Holmehurst Residential Home

Updated 2 October 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted as part of our Thematic Review of infection control and prevention in care homes.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Holmehurst Residential Home 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave less than 24 hours’ notice of this inspection. This meant we were able to work alongside the management team to identify any potential risks associated with the coronavirus pandemic and put measures in place to manage them.

What we did before inspection

We reviewed information we had received about the service since the last inspection. This included information about incidents the provider must notify us about. We sought feedback from the local authority professionals who work with the service. The provider was not asked to submit a provider information return prior to our inspection. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make or have made since the last inspection. We accounted for this when we inspected the service and made the judgements identified in this report.

During the inspection

We did not speak with people directly to seek their views on the service, due to the coronavirus pandemic, but observed interactions between staff and people. We contacted four relatives by telephone. During the visit we spoke with the consultant manager, two senior staff, a housekeeping staff member and a cook. We contacted five staff by telephone for their views.

We reviewed a range of records. This included two people’s care records and multiple medicine records. We looked at two staff files in relation to recruitment. We also reviewed a variety of records relating to the management of the service.

Updated 2 October 2020

About the service

Holmehurst Residential Home is a residential care home providing personal care for up to 21 older people, some of whom may be living with dementia. At the time of this inspection there were 19 people living there.

Holmehurst Residential Home is a large detached house in a quiet residential area which has been adapted as a care home.

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

At the last inspection of the service the provider had not made sure that governance systems were sufficiently effective to monitor and improve the quality and safety of the service. Since then improvements had been made, but the provider still needed to make sure that any actions were completed. We have made a recommendation about this.

At the last inspection there were no records to show how decisions had been taken by others in the best interest of people who lacked capacity. Records were now in place and these were improving as staff became more familiar with the reasons for supporting people in this way.

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

Relatives made many positive comments about the friendliness of staff and the support that people received. They felt involved and included in discussions about people’s care. They said people enjoyed the meals at the home.

People's needs were assessed to make sure their care could be provided by this service. Staff were familiar with each person's preferences and how they wanted to be supported.

The provider and management team were open and approachable. There was a friendly atmosphere in the home and relatives said the service was homely, personalised and family-orientated.

Relatives and staff were uncertain about future management arrangements. The provider was committed to strengthening on-site management support.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 6 April 2020) and there was a breach of regulation 17 (good governance). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 28 February 2020. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key domains of Effective and Well-led.

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 coronavirus and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Holmehurst Residential 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 inspection programme. If we receive any concerning information we may inspect sooner.