We carried out a review of the data available to us about Holmleigh Care Home 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 Holmleigh Care Home, you can give feedback on this service.
Some staff had entered and left the premises at the start and end of their shift wearing their uniform. This increased the risk of spreading infection. We also found recording of daily staff temperatures was not consistent. This meant the provider could not accurately monitor for potential signs of infection within the staff team. These issues were discussed with the deputy manager who took immediate action to address the concerns.
We found the following examples of good practice.
• A recent outbreak of COVID-19 was well managed and staff understood how to support people safely.
• Infection prevention and control policies had been updated to reflect current national guidance.
• The provider had a system in place to ensure a sufficient and continued supply of personal protective equipment (PPE) was maintained.
• Enhanced cleaning schedules were in place and housekeeping staff were clear about their responsibilities. In addition, arrangements were in place for deep cleaning of the premises by an external company.
• Staff who had tested positive or displayed symptoms of COVID-19 infection had been supported to isolate and subsequently return to work in line with government guidance.
• Staff had been trained about how to prevent and control the spread of infection. This included how to put on, take off and dispose of PPE safely.
• Guidance and information on COVID-19 restrictions was available and visible for people living in the home, staff and visitors.
• People living in the home and staff took part in a regular testing programme. This meant that anyone who had contracted COVID-19 was identified in a timely way.
• COVID-19 risk assessments were in place, which included information to guide staff about how to support people who lived in the home.
• People were supported to maintain contact with family and friends in whichever way they preferred. For example, they were supported with telephone calls, video calls and letter writing. Socially distanced or window visits had been restricted during the outbreak. However, systems were in place to ensure those people who were at the end of their lives were safely able to have more direct contact with family and friends.
Further information is in the detailed findings below.
Holmleigh Care Home is a residential care home providing accommodation and personal care for up to 44 older people. At the time of the inspection 40 people were living at the home.
Holmleigh Care Home is situated in the village of Navenby, Lincolnshire and accommodation is provided across two floors.
People’s experience of using this service and what we found
At the last inspection we identified issues and made recommendations about the quality of medicines arrangements, cleanliness, care planning, staffing levels and communicating with and responding to people’s needs. At this inspection we found the provider had made improvements in all these areas.
People were cared for by staff who understood how to safeguard them from the risk of harm. Risks to people’s health, safety and welfare had been assessed and management plans were in place to minimise the risks.
The provider employed enough staff to make sure people’s needs and wishes were met. Staff were recruited safely and trained to carry out their roles and responsibilities.
Medicines were managed in a safe way and systems were in place to control and prevent the spread of infection.
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.
Staff were kind and caring towards people and maintained their privacy and dignity. People and those who were important to them were involved in planning their care and asked for their views about the quality of the services they received.
People and the staff who cared for them had confidence in the way the home was managed. Systems were in place to regularly monitor the quality of the services provided for people and take actions to address any highlighted shortfalls.
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 28 August 2018) and there was one breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations
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 re-inspection programme. If we receive any concerning information we may inspect sooner.
Holmleigh care home offers accommodation for up to 44 older people with care needs. It is situated in the village of Navenby in Lincolnshire and offers accommodation on two floors. On the day of our inspection, there were 40 people living at the home.
At our last inspection in March 2016, we rated the service good. At this inspection, we rated the service as requires improvement overall and requires improvement in each domain.
There was a registered manager in place. 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.
Staffing levels were not always sufficient to meet the needs of people using the service due to vacancies and short term absence. People told us there were delays in staff responding to their needs and staff spoke about difficulties in providing the required levels of care, when planned staffing levels were not achieved. However, new staff were about to commence employment and the management team were taking steps to recruit additional staff. Safe recruitment processes were in place.
Systems were in place for the regular ordering and supply of medicines and people told us they received their medicines regularly. However, staff did not always stay with people to ensure they took their medicines. Processes to assess staff competency to administer medicines and to address gaps in the medicines administration record were not robust. We found some issues with the storage of medicines; however, following the inspection the management team took steps to address these issues. Systems were in place to maintain the premises and required maintenance and safety checks were completed. Staff had developed personal emergency evacuation plans for people to enable them to be evacuated from the building safely in an emergency. Most areas of the home were clean; however, we found some cleanliness issues in the kitchen and cleaning schedules were not being used to ensure a systematic approach was taken to cleaning the kitchen and catering trolleys.
People told us they felt safe. Processes were in place to keep people safe from abuse and avoidable harm. Staff reported incidents and accidents and a full investigation was completed following incidents and accidents to reduce the risk of reoccurrence.
Most of the people using the service were able to consent to the care and support provided and were able to leave the home freely if they wished. However, we identified instances when the principles of the Mental Capacity Act and consent legislation were not fully adhered to. The registered manager told us they would review the decision making in relation to these immediately.
Staff received an initial induction and training was provided, to ensure they were competent for their roles. However, the management team did not have full oversight of training to enable them to assure themselves that staff training was up to date. This was an issue which they had identified during their quality audits and they were in the process of developing a training matrix, to record all training completed and the dates of training.
People had access to healthcare services as they required. Staff were alert to signs people were unwell and sought medical advice when necessary.
