The Holt Retirement Home

Updated 14 July 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.

This inspection took place on 7 April 2021 and was unannounced.

The inspection

This was a targeted inspection to check on a specific concerns raised about personal care and COVID-19 management.

Inspection team

One inspector carried out the inspection.

Service and service type

The Holt Retirement Home is a residential care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a registered manager. This means that when registered they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spent time with people living at the service. We spoke with the registered manager, operations manager, seven care staff and domestic staff.

We reviewed a range of records. These included four people’s personal care records, a variety of records relating to the management of the service, including audits and procedures were reviewed.

After the inspection

We carried out telephone interviews with seven members of the care staff and continued to seek clarification from the provider to corroborate evidence found.

Updated 14 July 2021

This inspection took place on 9 and 16 October 2018 and the first day was unannounced.

The Holt Retirement Home is a 'care home' situated in the village of Hutton Buscel. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service supports older people, some of whom may be living with dementia, and can accommodate up to 22 people. At the time of our inspection 20 people lived at the service.

The service is provided in one large building and people have access to communal spaces including a conservatory and a recently landscaped outdoor area.

A registered manager was in post who assisted us throughout the inspection. They had managed the service since 2015. 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.

At our last inspection we rated the service 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.

Quality assurance checks completed by the registered manager and provider did not identify all the issues we highlighted during our inspection. For example, protocols for ‘as and when needed’ topical medicines not being consistently in place, bed rail checks had not been completed and the recording of reviews and activities required improvement. The management team were responsive and took actions to address the issues we raised.

Detailed risk assessments were completed and control measures to respond to and mitigate potential risks were clearly documented. There were sufficient staff, who worked well together, to safely meet the needs of people who used the service. Staff continued to be recruited safely. Health and safety checks on the building and equipment were completed to ensure people’s safety.

Overall, medicines management was safe. We found gaps in one person’s medication administration record and protocols for topical creams were not consistently in place. We have made a recommendation that the service ensure their medicines management is in line with best practice.

Staff undertook training to ensure they had sufficient skills and knowledge for their role. Staff had an annual appraisal of their performance and most staff had received a recent supervision. Staff described feeling supported in their role.

Assessments were completed before people moved into the home to ensure their needs could be met and to understand their like and dislikes. Staff sought people’s consent before providing care. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Applications to deprive people of their liberty were sought appropriately. The staff worked closely with professionals and sought their advice and input in the care provided. People's weight was monitored and choice of meals and snacks were available according to people's needs and preferences.

People who used the service, their relatives and professionals were positive about staff’s approach. Staff were calm and patient with people and promoted their privacy, dignity and independence. Information was available about advocacy services and advocates had aided some people in their decision making process.

People received person centred care from a staff team who understood and responded to their changing needs. Detailed care plans were in place which described people’s needs, the support required and contained information about their life history and personal circumstances. The service employed an activities coordinator who arranged a timetable of activities which included visits from performers and craft activities. Information was recorded about people’s end of life wishes. The provider had a complaints policy in place, however no formal complaints had been received within the last 12 months. People’s relatives were confident that any issues they raised would be listened to and addressed.

We received positive feedback about the management of the service with both the registered manager and provider described as approachable and visible. The management team worked closely with other agencies to ensure people received the care they required. People’s feedback on the running of the service was sought and a series of staff meetings were held to share important information about the service and to seek their views.

Further information is in the detailed findings below.