Holme House Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.
 

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Although systems such as monthly care plan reviews were in place, care records were often contradictory, inaccurate and did not consistently reflect people’s voices, preferences or assessed needs. This meant we could not be assured that care was always planned and delivered in a person-centred way.

Activities within the service were largely generalised and took place in communal areas, which limited meaningful choice for people who did not wish to participate. People who remained in their bedrooms did not receive consistent or meaningful engagement over the 2 days of the assessment. Staff confirmed people in their bedrooms received less engagement, with comments including; “We don’t have anything for people in their bedrooms to be honest. Some of them just stay in bed, they don’t have anything to do.”

Care records were not always reflective of people’s day-to-day experiences. For example, we observed 2 people who required hearing aids did not receive them until 12:25pm on the first day of the assessment, despite this being an identified need. Another person was wearing slippers that were significantly too large, which could pose a risk to their safety and comfort.

However, we did see some positive examples of person-centred practice. These included efforts made to celebrate people’s birthdays and anniversaries, as well as evidence of previous activities that had been meaningful for some individuals. Despite this, such examples were not consistently reflected in people’s everyday experiences.
 

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

People and their relatives provided mixed feedback about whether the care and support provided met their expectations and needs. Some people told us there were limited opportunities for engagement and expressed dissatisfaction with the level of stimulation within the service. One person commented “It’s nice but nothing spectacular, you expect more for your money. If I got the chance to leave, I would go somewhere better. There is nothing to do, it’s very limited.” Other people told us they felt they had their needs met.

Joined-up working with relatives was not consistently evident. Some relatives told us they received updates when visiting the service, while others reported limited communication about their loved one’s care. Care records did not always clearly document the involvement of other professionals or demonstrate how their input had been integrated into care delivery.

However, we did see some positive examples. One person in receipt of one-to-one funding consistently received this level of support, and staff rotas demonstrated a degree of consistency within the care team, despite the service’s reliance on agency staff. This provided some continuity in care delivery for people using the service.
 

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs, however, these were not routinely used by staff in every day life.

Staff told us pictorial menus were available in the service but on the days of assessment these were not used to support people to make choices about their meals and staff told us they could not find these. Show plates were not used at meal times either to help people make informed choices about their food.

We observed inconsistencies in how people’s communication needs were met with the use of additional aids. We found some people experienced delays in receiving items such as hearing aids.

At the time of the assessment, no-one we spoke with had requested information in alternative formats, and we did not identify any specific unmet needs in this area. However, the lack of consistent use of available tools meant the service was not always proactive in supporting accessible communication.
 

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

People and their relatives told us they did not feel consistently listened to or involved in the running of the service. No-one we spoke with was aware of any recent surveys or opportunities to formally provide feedback. Records indicated a relatives’ meeting had taken place in October 2025, with plans for further engagement; however, relatives told us these had not been followed up.

Feedback from people and relatives highlighted concerns about communication, with some describing it as poor or inconsistent. This indicated that systems to gather, respond to, and act on feedback were not fully effective.

However, we reviewed recent complaints and found these had been investigated thoroughly and documented clearly, with evidence of actions taken and outcomes communicated. We also saw examples of positive feedback and thank-you messages from relatives following the passing of their loved ones, which reflected some positive experiences of care.
 

The provider made sure that people could access the care, support and treatment they needed when they needed it.
The environment was generally accessible. There was appropriate signage in place to support orientation, and equipment such as profile beds, hoists and specialist seating available to support people with mobility and positioning needs. These provisions supported people to move around the service and access different areas more easily. We also observed people moving between the 2 floors independently to spend time together.

Relatives had access to relevant contacts for out of hours calls and support, and staff had protocols in place for out of hours guidance and support in emergencies.

Some people told us they sometimes experienced long waits for support, however during assessment we did not find evidence of this.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

We observed some positive practice in relation to promoting equality and inclusion. For example, 1 person who identified as gender fluid was supported to express themselves in line with their preferences on a day-to-day basis. Staff respected and used the person’s chosen pronouns and supported them to dress in a way that reflected their identity.

We also saw staff rotas had been adapted to accommodate religious observances, such as Eid, and that cultural awareness was promoted through initiatives including staff-led food events. These approaches supported inclusion and mutual respect within the workforce.

However, this was not consistently reflected in the experiences of all people using the service. We found that people who were unable to express their views, or who were cared for in bed, did not always have their assessed needs, wishes and preferences consistently met. This meant that some people, including those living with dementia or cognitive impairment, did not always experience the same level of personalised care, which could result in inequitable outcomes.
 

People were not supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.
The service had taken some steps to support end of life care, including having a staff member trained in verification of death and holding an end of life charter certificate, demonstrating a commitment to delivering good care in this area.

However, this commitment was not reflected in what we saw in practice. We found where people were identified as being on an end of life pathway, care planning was not always in place or sufficiently detailed. For example, we reviewed 2 people who were identified as receiving end of life care, including 1 person on the Gold Standards Framework; however, neither had a completed advanced care plan or clearly documented preferences for their future care.

This meant there was a lack of clear, documented planning to guide staff in delivering care aligned with people’s wishes at the end of their lives. As a result, we could not be assured that people’s preferences and choices would be consistently recognised and respected during this important stage of care.