The majority of people told us staff were kind and caring towards them; however, we received some feedback about poor staff interactions and comments which were uncaring. We observed some positive communication from staff, but we also saw occasions when staff were task orientated and they did not always show empathy and understanding towards the people they cared for.
The care staff gave was responsive to people’s individual needs and staff were knowledgeable about the people they care for. Care plans did not always provide sufficient information about the support people required and their preferences in relation to their care. A new electronic care planning system had recently been introduced and some of the issues we identified may have been due to the inexperience of staff in using the system. Activities were available for people in the form of entertainment, one to one and group activities. People told us they enjoyed the range of activities available.
People had confidence in the registered manager and the management team to address concerns. Quality audits were completed by the management team and the provider and some of the issues we identified during the inspection had been identified in the audits and actions put into place to address them. However, we found action plans and follow up of issues were not always robust and timely. Following the inspection, the management team acted immediately to address our concerns where possible, and develop further action plans to progress concerns that required a longer term approach. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, as audits had not always identified the improvements required.
We inspected Holmleigh Care Home on 19 January 2016. The inspection was unannounced.
Holmleigh Care Home is owned and managed by Lincolnshire Licenses Limited. It is situated in the village of Navenby in Lincolnshire and offers accommodation for to up to 44 older people. It is registered to care for people who require accommodation with personal care.
There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
CQC is required by law to monitor the operation of the Mental Capacity Act, 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of the inspection no-one who lived in the home had their freedom restricted. The registered manager demonstrated their understanding of how to identify restrictions to people’s freedom and apply for DoLS authorisations if this was required.
People felt safe living at the home. Staff knew how to manage any identified risks and they understood their responsibilities to report any concerns for people’s safety. People’s individual health and nutritional needs were managed effectively, in ways that met with their wishes and preferences. The registered manager and staff had developed good working relationships with other professionals involved in people’s care so as to ensure they had the full range of support they needed.
People were treated with kindness by staff who demonstrated genuine concern for their health and well-being. They were able to make their own choices and decisions about their lives and were consulted about the care they received. People were encouraged to express their views and opinions about the way the home was run. They knew how to raise concerns or complaints and were confident they would be dealt with appropriately.
Staff had the skills and knowledge to provide people’s care in the ways they needed and preferred. They had been recruited in a way that ensured they were suitable to work in the home. Sufficient staff were employed in the home to ensure people received their care in a timely manner. Training and support systems ensured that staff were kept up to date in their knowledge and could develop their skills.
The registered manager acted in accordance with their responsibilities as a manager who was registered with CQC. They had systems in place to regularly assess and monitor care practice and to ensure people received a good quality of care. The systems in place meant that any shortfalls in quality could be quickly identified and improvements made.
Overall we observed that people were supported by skilled and experienced staff who understood their roles and responsibilities.
We observed care and saw staff were responsive to people and interacted with them positively. During our visit we saw staff were caring towards people and responded to their wishes.
We saw from the care plans and observations people received care which was safe and appropriate to their needs.
People told us they were, "Very happy here" and said "Staff are caring."
We observed people received effective nutritional support. When we spoke with people they told us the food was good. We saw people were offered choices at mealtimes.
The provider had a process in place for reporting and recording accidents. However when we looked at the records we found there were two incidents which should have been reported to us as a serious injury. We spoke with the deputy manager who told us they would address this.
Overall we observed that people were supported by skilled and experienced staff. We saw staff had received the appropriate checks before commencing employment and subsequently received training and support.
We saw people were treated with dignity and supported to make decisions about their care. Care records were up to date and we saw care reflected what was written in the care plans.
People told us they liked living at the home and they were well cared for. One person said, 'Love it here,' and 'Couldn't have a better place.'
People said the food was good and were given a choice at mealtimes. They told us, 'The food is very good.'
Relatives told us the home provided 'excellent' care.They told us if they had any issues they would be able to discuss them with the staff.
When we spoke with a nurse visiting the home they told us the home provided good care and they had a good relationship with the home.They told us care was carried out as they recommended for people.
Another person told us staff respected their privacy and always knocked and asked before entering their room. They also said, 'Staff are polite and respectful.'
People told us they felt their needs were being met by the support they had received and this was provided in a way they wished. People said they were able to make the decisions they felt able to. One person told us, 'If I go out with relatives and miss a meal they always make sure there is something for me to eat when I get back. The food is very good.'
We asked people if they felt safe in the home and they said they did. People also told us they did not feel they had ever been put at risk.
A visitor told us staff had been 'outstanding' in ensuring their relative's safety and putting a plan into place to ensure this from an identified risk.
We asked people if they felt they had been able to make comments about what it was like to live in the home. People said that they did, one person told us, 'To be honest I get out more now than when I lived on my own. It's a wonderful place and the staff are brilliant. The food is excellent and I've put on weight since I've been here.'
Other people told us they thought the home was friendly and homely. They said the food was good. A relative commented they appreciated the care staff took to ensure people were well presented. They commented,' Overall I would say the care is excellent. If it wasn't they (their relative) would have been moved by now. This is the best place for them.'