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Inspection Summary


Overall summary & rating

Good

Updated 21 December 2017

The inspection took place on 31 October and 2 November 2017. The inspection was unannounced.

Holmwood Rest Home provides accommodation and personal care for up to 16 older people. There were 11 people living at the home at the time of inspection. The service is located in West Parley and is a detached dormer bungalow. The accommodation offers 14 bedrooms on the ground floor and two bedrooms on the first floor. There are two staircases to access the first floor, one with a stairlift. There is a communal lounge and dining area on the first floor. There is also a conservatory and an accessible garden.

Quality assurance measures were not always effective because they did not consistently identify gaps or trends in areas of support people received. The manager rectified gaps when we identified these, but improvements were needed to ensure that there was consistent oversight of the service.

The manager of the service did not have any external links or sources of good practice guidance. We made a recommendation about this.

Risk assessments were in place and identified the risks that people faced and provided guidance about how to manage these. Staff knew peoples individual risks well and their role in supporting people to manage these safely.

People were protected from the risk of harm by staff who understood the possible signs of abuse and how to recognise these and report any concerns. Staff were also aware of how to whistle blow if they needed to and reported that they would be confident to do so.

There were enough staff available and people did not have to wait for support. People had support and care from staff who were familiar to them. Staff were consistent in their knowledge of people’s care needs and spoke confidently about the support people needed to meet these needs.

People were supported by staff who had been recruited safely, with appropriate pre-employment checks in place.

People received their medicines as prescribed and these were securely stored. Where there were gaps in information about what medicines people needed ‘as required’, the manager addressed these immediately.

The home had good links with health professionals and regular visits and discussions meant that people were able to access appropriate healthcare input promptly when required.

People were supported by staff who had the necessary training and skills to support them. Training was provided in a number of areas the service considered essential and other learning offered was relevant to the conditions that people faced.

Staff understood and supported people to make choices about their care. People's legal rights were protected because staff knew about and used appropriate legislation. The manager was in the process of ensuring that documentation was in place for people who required decisions to be made in their best interests.

People spoke positively about the food and had choices about what they ate and drank. The kitchen were aware about people’s dietary needs and catered to people’s preferences and special diets where needed.

Staff knew people well and interactions were relaxed and caring. People were comfortable with staff and we observed people being supported in a respectful way. People were encouraged to make choices about their support and staff were able to communicate with people in ways which were meaningful to them.

People were supported by staff who respected their privacy and dignity and told us that they were encouraged to be independent.

People were supported by staff who knew their likes, dislikes and preferences. Staff told us that they communicated well staff were confident about their roles and responsibilities.

People were able to engage with a range of activities including one to one time with staff. People told us that they had enough to do at the home and enjoyed the activities on offer.

Relatives spoke positively about the staff and management of the home. They told us that they were always welcomed a

Inspection areas

Safe

Good

Updated 21 December 2017

The service was not always safe

People had risk assessments and staff were aware of the individual risks people faced and how to manage these.

People were protected from the risks of abuse because staff understood their role and had confidence to report any concerns.

People were supported by staff who had generally been recruited with appropriate pre-employment, reference and identity checks.

People received their medicines as prescribed.

Effective

Good

Updated 21 December 2017

The service was effective.

Staff were knowledgeable about the people they were supporting and received relevant training for their role.

People who were able to consent to their care had done so and staff provided care in people�s best interests when they could not consent.

People enjoyed a choice of food and were supported to eat and drink safely.

People were supported to access healthcare professionals appropriately

Caring

Good

Updated 21 December 2017

The service was caring.

People had a good rapport with staff and we observed that

people were relaxed in the company of staff.

Staff knew how people liked to be supported and offered them appropriate choices.

People were supported to maintain their privacy and dignity.

People�s confidential information was stored securely.

Responsive

Good

Updated 21 December 2017

The service was responsive.

People had individual care records which were person centred and gave details about people�s history, what was important to them and identified support they required from staff.

People enjoyed a range of activities and staff spent one to one time with people.

People and relatives knew how to raise any concerns and told us that they would feel confident to raise issues if they needed to.

Well-led

Requires improvement

Updated 21 December 2017

The service was not consistently well led.

Quality assurance measures were not consistently effective and meant that there were gaps in the oversight of the service.

People, relatives and staff felt that the manager was approachable and had confidence in the overall management of the service.

Staff felt supported and were confident and clear about their roles and responsibilities within the service.