Holmwood Care Home

Holmwood Care Home is a residential care home providing accommodation and personal care for up to 21 people aged 65 and over. At the time of the inspection there were 20 people living at the home.

People’s experience of using this service and what we found

People and their families told us that they felt they lived in a “real home”, and they felt people were supported well.

There were enough staff to support people in a caring and person centred way. We saw call bells were responded to quickly.

There were audits in place to review the care of people. The provider reviewed the care audits to ensure they learnt from them.

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.

The service was led by the provider and management team in a responsive way. They acted immediately to any areas of concern raised during the inspection and drove improvements.

Staff recruitment was not always in line with current legislation. We discussed this with the registered manager and the business director, and they took immediate steps to address this.

Issues were found with fire risk management. The registered manager and the business manager took immediate steps to address this during the inspection.

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

Rating at last inspection

The last rating for this service was good (published 28 May 2020).

Why we inspected

The inspection was prompted in part by notification of an incident where a person using the service sustained a serious injury and an incident where someone who was put at risk. The information shared with Care Quality Commission (CQC) about these incidents indicated potential concerns about the management of risk. This inspection examined those risks.

We undertook a focused inspection to review the key questions of Safe and Well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last focused inspection, by selecting the ‘all reports’ link for Holmwood Care Home on our website at www.cqc.org.uk.

Holmwood Care Home is a residential care home providing accommodation and personal care to 21 people aged 65 and over. At the time of the inspection, there were 18 people living at the home.

Holmwood Care Home accommodates people in single rooms on three floors, within one building. There is a passenger lift to give easy access. There are two communal lounges, with one having an adjacent dining room. One lounge leads on to a large patio and garden. There was also a domestic kitchen, where people were able to prepare and cook their own meals.

People’s experience of using this service and what we found

Risks to people's safety had been identified.

Most of the home was clean, although this was not the case for less visible areas. There was debris on the framework of the dining chairs, and the seals of the kitchen sinks and shower cubicles were stained and worn. This was due to a delay in the normal “deep clean”. On the second day of the inspection, the seals and re-grouting in the shower cubicles had been replaced.

There were enough staff to support people safely and a robust recruitment process was in place. People’s medicines were safely managed although two people’s medicines were not being administered in a timely manner. Accidents and incidents were reviewed, and lessons learnt where required.

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. People had enough to eat and drink, although fluid monitoring for some was not fully completed due to a change in the documentation systems. People were supported by a range of health and social care professionals to maintain good health. The environment was comfortable, homely and met people’s needs. Staff were undertaking their mandatory training, which needed to be completed by the end of the year. Staff felt well supported but said they would like more formal meetings with their manager.

People were supported by staff who showed kindness and compassion. There were positive interactions, and staff showed a friendly and respectful approach. People’s rights to privacy, dignity and independence were promoted. People were encouraged to direct their care and give feedback about the service they received.

People were happy with their care and had a care plan in place, which showed their preferences. People were encouraged to follow their own routines and be as independent as possible. There was a varied social activity programme, which included in house and external events. People knew how to raise a concern and there was a weekly meeting to raise any concerns. This helped to minimise the number of formal complaints. Staff were passionate about providing good end of life care, but people’s wishes were not always detailed in their care plan.

There were two registered managers. Both had an overview of the service, rather than day to day involvement. The registered managers were supported by a wider management team. Each had their own roles and responsibilities. The management team were passionate about the standard of care delivery and wanted to continually improve. There was a clear ethos of Holmwood Care Home being each person’s home. Clear networking took place and there were a range of audits, to assess the safety and quality of the service.

Rating at last inspection

The last rating for this service was good (published 25 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Holmwood Care Home on our website at www.cqc.org.uk.

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.

The home was last inspected in February 2015 and was rated good overall. At this inspection we found the service remained Good.

A registered manager was employed by the service and was present throughout our inspection. 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.

People were protected against the risks of potential harm or abuse. Staff had received relevant training and understood their roles and responsibilities in relation to safeguarding people from abuse and harm.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Feedback from people, their relatives and staff on their experiences was encouraged by the service and procedures were in place for the registered manager to monitor, investigate and respond to complaints in an effective way.

People were supported to have sufficient to eat and drink and maintain a balanced diet. Feedback from people on the quality and choice of food was positive.

People’s medicines were managed safely. People’s health care needs were managed effectively in response to their changing needs and had access to health and social care professionals as required.

People were supported by sufficient staff with the right skills and knowledge to meet their individual needs. Safe recruitment practices were followed to ensure staff were of good character and suitable for their role.

There were quality assurance systems in place which enabled the provider and registered manager to assess, monitor and improve the quality and safety of the service people received.

People’s dignity, privacy and independence were promoted and people were treated with respect.

People were treated with compassion and kindness in their day to day care. Staff worked well together and had a good understanding of people’s needs including how they expressed their individual needs and preferences.

Care plans were personalised and contained information about the person’s preferences, likes, dislikes and what was important to them. Staff were knowledgeable about people’s care and support needs and acted in accordance with the guidance in their care plans.

People had a range of activities they could be involved in which they said they enjoyed. People were supported to form bonds with each other and had good links to the community.

Risks to people and their safety had been identified and actions taken to minimise these. Risk management plans were in place to ensure people received safe and appropriate care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Further information is in the detailed findings below.

We spoke with seven people in the home who were all very positive about their experience of living there. One person said 'the home is lovely and the food is terrific', another person told us 'it's certainly never dull here and there is always something going on'.

The provider has taken steps to provide care in an environment that was suitably designed and adequately maintained. We saw the home was in good decorative order and clean throughout. All the stairs and hallways had recently been re-carpeted. Everyone had their own bedroom and these had been furnished with a range of their own furniture and personal items.

We saw the manager maintained a record of training attended by staff during the past year. We saw from this year's training records staff had a regular training programme to update their knowledge and skills in areas relevant to their role.

We saw a copy of the current complaints procedure on a notice board in the entrance hall. We saw that the information was clear and guided people through the procedure should they wish to make a complaint. There was also information about a local advocacy support service next to the policy and a suggestion box was also in the hall.

A person told us: 'Staff understand what I need. They don't try to do other things I don't need.' People told us they saw a doctor quickly if they needed to. All the people we talked with described staff as kind. Two people told us they sometimes had to wait for staff to be available, which could be uncomfortable.

Care plans were up to date. They showed evidence of agreement by people in the home or family advocates. They were evaluated regularly in a meaningful way.

People felt Holmwood was a safe place to live. We saw staff treat people with respect and courtesy. They were trained to be alert to risks of abuse and to respond appropriately to concerns about people's safety.

New staff received training in essential skills and values. They shadowed experienced staff, met people in the home and read care plans before working as part of a care shift.

There was an open culture, including meetings for people in the home and their relatives. People told us: 'The managers are approachable and interested' and: 'They want to know everything is right.' There were regular staff meetings. Staff told us: 'They share things openly with us' and: 'People have their say. We get good information.'