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Inspection Summary

Overall summary & rating


Updated 22 November 2018

We inspected Homemead on 22 October 2018. The inspection was unannounced. We had previously carried out a comprehensive inspection in August 2017 where the overall rating was Requires Improvement.

Homemead is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Homemead provides accommodation and personal care for up to 26 older people with dementia. At the time of our inspection there were 23 people living in the home. The home is situated in its own grounds and has three floors, served by a lift.

At the previous inspection in August 2017 we found that the service was not meeting all the quality standards and was rated "Requires Improvement” in the key areas of safety and well-led. The inspection rated the service overall as “Requires Improvement”.

We asked the service to provide us with an action plan for improvement and we monitored improvement during this inspection. At this inspection we found that the provider and registered manager had made the necessary improvements to their service.

At the previous inspection we found that people were not always supported in a safe way when receiving their medicines. There were some occasions where people were not always given their medicines on all days and that the recording of medicines used was not always accurate.

During this inspection we found that the management of the recording of medicines had improved. We found that daily medication audits were completed and fed into a weekly audit, completed by one of the senior management team.

At the previous inspection we found that people were not always supported in a safe way at night due to the numbers of staff on duty. There were occasions when people had to be left unattended whilst staff were carrying out other duties.

During this inspection we found that the night staffing had improved because the provider had increased the numbers of staff on duty. This meant that people were more frequently monitored and have their needs met sooner.

At the previous inspection we found that the service had systems and procedures in place to help deliver high quality care. However, it did not always use its audits and information to make improvements or address issues that needed resolving.

During this inspection we found that the service had improved the way it used its quality assurance systems to help managers and staff understand what was important to people and how the service could develop and improve.

The home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 who lived at the home were protected from the risk of abuse happening to them. People told us they felt safe and well cared for at the home and they would not be afraid to tell someone if they had any concerns about their safety or wellbeing. Care staff could describe how they would report incidents of concern and records showed that training in safeguarding people had been updated.

Staff provided attentive care to people and risks to people’s health, safety and welfare were well managed. Risks had been assessed and where appropriate contributed to the person’s overall care plan.

Risk management plans clearly identified what the risk was and provided staff with instructions about how they needed to manage the risk to ensure people received safe care and support whilst enabling them to remain as independent as possible.

There were procedures and policies in place to control infection. We looked around the home and saw that all areas were clean and hygienic. Staff had received infection control training and records confirmed this.

People and their relatives spoke positively about the care and support provided by the staff working at Homemead. A relative's view was that there could be more stimulation for those with the mental capacity to benefit from it.

There was a consistent team of staff working at the home who were appropriately trained. There was some dependency on agency staff but efforts were made to minimise this using bank workers and overtime.

The home ensured that wherever possible people were asked for their consent before care plans were agreed, medicines given or access to their rooms or personal information was requested. Records of signed consent forms were contained in people’s care records including Do Not Attempt Resuscitation (DNAR) forms where people had requested these.

People received nutritious meals and could choose from a variety of dishes which took people’s cultural and religious preferences into account. At night people could request snacks, including cereal and toast, as well as having plenty of fluids such as tea or juice. However, we noted that no liquid was provided during one lunch session until after the meal was eaten. This was discussed with the quality and compliance manager and we were satisfied that this was an error that would be rectified.

People’s privacy and dignity were respected and promoted. There was a positive culture of inviting and encouraging people to socialise and take part in activities. However, people’s wishes were respected and some chose to spend time in their room at various times of the day.

Bedrooms were personalised with people’s belongings, such as ornaments, family photographs and small pieces of furniture. People received personal care either in their own room or bathrooms with doors closed. During our inspection we observed how staff interacted with people who used the home and found it to be respectful and sensitive. Examples included referring to people by their preferred name and knocking and waiting before opening doors to bedrooms or bathrooms.

People said they felt confident that any problems or complaints that might arise would be dealt with by the management in a satisfactory way. A copy of the complaint’s procedure was displayed near the main entrance to the home. This procedure told people how to complain, who to complain to and the times it would take for a response.

The home demonstrated good management and leadership through having an experienced registered manager in place with the support of a deputy manager and senior staff members leading on each shift. The registered manager understood their responsibilities and was supported by a wider managerial team.

Inspection areas



Updated 22 November 2018

The service was safe. People were protected from the risk of abuse and harm because staff had received a thorough recruitment process and had been trained in safeguarding people.

People received their medicines in a safe manner and there were good infection control procedures in the home.

People had been assessed with regard to any risks to their health or safety. These included their mobility, emotional well-being, health and nutrition. Risk assessments were used as part of the overall care planning.



Updated 22 November 2018

The service was effective. People were supported to have their assessed needs, preferences and choices met by staff with the necessary skills and knowledge.

Staff understood the relevant requirements of the Mental Capacity Act 2005 and the rights of people to make their own choices where possible. Where people lacked capacity, staff acted in their best interests.

People were supported to have enough to eat and drink. Meals were appropriately spaced and flexible to meet people�s needs and people had a diet that was balanced and nutritious.

People were supported to maintain good health and had access to healthcare services which offered on-going healthcare support.



Updated 22 November 2018

The service was caring. Positive caring relationships were developed with people using the service and they were treated with kindness and compassion in their day-to-day care.

People were supported to express their views and be actively involved in making decisions about their care, treatment and support.



Updated 22 November 2018

The service was responsive. People received personalised care that was responsive to their needs.

The service had systems and guidance in place to enable people to raise concerns and for those concerns to be listened to and learned from.



Updated 22 November 2018

The service was well-led. Quality assurance systems were being used by the provider to evaluate and improve their practice.

The service demonstrated good management and leadership through the registered manager, deputy and team of senior staff.

The registered manager and staff promoted a positive culture that was person-centred, open, inclusive and empowering.