Archived: The Homestead Residential Home

Below is a summary of our finding based on our observations, speaking with people who used the service, the staff supporting them and from looking at records. As part of the inspection we asked the following questions:

Is the service safe?

We were aware that concerns regarding the safety of some people who used the service had been referred to the local authority for further investigation. The investigations had not been concluded at the time of our inspection.

When staff identified shortfalls in the safety of the service, the provider did not always act on them effectively. This inconsistent approach to risk and safety meant that this service does not have a track record of ensuring the safety and welfare of people.

Is the service caring?

People who used the service and visitors were consistently positive about the care and support they received from the staff.

We saw staff treated people with kindness and compassion. One person who used the service told us: 'It's lovely here, the staff are kind and caring and work very, very hard to make sure we are alright'.

A visitor told us: 'The staff are genuine people who really care. We are lucky to have such wonderful staff'.

Is the service effective?

People who used the service and their relatives told us that the care they received fully met their needs. Staff had an in depth knowledge of each person's individual requirements to ensure care and support was provided in a consistent and reliable way.

The physical environment is in need of capital investment to improve people's quality of life and promote their wellbeing.

Is the service responsive?

People's needs were met because staff had knowledge of the individual care and support requirements. Care and support plans, risk assessments and monitoring charts were completed and reviewed at regular intervals or when a change of need was identified.

The provider did not respond in a timely way when concerns were identified to ensure the safety and welfare of people who used the service.

People told us of the continued lack of equipment and resources which impacted on the service provided.

Is the service well led?

The service had a registered manager. People who used the service, staff and visitors told us the manager was approachable, friendly and very supportive.

Support and resources needed to run the service were not always available.

We had concerns with the conduct and fitness of the provider of the service and will be liaising with other authorities to monitor the situation.

Below is a summary of our finding based on our observations, speaking to people who used the service, their relatives, the staff supporting them and from looking at records.

Is it safe?

We saw staff were available in all areas of the home. We did not see or hear anyone had to wait for support when it was requested or needed.

Risk assessments were completed when risks were identified. Staff had the information to support people though periods of unease to reduce the risk of harm to the person and other people who used the service.

Staff encouraged and supported people to make choices and decisions. When people did not have the capacity to make certain decisions, family and medical professionals were involved.

There were some areas within the environment that needed attention to ensure the premises and equipment were safe.

Is it responsive?

We saw that positive action had been taken to ensure people's individual care and support needs were fully met. People's health, social and support needs were assessed and reviewed at regular intervals.

Is it caring?

We observed that people who used the service were treated with dignity and respect by the staff supporting them.

People told us they were happy and liked living at The Homestead. One person told us: 'I like it here; the staff are all very good and kind. The food is good and I have a comfortable bedroom'.

People who were unable to comment or did not wish to speak with us looked comfortable, well groomed and cared for.

There were some areas within the home that would not fully support and uphold the privacy and dignity of people.

Is it effective?

People who used the service told us they were able to do whatever they wished to do each day. Sometimes they liked to participate in group activities and at other times they liked to spend time alone. We saw that staff respected these choices.

Visitors told us the staff were very caring, coped very well with the changing support needs of their relative and did a very good job. They told us: 'I have no concerns whatsoever'.

Is it well led?

People who used the service, visitors and staff all told us that the current manager was supportive, approachable and friendly.

We previously had concerns about the monitoring of the quality and safety of the service. We saw that some improvements had been made. However there were still areas that required improvement and action by the provider to ensure the environment was safe.

We completed a responsive review in April 2013 to look at how things had improved since the inspection in November 2012. We had also received information of concern regarding the financial management of the home. We found that although some improvements had been made, we judged the provider as non-compliant with outcome 10: safety and suitability of premises. We referred our concerns about the provider's financial management of the home to the respective local authorities who funded people's placements at the home for their consideration.

At this inspection we checked whether required improvements had been made to the interior and exterior of the premises.

We completed a tour of the home; spoke with the registered manager, the provider and other staff members and people living in the home. We found that the provider did not have an effective system in place to ensure the safety and suitability of the premises.

We found that the provider did not have an effective system in place to identify repairs, assess and manage risks to the health, safety and welfare of people using the service and others.

We completed an unannounced responsive review to look at how things had improved since the last inspection. This meant that the provider and the staff did not know we were coming.

In addition to this we received information of concern regarding the financial management of the home. We completed the responsive review to assess whether these reported concerns had impacted on the care and wellbeing of people living in the home. In addition, we wanted to check whether there were sufficient staff in place to manage the needs of people living in the home in light of these concerns.

During our visit we spoke with the registered manager about changes and improvements that had been made at the home and about the reported concerns.

Having spoken with the registered manager and reviewed evidence provided we found that the provider was compliant with managing the care and welfare needs of people living in the home. We found that the home was compliant with respect to sufficient staffing levels within the home.

We found however that the provider was still non compliant with outcome 10 and had not taken sufficient steps to ensure the safety and suitable of the premises.

People who lived at the home that we spoke with were positive about living there.

One person told us, 'It is home from home here. It is very nice and pleasant'.

Another person told us, 'It is very good here. Everyone is helpful. They look after us well'.

We spoke with three relatives who were visiting the home. They told us they were very happy with the care provided at the home and the staff.

One relative told us, 'I am very happy with the home. The staff are brilliant. They always let me know what is happening'.

Staff we spoke with told us they had appropriate training to undertake their work competently and had the right level of support from the management team.

We looked at five key outcomes to establish whether people were involved and participated in the service they received; whether care was provided appropriately; whether the home could adequately ensure people's safety; whether there were sufficient staffing levels and whether there was a system for ensuring ongoing quality assurance within the home. The Homestead Residential Home was compliant in these five outcome areas.

We looked at an additional outcome regarding the safety and suitability of premises due to concerns raised during our inspection. We found that the home was non compliant with this outcome.