• Care Home
  • Care home

SENSE Holmlea

Overall: Good read more about inspection ratings

53a Shipdham Road, Toftwood, Dereham, Norfolk, NR19 1JL (01362) 854165

Provided and run by:
Sense

All Inspections

During an assessment under our new approach

About the service:

The service is a care home. There were 6 people living at the service in ground floor purpose-built accommodation.

Who the service is for:

The service supports people with sensory needs, including autism, learning disability and additional health care needs.

Our view of the service:

Key findings

We carried out this assessment on 24 July 2026. This service was previously rated good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice.

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. We were assured the service met the principles of ‘Right support, right care, right culture’ and people received safe, person-centred and outcomes focused care and support.

Staffing levels were appropriate, and staff had the necessary skills to meet people’s comprehensive needs which included physical disability, learning disability, sensory needs and health needs. Staff had adequate training and their competencies were assessed to help them deliver safe, effective care.

A staff member told us, “I have had face to face training for first aid which covered the topics of emergencies, diabetes and recognising health conditions, and a separate face to face training for epilepsy. I am medication trained and had my assessment of competence.”Some staff had completed end of life training and others had not which was raised with the registered manager.

A staff member told us, “The team seems to all work well together and complement each other’s strengths. ”Another said, “I feel part of the team and respected.”

Staff told us they felt well supported by the management team and the out of hours support. One staff said, “I feel both my manager and deputy are responsive to my questions, and it is nice that they have an open-door policy.” Another said the out of hours on call was sometimes difficult as it could be covered by a manager who was not familiar with the service, However the on-call was a 2 tier system and the registered manager told us they were local and could be contacted.

The registered manager was complimentary about their staff and their abilities. Ongoing support and recognition of staff’s talents and skill set could be enhanced by the development of further champion roles, train the trainer and a greater take up of national recognised qualifications. There was a registered manager and deputy manager and a team lead had recently been appointed to enhance the running of the service.

The environment was appropriate to people’s needs and was spacious, personalised and very clean. People had the equipment they needed to support safe care. No risks to people’s environment were identified and regular maintenance checks helped ensure people’s safety.

We observed lunch time and interactions across the day between staff and people using the service. These were wholly positive and demonstrated to us that staff were skilled communicators and treated people with respect and dignity. A staff member told us, “We are a really good team, and all have the same goal to give our guys, their families all the love and support we can to make their lives fulfilling.” Electronic care plans clearly described people’s needs andvwhat was important to them to help ensure any care delivery was person centred.

Activities were provided sensitively around people’s needs and assessed risks. Whilst staff took people out and this included holidays and day trips, staffing levels did not lend themselves to people going out every day due to the high level of support people required with their mobility. The home had adequate transport and the service-maintained relationships with the external community, friends and family. We suggested that external entertainers might ease the pressures on staff and enhance people’s experiences.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the principles of the Mental Capacity Act 2005 (MCA). Whilst restrictions were in place: for example, a monitoring system, the rationale for this was clearly documented and there was a risk assessment and best interest decision in place. People had communication plans in place to support staff in understanding how people expressed themselves.

Deprivation of Liberty Safeguards (DoLS) authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions they had choice,control and freedom over their lives.

The service used learning from feedback, incidents and reviews to make service improvements. Staff confidently answered questions about safeguarding people in their care and received appropriate training. A staff member told us, “Management are with us every step, and very approachable and supportive, and I would not think twice about approaching if I had any concerns about another member of staff or the people we look after.” Safeguarding records were appropriate.

Medicines were managed safely and staff were conscientious.Tablet counts were completed multiple times a day and handed over to the next medication lead so if a medication error occurred, this could be quickly identified to ensure people’s safety. Medicines were regularly reviewed and the service worked closely with other services to ensure joint up care. A safeguarding concern had been raised when care between services had not been seamless and staff advocated for people as they knew them best.

There was a positive culture in the home and staff had confidence in the management team and the support they received. Staff felt valued and had the necessary skills to deliver appropriate care and were supported to develop their skills. Quality assurance systems were firmly embedded and helped staff to evidence their compliance with regulation and good practice. Electronic care plans had taken over from paper records and whilst these were detailed staff were still getting use to the new system. We discussed with the registered manager about making care plans accessible to parents where appropriate and where they held Power of attorney. Relatives told us communication was good but said sharing photographs and good new stories would be appreciated. The registered manager said they would be developing a newsletter.

