Background to this inspection
Updated
9 April 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
This inspection was completed by one adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience had experience in caring for older people and people living with dementia.
Service and service type:
Holmewood is a ‘care home’. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
This inspection was unannounced
What we did:
We reviewed information we had received about the service since the last inspection inn ??. This included details about incidents the provider must notify us about. We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
We contacted social care commissioners who help arrange and monitor the care of people living at Holmewood. We observed the lunchtime meal and conducted a SOFI on one of the units. A SOFI is a tool for observing interactions between care staff and people who may not be able to communicate with us verbally. This gives us an idea of what their care experience might be like for the time that we are there.
People using the service at Holmewood were not all able to fully share with us their experiences of living at the service. Therefore, we spent time observing staff with people in communal areas.
We reviewed three peoples care records including risk assessments, care plans, consent documents and daily and nightly notes. We also looked at policies and procedures and records relating to fire, health and safety, complaints, incidents, and lessons learned. We examined Medicine Administration Records (MAR) for three people and reviewed three staff recruitment files. We observed handover of staff between the day staff and the afternoon staff.
During the inspection we spoke with eight people who lived or were staying at the home, three relatives/visitors, three care workers, the activities co-ordinator, two cooks, an assistant unit manager, registered manager and deputy manager. We also spoke with three health professionals who worked with the service.
Updated
9 April 2019
About the service:
Holmewood is a residential care home that was providing personal care to people aged 65 and over. At the time of the inspection there were 23 people living or staying in the home.
People’s experience of using this service:
¿ People told us they felt safe and happy. There were positive and caring relationships between staff and people, and this extended to relatives and other visitors. Staff understood the importance of providing person-centred care and treated everyone as individuals, respecting their abilities and promoting independence.
¿ Staff knew how to recognise and report any concerns they had about people's welfare and how to protect them from abuse.
¿ 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.
¿ Care plans included risk assessments, which identified any risks, associated with people’s care and had been devised to help minimise and monitor the risks without placing undue restrictions on people.
¿ People's medicines were managed safely.
¿ The provider ensured incidents and accidents were fully investigated.
¿ Staff were recruited safely and only suitable staff were employed to work in the service.
¿ There were enough staff to keep people safe and to meet people’s individual needs, and the staff told us they received good training and support. Staff knew people well and had built good relationships. There was also a good mix of staff.
¿ People were encouraged to make decisions about meals, and were supported by staff if they needed any assistance with eating and drinking.
¿ People were involved and consulted about all aspects of their care and support.
¿ Staff spoke to people in a caring and positive way, treated people with respect and were mindful of their rights and dignity.
¿ There was a nice, relaxed atmosphere and people were relaxed and smiling in the staff’s presence.
¿ The environment was clean and fresh and good signage made it easy for people to find their way around the building.
¿ People and their relatives were encouraged to give the views about the service. People could join in activities if they wished and comments received were positive.
¿ The registered manager showed effective leadership and the home was well run.
¿ Staff knew their roles and understood what was expected of them.
¿ Staff felt supported by management and each other.
¿ People, their relatives and staff told us management were approachable and that they listened to them when they had any concerns or ideas.
¿ Feedback was used to make continuous improvements in the service. The provider had good oversight of the service and used effective systems to monitor quality and safety. Where improvements were needed or lessons learnt, action was taken.
Rating at last inspection:
Requires Improvement (report published 27 December 2017). The overall rating has improved following this inspection.
Why we inspected:
This was a planned inspection based on the rating at the last inspection.
Follow up:
We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk