The Holt

Updated 20 April 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 4 March 2021 and was announced.

Updated 20 April 2021

We carried out an unannounced comprehensive inspection on 27 October 2018.

The Holt Residential Home provides care and accommodation for up to two people. On the day of our inspection there were two people living at the service. The home provides residential care for people with a learning disability.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was a registered manager in post, however they were currently not available. In their absence, there was an acting manager working in the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We checked the service was working in line with ‘Registering the right support’, which makes sure services for people with a learning disability and/or autism receive services are developed in line with national policy - including the national plan, Building the right support - and best practice. For example, how the service ensured care was personalised, discharge if needed, people’s independence and links with their community.

At the last inspection on the 17 March 2016, the service was rated Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good:

People were not all able to fully verbalise their views therefore they were not able to tell us verbally about their experience of living there. We spent short periods of time with people seeing how they spent their day and observing the interactions between people and the staff supporting them. However, one person when asked if they were happy living in The Holt said ‘Yes’ they were.

People remained safe at the service. People were protected from abuse as staff understood what action they needed to take if they suspected anyone was being abused, mistreated or neglected. Staff were recruited safely and checks carried out with the Disclosure and Barring Service (DBS) ensured they were suitable to work with vulnerable adults. There were sufficient numbers of staff to meet people’s needs and help to keep them safe.

People’s risks were assessed, monitored and managed by staff to help ensure they remained safe. Staff assessed and understood risks associated with people’s care and lifestyle. Risks were managed effectively to keep people safe whilst maintaining people’s rights and independence.

People had their medicines managed safely, and received their medicines in a way they chose and preferred. Staff undertook regular training and competency checks to test their knowledge and to help ensure their skills in relation to medicines were up to date and in line with best practice.

People were supported by staff who had received training to meet their needs effectively. Staff meetings, one to one supervision of staff practice, and appraisals of performance were undertaken. Staff completed the Care Certificate (a nationally recognised training course for staff new to care). Staff confirmed the Care Certificate training looked at and discussed the equality and diversity and the human right needs of people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's health was monitored by the staff and they had access to a variety of healthcare professionals. The acting manager worked closely with external health and social care professionals to help ensure a coordinate approach to people’s care.

People’s care and support was based on legislation and best practice guidelines; helping to ensure the best outcomes for people. People’s legal rights were up held and consent to care was sought as much as possible. Care records were person centred and held full details on how people liked their needs to be met; taking into account people’s preferences and wishes. Overall, people’s individual equality and diversity preferences were known and respected. Information recorded included people’s previous medical and social history and people’s cultural, religious and spiritual needs.

People were treated with kindness and compassion by the staff who valued them. Staff had built strong relationships with people who lived there. Staff respected people’s privacy. People, or their representatives, were involved in decisions about the care and support people received.

The service remained responsive to people's individual needs and provided personalised care and support. People’s communication needs were known by staff. Staff had received training in how to support people with different communication needs. The provider had taken account of the Accessible Information Standard (AIS). The AIS is a requirement to help ensure people with a disability or sensory loss are given information they can understand, and the communication support they need.

Staff adapted their communication methods dependent upon people’s needs, for example using simple questions. Information for people with cognitive difficulties and information about the service was available in an easy read version for those people who needed it.

People could make choices about their day to day lives. The provider had a complaints policy in place and it was available in an easy read version. Staff knew people well and used this to gauge how people were feeling.

The service continued to be well led. People lived in a service where the provider’s values and vision were embedded into the service, staff and culture. Staff told us the acting manager was approachable and made themselves available. The provider had monitoring systems which enabled them to identify good practices and areas of improvement.

People lived in a service which had been designed and adapted to meet their needs. The service was monitored by the provider to help ensure its ongoing quality and safety. The provider’s governance framework, helped monitor the management and leadership of the service, as well as the ongoing quality and safety of the care people were receiving.