 

25 March 2019

During a routine inspection

About the service:

Sense Holmlea is a residential care home that provides care and support for up to six people who have learning disabilities, sensory impairments and may also have physical disabilities. At the time of our inspection there were five people living in Sense Holmlea.

People’s experience of using this service:

¿ The service was safe and people were protected from harm. Staff were knowledgeable about safeguarding adults from abuse and knew what to do if they had any concerns and how to report them. Risks to people who used the service were assessed and their safety was monitored and managed, with minimal restrictions on their freedom. Risk assessments were thorough and personalised.

¿ The service ensured there were sufficient numbers of suitable staff to meet people’s needs and support them to stay safe. The registered manager confirmed that robust recruitment procedures were followed.

¿ Medicines were stored, managed and administered safely. Staff were trained, and their competency checked, in respect of administering and managing medicines.

¿ People who used the service were supported to have sufficient amounts to eat and drink and maintain a balanced diet. People enjoyed their meals and were supported to choose what they wanted from the menus and other options available.

¿ Staff demonstrated a good understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards. Staff understood the importance of helping people to make their own choices regarding their care and support. People who used the service were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible

¿ Staff treated people with kindness, respect and compassion. People also received emotional support when needed. People were involved in planning the care and support they received and were supported to make choices and decisions and maintain their independence as much as possible. Communication needs were identified and planned for in line with the accessible information standard. Information was provided to people in formats they could understand.

¿ Care plans were personalised and described the holistic care and support each person required, together with details of their strengths and aspirations. Information also explained how people could be supported to maintain and enhance their independence and what could help ensure they consistently had a good quality of life. People’s comments and concerns were listened to and taken seriously. The service also used any comments or complaints to help drive improvement within the service.

¿ Rating at last inspection:

The last rating for this service was Good (report published 15 September 2016).

Why we inspected:

This was a planned inspection based on the date and the rating of the last inspection.

Follow up:

We will continue to monitor the service through the information that we receive.

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

17 August 2016

During a routine inspection

The inspection took place on 17 August 2016 and was an announced inspection. This meant that we gave the home notice of our arrival so that we could meet with people who lived there.

The home is registered to provide accommodation with personal care and there were six people living at the home at the time of this inspection. The home provided care and support to people with a sensory impairment and physical and learning disabilities.

There was a registered manager for this service, who was available every day. 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 home is run.

People’s relatives told us that people were safe at the home. Staff were trained in adult safeguarding procedures and knew what to do if they considered someone was at risk of harm, or if they needed to report concerns.

There were systems in place to identify risks and protect people from harm. Risk assessments were in place and carried out by staff who were competent to do so. Risk assessments recorded what action staff should take if someone was at risk and referrals were made to appropriate health care professionals to minimise risk going forward.

There were sufficient staff to keep people safe and meet their needs, and the registered manager had followed safe recruitment procedures. Staff were competent with medicines management and could explain the processes that were followed. Policies and procedures were in place to guide staff in relation to the Mental Capacity Act 2005. The registered manager understood that there should be processes in place for ensuring decisions were made in people’s best interests. Staff sought consent and recorded this.

Staff were caring, knew people well, and supported people in a dignified and respectful way. Staff acknowledged people’s privacy. Relative’s felt that staff were understanding of people’s needs and had positive working relationships with people.

Care provided was individualised according to each person’s needs and preferences. People and their relatives were involved in assessment and reviews of their needs. Staff had knowledge of changing needs and supported people to make positive changes to their care plans.

People and staff knew how to raise concerns and these were dealt with appropriately. The views of people, relatives, health and social care professionals were sought as part of the quality assurance process. Quality assurance systems were in place to regularly review the quality of the service that was provided.

8 April 2014

During a routine inspection

We were unable communicate verbally with people who used the service due to their complex communication needs. However we carried out direct observations of staff supporting and interacting with them.

We spoke with two staff. We looked at three people's care and support records, risk assessments, communication plans, daily records of care and support provided, maintenance records, quality assurance audits and health and safety records.

We considered our inspection findings to answer questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found-

Is the service safe?

People had been cared for in an environment that was safe, clean and hygienic. There was sufficient moving and handling equipment at the home which had been well maintained and serviced regularly. Staff had received appropriate training and guidance to use the equipment safely.

