The Holt

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection we rated this key question good. At this inspection the rating has remained good. This meant people were protected from abuse and there were enough well trained and knowledgeable staff available to support them. Risks to people's health, safety and welfare were identified and managed in the least restrictive ways.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People were comfortable and relaxed around the staff who supported them. They actively sought out staff and made their needs known in ways staff understood. Staff knew people very well and were alert to any changes in the way they presented, such as their mood or behaviours. A member of staff said, “We know if anything is wrong because [a person’s] body language and behaviour changes.” Feedback from families indicated they felt their loved ones were safe living in The Holt. A relative told us, “Very confident [loved one] is kept safe.” They also told us staff informed them of any issues related to their loved one’s care in a timely way and felt able to raise any concerns they had openly with staff. Staff demonstrated a good understanding of their role in keeping people safe, including how to recognise, report and record abuse. They received training about keeping people safe and told us the management team responded quickly to any concerns they raised about people’s safety. The provider’s policy for keeping people safe was readily available to staff along with contact details for relevant agencies such as the local authority. Records showed these types of events had been managed and reported appropriately. Any learning from the events had been shared with the staff team.

Risk assessments and positive behaviour support plans relating to the health, safety and welfare of people using the service were in place and regularly updated. Staff worked creatively with people to reduce risk. An example of this was the addition of a private bathroom and an alternatively shaped bath for a person who experienced distress during personal hygiene routines. This enabled them to bathe in the way they wanted to and removed a point of stress from their daily life. This supported them to stay calm and relaxed. Managers and staff demonstrated a commitment to reducing restrictions in people’s lives and developed detailed risk management plans to achieve this. Records showed continuing and significant reductions in the use of physical and environmental restrictions in line with best practice guidance. An example of this was a person who no longer needed a special harness when travelling in vehicles which enabled them to enjoy their journeys more. In addition, there was a significant reduction in the use of medicines to manage distress in line with STOMP guidance (Stopping over medication of people with a learning disability and autistic people). A member of staff told us they were ‘proud’ of the work being done to reduce restrictions. They added, “They [people using the service] do things now that past staff wouldn't have thought possible.” Staff spoke enthusiastically about, for example, people now being able to use the kitchen safely, joining local community groups, using public transport and enjoying community based social events. This gave people more opportunities to lead meaningful lives and minimised the risk of people experiencing distress. Incidents were recorded and reviewed which meant the registered manager and the provider had an accurate overview of incidents and were able to monitor trends. This meant they could highlight any lessons that could be learned to inform improvements in the way situations were managed.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

There were enough skilled and knowledgeable staff employed to ensure people received individualised support. Staff told us they received regular supervision from senior staff which supported their learning and development. Staff received regular training to ensure their skills and knowledge remained up to date and relevant to the needs of the people they supported, for example, autism, positive behaviour support, epilepsy and communication. A relative told us, “We feel staff are well trained and very aware of [loved ones] needs.” The provider had robust recruitment processes in place and staff told us they received a thorough induction training programme which included the opportunity to shadow experienced staff.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.