Homelands Nursing Home

Updated 27 May 2025

Dates of assessment 30 June to 14 July 2025. Homelands Nursing Home is a care home, providing accommodation, nursing and personal care to people. The Manor House supports people with nursing needs and the Coach House supports people with nursing needs and advancing dementia. At the time of our inspection, 31 people were being supported at the service.

Homelands Nursing Home had made considerable progress since our last inspection in January 2025. People now received their medicines safely and as prescribed, and there was a policy in place to support safe and effective use of medicines. People were now protected from the risk of harm or abuse; staff were aware of how to reduce restrictive practices and escalated any concerns regarding unexplained bruises or injuries. Managers now appropriately referred incidents to the local authority safeguarding team.

Risks to people’s health were now being assessed and managed. However, we identified instances where risk assessments and care records were inconsistent or not updated with professional’s advice. Daily notes did not always echo the guidance in care plans, although staff did know people well and supported them in accordance with their assessed needs.

Works had been completed and some were ongoing to improve the environment, specifically the Coach House, risk assessments had been conducted to consider the impact this had on people. Environmental risks were not always assessed, for example, the stairwell gate had been removed without assessments undertaken to consider people’s safety regarding this decision.

Staff now received relevant training and supervisions were held to assess their knowledge. Staff told us they welcomed the additional training and their practice was also observed to explore additional training needs.

We observed enough staff to support people, staff delivered care with kindness and respect. People and relatives spoke positively about staff interactions. The provider had taken steps to promote people’s independence and choice, for example, by introducing pictorial menus and personalised activities.

People did receive person-centred care, however, documents did not always reflect people’s specific wishes. People and their relatives were being consulted on their support, care plans were being reviewed to include wishes, needs and preferences.

Staff now engaged more proactively with professionals and mostly followed their advice. Steps were being taken to strengthen integration between the Coach House and the Manor House to promote greater consistency across both settings.

The service was in a transitional period with a new management structure in place, they were supported by an external consultant. While visible leadership and staff engagement had improved, governance systems were not yet embedded. Internal audits were planned but had not commenced at the time of inspection, this limited the provider’s ability to proactively identify and address where systems required review and where further improvements were needed.

Although vast improvements had been made, we identified 2 continued breaches of legal regulations in relation to safe care and treatment and good governance.

Updated 27 May 2025

People and their relatives told us the service had made clear improvements in recent months, particularly in staffing, communication, and the environment. Most relatives told us their loved ones were safe and well cared for. A relative commented, “[Person’s] medical needs were urgently responded to. Their swallowing needs were sorted by the speech and language therapy team and the denture problems and chest infection was caught really early and sorted out. They (staff) are very good at communication.”

People and their relatives gave examples where staff had monitored changes in health needs and responded to them. A relative said, “[Person] becoming more frail was discussed with us. There had been an infection and antibiotics were given. Their eating had reduced, so milkshakes and energy drinks were provided. Food is pureed and carers feed [person]. There have been improvements recently.”

People’s bedrooms were clean and they were able personalise their space. A relative said, “Clothes are put away. The general appearance of the home is clean. The main room has a good airflow so there’s no bad smells.”Another added, “[Person] has a lovely big space and a lovely view from the window of wildlife. We are always welcomed by staff. It’s very homely. Bit by bit we’re bringing [person’s] personal things slowly so that [person] gradually accepts that they will be there.”

People were supported by kind and caring staff. We received mostly positive feedback about staff. Comments included, “They are all trained to work with dementia and talk normally to [person]. [Person] talks about their pet dog and grandchildren. [Person] calls the teddy bears their babies. Staff don’t correct them, just encourage them.” Another relative stated, “A couple of the new carers get on well with [person] but they don’t like the assigned carer.”

People now had a full schedule of activities to attend if they wished. Where people were cared for in bed, staff spent 1 to 1 time with them. A relative told us, “There’s plenty of activities. They have balloons, scarves and music going. They have holy communion when a vicar comes in. [Person] does bingo and dominoes. Singers come in. There’s a good variety. [Person] is helped to join in the exercises and enjoys them”

People’s nutritional needs were assessed and their preferences were documented, we saw people enjoyed their meals and were being offered choices. A relative said, “[Person] has to be fed and eats all that they give. A lady asks [person] what they want and they know the likes and dislikes. [Person’s] food is tailored to their needs.” Another commented, “[Person] can’t read the menu and now staff show pictures of the food. The food is cut up and they eat independently. They like fruit water and gets enough fluids.”

People’s suggestions were now listened to and valued. A relative said, “We asked for more carers to be in the lounge and that is visible.” Another said, “I’ve had a survey. Around 2-3 weeks ago. There was an audit form to fill in. It was quite comprehensive, with marks from 1-5 ratings.”