Archived: Holmer Care Home with Nursing

The home provides accommodation for a maximum of 35 people requiring personal care. There were 31 people living at the home when we visited. A registered manager was in post when we inspected the service. 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 and associated Regulations about how the service is run.

People felt safe living at the home and felt comfortable and at ease around staff. Staff understood what was required to keep people safe and had received training on the subject. The registered manager understood their obligation to record information of concern and ensured the local authority and CQC were made aware of these.

People’s risks to their health were monitored by staff who were aware of how best to support people which maintained their safety. People had access to help and support from staff when they needed it.

Staff working at the home had undergone the providers recruitment processes aimed at ensuring it was safe for them to work at the home. Background checks were completed so that the registered provider was assured of their suitability.

People received support to have the medicines. People’s medicines were regularly checked by the registered manager to ensure staff supported people appropriately.

People felt assured that staff were gave them the care and support they needed. Staff undertook regular training that was reviewed and supervisions with staff took place regularly.

The registered manager understood their legal obligation with respect to ensuring people’s ability to make decisions was recorded appropriately and any necessary action taken to protect them. Staff understood which decisions people were not able to make for themselves and how to appropriately support them in their best interests.

People made choices about the drinks and enjoyed the variety of meals that were prepared for them. People accessed additional medical help when this was appropriate and staff followed instructions left with them by the GP.

People liked the staff supporting them and felt staff included them in decisions about their care. People’s friends and families were encouraged to visit and to participate in discussions about how care could be improved at the home.

People had an opportunity to participate in activities that they enjoyed and staff supporting them understood which activities people liked.

People knew and liked the registered manager. They understood they could approach her and chat with her about things that were important to them. Staff were positive about working at the home and felt supported in their role. The registered manager monitored the care provided and how staff provided that care and support . The Service Quality Manager met with the registered manager regularly to support her and assure the registered provider of the quality of care being delivered at the home.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found.

Is the service safe?

The people who lived in the home and their relatives told us they were pleased with the care provided although many of the people were unable to express themselves due to their condition. Those that could said they felt that their views were respected and listened to.

We saw that staff had received specialist training in skin care. This was to protect people's physical wellbeing as well as their human rights and dignity.

Recruitment processes showed that staff employed to work at the home were suitable and had the skills and experience needed to support the people living there.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While nobody was currently subject to a DoLS proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made and how to submit one.

Is the service effective?

People and their relatives told us that they were happy with the support they received. They told us that the acting manager and the staff had asked them what their needs and wishes were and how they would like them met.

Personal records confirmed people's needs and preferences had been recorded and support had been provided in accordance with their wishes.

Relatives told us they were happy to discuss the support for their family member with staff. They said that staff obtained help for them if they were unwell. This meant people were helped to keep in good health, have access to health care services and received ongoing support.

We found that the staff received the support and training that enabled them to meet the needs of the people living in the home.

Is the service caring?

Staff took the time to find out about people's background. Staff knew people's needs well and how they needed to be supported. This meant that staff cared about the person as an individual and were concerned about their well-being.

People and their relatives were encouraged to make their views known about their care. Relatives that we talked with told us that they found the acting manager and the staff easy to approach about any issues they had. This meant that people were listened to and they felt that their views mattered.

Is the service responsive?

People had been assessed before they moved into the home. There needs were re-assessed regularly so that arrangements could be made to meet their needs.

Is the service well led?

The registered manager had recently left the service and was in the process of applying to de-register with us.

The acting manager and the staff demonstrated values that promoted involvement, openness, dignity, respect and independence. We talked with staff who showed they understood those values as they discussed their role and responsibilities in their work. This meant the service promoted an open culture that was centred on the individual and empowered them to take control of their life as much as they were able.

The provider had systems in place to assess and monitor the home so that potential improvements in meeting people's care needs could be identified and put into place.

People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. Staff told us about the training that the home had arranged for them to attend so that they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. They said that the staff were friendly and always acted professionally. One person said, 'The staff are very good' and 'They're very helpful'.

Staff provided health and social care support well. Community services were accessed to support people when necessary.

People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. Staff told us about the training that the service had arranged for them to attend so that they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. The relatives that we talked with told us that staff were around and available to talk to when they visited. They said that staff were friendly and always acted professionally. One person said that, 'They are very helpful' and another said, 'They're all pretty good'.

People we spoke with said their comments were listened to. One person said, 'They keep you up to date with what's going on'.