive supervision, and how are staff concerns recorded and acted on?
This was an unannounced comprehensive inspection covering all five questions and the overall rating. This explanation was written from the published report of 11 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.
Every inspection of The Holt
3 rated inspections over 4 years: the service has held its Good rating throughout.
- October 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2015GoodSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 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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9 live-in carers within about an hour of Lincolnshire
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.
8 can care for a couple. 10 years' experience on average.
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
“Magda was always positive and proactive about trying new things to keep dad busy. She also introduced new ideas for keeping dad healthy.”
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.