Heather Holmes Care Home

Updated 24 August 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Heather Holmes is a ‘care home'. 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.

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 before the inspection

Before the inspection visit, we reviewed information we had received about the service since the last inspection. This included information about incidents the provider must notify us of, such as any allegations of abuse. We sought feedback on the service from the local authority.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with three people who use the service about their experience of the care provided.

We spoke with seven members of staff including the operations manager, the registered manager, a senior care worker and care workers. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We spoke with two relatives and one community health and social care professional about their experience of care provided. We continued to seek clarification from the provider to validate evidence found. We looked at training data and policies.

Updated 24 August 2019

About the service

Heather Holmes is a residential care home providing personal care for up to 12 people in one adapted building. It specialises in supporting people who have learning disabilities and or autism. At the time of our inspection, there were 10 people living at the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes.

The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 12 people. Ten people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size.

People’s experience of using this service and what we found

The provider's quality assurance systems and processes were not always as effective as they needed to be. They had not enabled the provider to ensure staff always maintained accurate and complete records of people's care or ensured a consistent approach to risk assessment.

The provider's risk assessment procedures required strengthening. The registered manager advised that care plans were in the process of migration to a new standardised process. However, consistency was needed when risk assessments were being evaluated and used by staff to keep people safe. Staff were clear how to identify and report abuse.

People's needs were assessed before they moved into the home. People were protected from the risk of infections; however, improvements were needed in relation to infection control practices.

The provider followed safe recruitment procedures. Staff received ongoing training and management support to enable them to work safely and effectively.

People had enough to eat and drink and any associated risks were managed with appropriate specialist input.

Staff worked effectively with community health and social care professionals to achieve positive outcomes for people and ensure their health needs were met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interest. Policies and systems were in place; however, staff practice did not always follow policy in relation to the administration of Deprivation of Liberty safeguards (DoLS).

Staff knew the people they supported well and adopted a caring approach towards their work.

People were encouraged to express their views about the care provided, and these were listened to. People were treated with dignity and respect at all times.

People's care plans were individual to them, covered key aspects of their care needs and promoted a person-centred approach.

People had support to participate in a range of therapeutic, social and recreational activities.

People and their relatives understood how to raise any concerns or complaints with the provider.

The management team promoted effective engagement with people, their relatives and community professionals. Staff felt well-supported and valued

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good 30 November 2016 (published 24th December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements.

Please see Safe and Well-Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

The provider is aware of the concerns and has a service wide action plan in place to mitigate the risks.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heather Holmes Care Home on our website at www.cqc.org.uk.