Records contained detailed assessments of people's needs that had been carried out prior to them moving to the home. Any training needed for staff to support people safely was identified and provided prior to the person moving to the service. This was to ensure that they had the relevant skills and knowledge required to meet the individuals identified needs.

There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies.

Is the service effective?

People who used the service were unable to tell us verbally whether they felt their needs were being met. For this reason we observed staff providing care and support. We saw that they had a good understanding of individual's needs, preferences and dislikes.

The premises had been adapted so that someone with physical impairments could move around the home.

Is the service caring?

Staff engaged with people in a polite caring and sensitive manner, treating people with dignity and respect. Staff had received training to meet the needs of the people who used the service

People were supported by kind and caring staff that were attentive to the needs of the people who used the service. Our observations identified that care and support was provided at a pace that was unrushed.

Is the service responsive?

People's needs were assessed before they moved into the service. People were encouraged to visit the service before moving in. Where this was not practicable for one person the provider had ensured that staff visited the person in their existing home on eight occasions over a three week period. The provider provided a video of the home for the person on an IPad which staff in their home could support the person to have contact with the manager and staff through SKYPE when they had any questions.

Is the service well led?

The management team held regular team meetings and staff received 1-1 supervision sessions and annual appraisals. This meant they would be clear about their roles and responsibilities. The manager monitored staff training to ensure that staff received the required training to meet the individual needs of the people who use the service. The manager consulted with staff regarding any changes to the home.

The provider had an on-call system in place to ensure that appropriate management support was available for staff in an emergency. A senior manager visited the service regularly to audit the quality of the service provided.

30 August 2013

During a routine inspection

People living in the home were unable to tell us verbally what they thought of the service. We observed and listened to how staff supported them, discussed their needs with staff and reviewed their records. We were not able to use a formal observational tool to assess people's experiences, as it would have been intrusive given the small number of people using the service.

There was guidance in place for supporting one person to understand information about their care and how staff were to communicate with them. For another person, we found that there was an assessment of their ability to understand and retain information about their care, and records to show how a particular decision had been taken that reflected their best interests. This showed that the service was responsive to individual needs and offered safe care.

The information staff gave us about people's care, including recent changes, was consistent with what we saw in care plans. Staff understood how to support people safely. They also understood how people expressed themselves, including when they were distressed or happy. Staff also supported people to receive a healthy diet, taking advice from other professionals where appropriate. This was confirmed by discussion and from records. This showed that people were treated as individuals and the service responded to their needs. A visiting professional told us they had no concerns about the way service met people's care needs and sought appropriate advice when it was needed.

Medicines were managed safely and checked regularly so that any anomalies could be addressed promptly. The records of medicines given were complete. This helped to show that the care people received was safe.

We found that, although there were acknowledged problems with holidays and sick leave, staff were covering shifts to ensure there were enough of them to support people effectively. We were informed this was a short term problem and was likely to improve during the following week. The staff spoken with were knowledgeable about the support people required.

5 December 2012

During a routine inspection

People living in the home were not able to tell us verbally what they thought. Because of this we used a formal tool to help us observe and assess the support that people received. Our observations and discussions with staff showed that staff understood people's needs and supported them well. They made efforts to explain things to people, despite clear difficulties with communication. The interactions we saw and listened to were respectful and polite and we saw that staff took time to assist people at their own pace. However, although interactions were positive and encouraging we did note that praise for one person was not always appropriate to their age. We told the manager about this so that it could be addressed.

Staff were able to give us information about people's needs, their mobility, personal care, communication, diet and health. We concluded that this meant they understood how to support people safely and how independence was encouraged as far as practicable.

We found that there were systems in place to ensure staff had access to training and support so that they worked with people effectively and safely. They spoke highly of the support that they received from the management team. There were also systems to assess the quality and safety of care.

25 March 2011

During a routine inspection

While we were unable to discuss matters directly with people at Holmlea due to difficulties with communication, we did see that people were relaxed and fully included in discussions during our assessment visit.

We have also had comments from family members that include 'I am most satisfied', 'I would give medals to all staff and managers' and 'Holmlea does extremely well to meet individual needs'. There is also a book with thank you letters and cards that have been sent to the staff from various people.

There is also further information contained in this report that shows what people at Holmlea actually experience.