We carried out a review of the data available to us about Holmesdale House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Holmesdale House, you can give feedback on this service.
Holmesdale House is a residential care home providing personal care for up to six older people. At the time of our inspection, four people were in residence. The care home is located close to local shops and amenities. It consists of one adapted building. There are a range of communal areas, including a garden for people to enjoy.
People’s experience of using this service and what we found
We found some issues in relation to record keeping for staff recruitment, equipment safety testing and the provider’s understanding of their regulatory responsibility to submit notifications to the Care Quality Commission (CQC). Each of these issues was quickly addressed by the registered manager.
We have made a recommendation that the provider updates their practice in line with current guidance on disclosure and barring (DBS) checks.
People were enthusiastic in their praise for the home. One person said, “You've got all the facilities. All the staff are very good. I say I get spoilt”. Another told us, “It’s lovely”. Feedback from reviews included, ‘The staff are super friendly and nothing is too much trouble for them’, ‘She (person who received care) is forever singing their praises’ and ‘Excellent standard of care on all levels within a wonderful, warm and family-like setting’.
The provider prided themselves on offering a ‘home from home’ and a family feel. This was being achieved and everyone spoke of how homely Holmesdale House was. In a review, a relative wrote, ‘Behind Holmesdale’s typically leafy suburban façade lies a true sanctuary of wonderfulness. Staff become friends and residents are cared for each to their own needs in an environment that is truly home from home’.
People received high quality care that improved their wellbeing. Strong relationships were formed between staff and people due to the continuity of staff and the caring approach of staff members. Staff knew people as individuals and worked to ensure people felt fulfilled and were able to live their lives as they wished. Staff actively supported people to remain independent and to retain their mobility. People were treated with the utmost dignity and respect.
There was strong leadership within the service and everyone said they would recommend the home. The registered manager had shaped a culture where people were at the heart of the service.
People felt safe at the home. Risks to people had been assessed and staff followed guidance to keep people safe. Staffing levels met people's needs. Medicines were managed safely. Lessons were learned if things went wrong.
People spoke very positively about the staff who supported them and had confidence in their skills and experience. Staff had regular supervisions and an annual appraisal. People enjoyed the food and worked together weekly to plan the menu. People had access to a range of healthcare professionals and support. Premises were suitable, comfortable and met people's needs.
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.
Care was highly personalised to meet people's needs. Care plans provided detailed information and guidance for staff on people's care and support needs, likes and dislikes, and exactly how they wished to receive personal care. Activities were organised according to people's preferences, interests and suggestions. People's communication needs were identified and planned for. People expressed confidence that they could raise any issues or concerns and that these would be addressed.
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 (published 7 Feb 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.
This inspection took place on 5 October 2016 and was unannounced. There were six people living at the service at the time of this inspection.
There was a manager at the service who was registered with CQC. 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 2008 and associated Regulations about how the service is run.
The service was exceptionally caring. People and their relatives were extremely satisfied with the care and support provided and spoke very highly of all staff. The ethos of the service was that of an extended family. The small staff team had developed very positive, caring and compassionate relationships with people. Staff knew each person as an individual and understood what was important to them and placed their wellbeing at the heart of their practice. People were treated with dignity and respect and staff approach was considerate, friendly and personalised. People experienced a lifestyle which met their expectations and preferences, and satisfied their social, cultural, religious and recreational interests and needs.
Staff supported people to engage in a variety of activities and people’s independence and choice was promoted. Staff spent time engaging people in conversations and activities.
People said they felt safe. They were protected against the risk of abuse. Staff had been trained to recognise what to look for. The registered manager and staff understood their responsibilities to report any concerns.
Assessments identified people's specific needs or risks, and showed how risks could be reduced. There were systems in place to review accidents and incidents and the registered manager ensured action was taken where necessary to reduce future risks. Medicines were managed safely and people were supported to take their medicines as prescribed.
There was a sufficient number of staff deployed to meet people's needs and staff were trained and competent to meet people’s individual needs.
People were protected by good practice in relation to decision making. The registered manager and staff had an understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS).
People were offered a diet that met their needs and wishes. Menus offered variety and choice. People said they liked the food. People had access to a variety of health professionals for specialist advice and support when appropriate.
Staff felt valued and supported by the registered manager and the management team. The registered manager was open and transparent in their approach. They placed emphasis on continuous improvement of the service and aimed to promote links with the community. Consistently positive feedback from people and relatives meant the service had achieved a top 20 care home rating in South East England for the past three years.
There were systems in place to monitor the service to identify any improvements that needed to be made. The management team acted on the results of any feedback to improve the quality and safety of the service.
People told us that they were treated with kindness and respect and that they had given consent to the care and support that was given. One person told us, 'I chose to move in here and so I gave my agreement to the support I received.' Another said, "We are so lucky to live here, we are all friends and get on well." One person said, "I knew the home before I came to live here, so I am very content and never want to move."
We examined four care plans and saw evidence that delivery of care was individual and person specific. Care plans and activities were designed and carried out to give people new experiences and independence while keeping them safe.
We found good management processes in place in relation to obtaining, storing, administering and disposing of medicines.
There were robust recruitment processes in place that protected the people who used the service from abuse.
We looked at the systems and processes the home had in place to respond to complaints. There had been no complaints received in the past year.
People told us they were involved in decisions about their care and treatment. They told us they had choice in every area of their life. People told us they had, 'No complaints.'
We talked with two staff and the manager. These staff were committed to supporting people to live their life in as independent a way as possible. Staff provided the level of support requested by the person who used the service. We observed that people were treated with respect and dignity.
We looked at the arrangements to keep people safe in the home. There were risk assessments, and policies and procedures in place. People told us, 'We feel as safe as houses here.'
There were processes in place to review and evaluate the standard of service being offered. There were mechanisms in place to ensure that people were involved in identifying improvements needed in the home.