Archived: Holbeche House Care Home

Holbeche House is a residential care home providing personal and nursing care for up to 49 older people, some of whom live with dementia. At the time of the inspection the service was supporting 42 people. The care home accommodates people in one adapted building which is split into two units. One unit supports people with nursing needs and the second unit supports people who live with dementia.

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

The risks to people had not always been assessed, recorded and plans put in place to manage these. However, staff were aware of these risks and what to do to keep people safe. People had support to take their medicines safely and as prescribed. However, some people’s thickener was not safely stored. People’s relatives and staff gave us mixed feedback on staffing arrangements at the service. Staff knew how to identify and report any abuse concerns. Incidents and accidents involving people were monitored to learn from these.

The environment of the dementia unit was not dementia-friendly. People’s care plans did not always show their health needs had been considered. People had help to access external healthcare professionals and services. Staff received induction and training to enable them to perform their duties. People had the support they needed to eat and drink.

Staff did not always have time to support people in a personal way. We received mixed feedback from people’s relatives on the extent to which they were involved in care planning and people’s care plans did not reflect their involvement. People had support to maintain valued relationships.

People’s care plans were not person-centred or always updated in response to changes in their needs. People did not receive enough support to pursue their interests or participate in meaningful activities. People’s communication needs had been considered.

The provider’s quality assurance systems and processes were not sufficiently robust or effective. We received mixed feedback from people’s relatives and staff on the management of the service.

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

Rating at last inspection

This service was registered with us on 21 September 2020 and this is the first inspection. The last rating for the service under the previous provider was requires improvement, published on 21 August 2019.

Why we inspected

The inspection was prompted in part due to concerns received about medicines, infection control and staffing. A decision was made for us to inspect and examine those risks.

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 the service can respond to COVID-19 and other infection outbreaks effectively.

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

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified a breach in relation to the overall governance of the service at this inspection.

Follow up

We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.