Homewood

Updated 8 February 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 1 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.

Service and service type

Homewood is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Homewood is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before 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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service and 4 relatives about their experience of the care provided. We spoke with 6 members of staff including the registered manager, home manager and support workers.

We reviewed a range of records. This included 4 people’s care records and multiple medication records. We looked at 2 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.

Updated 8 February 2023

About the service

Homewood is a residential care home for people living with a learning disability and autistic people It is registered to provide personal care for up to six people; at the time of inspection six people were living at the service.

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

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 interests; the policies and systems in the service supported this practice.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

Each person had their own room, which were personalised to meet their needs and preferences. People were being supported to be actively involved in their day to day lives, cooking and doing their own household tasks with staff support. People valued these opportunities and they helped to maximise people’s independence.

The service had worked hard since the last inspection, with people, to plan for when they experienced periods of distress so their freedoms were restricted only if there was no alternative. Staff successfully did everything they could to avoid the use of restraint. The past year had seen no recorded incidents where people had needed emergency medication to help them when distressed. Improved staff knowledge and effective strategies had supported this positive improvement. Staff learned from those incidents and how they might be avoided or reduced.

Staff supported people to make decisions following best practice in decision-making.

Right care

People experienced an improved quality of care. People and their families told us staff were kind and supportive. We observed staff respecting people’s dignity and ensured people had the right to have their say on their care and support. Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. People’s care, treatment and support plans mostly reflected their range of needs and this promoted their wellbeing. Staff and people worked together to assess risks people might face and were continuing to develop this area to encourage more positive risk taking.

Right culture

The formal governance system had been running for a year at the time of this inspection and was delivering assurances. There were areas which were identified at inspection the system had not picked up. Mainly some cleaning and maintenance shortfalls but the registered manager acted promptly to improve the areas the system looks at to avoid future issues.

People’s opportunity to lead inclusive and empowered lives had improved since the last inspection. This is because staff knowledge and understanding had improved due to the investment in training and the development of a coaching and reflective culture. Managers understood that further work was needed to support more people to develop skills and have the opportunity to all voice their aspirations and plan towards meeting them. Managers and staff clearly tried to deliver person centred support, people and their families were listened too and consideration of their views were reflected in the service delivery.

People received good quality health care, support and treatment because trained staff and specialists could meet their needs. Staff knew people well and the staff team was consistent in both numbers of staff and staff approach.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 01 November 2021) and there were breaches in the following regulations. Safeguarding service users from abuse and improper treatment, staffing and good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve. We undertook this inspection to check they had followed their action plan and to confirm they now met legal requirements. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

Why we inspected

This was a planned focused inspection based on the previous rating. We looked at the key questions of Safe, effective and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Homewood on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.