Holmhurst Care Home

Holmhurst Care Home is a residential care home providing personal and accommodation to up to 17 people. The service provides support to people with a mental health condition. At the time of our inspection there were 17 people using the service. Accommodation was spread over 3 floors accessible via stairs.

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

People were protected against risks to their safety and wellbeing, including the risk of abuse and unsafe care. Everyone we spoke with said they felt safe and did not worry about who to speak to if they had a problem. There were sufficient suitable staff deployed to support people safely. People's medicines were administered safely and in line with their prescription. We were assured the provider’s infection, prevention and control processes and practices kept people safe from infection.

People's needs and choices were assessed, and care, treatment and support were delivered in line with guidance to achieve effective outcomes. People were supported by staff with the relevant skills and knowledge. People’s dietary and hydration needs were being met. The provider worked with other services and agencies to make sure people had access to the healthcare services they needed.

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.

There were positive, caring relationships between people and the staff who supported them. The provider supported people to be involved in decisions about their care and support where they wanted to. Staff respected and promoted people's privacy, dignity and independence.

People's care and support reflected their needs and preferences. People could access leisure activities and interests both independently and with support from staff. People were happy with the service they received but knew how to complain if they needed to.

There were management systems in place, and staff were motivated in a relaxed, and supportive atmosphere. There were internal and external systems to monitor, improve and sustain the quality of service people received. The provider made improvements during the inspection based on our findings. People who used the service were engaged positively by the provider. The provider worked actively with other agencies where this could lead to improvements in the service people received.

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 3 November 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

Arrangements were in place to ensure people could have visitors and go out in accordance with national guidance.

The registered manager told us there had been very good external support for the home from health and social care professionals during the pandemic. The registered manager dialled in to weekly virtual meetings for professionals which ensured they were always up to date with current COVID-19 guidance.

The registered manager reported no impact on people's care due to sector workforce challenges.

Holmhurst Care Home is a residential care home for up to 16 people with mental health needs. At the time of our inspection there were 14 people living at the home. Accommodation was in a converted older building in a residential area of Southampton close to shops and other amenities. There was a shared lounge and dining area, a quiet room, an outdoor smoking area and sitting area with barbecue.

Rating at last inspection

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated good.

People were protected against risks to their safety and wellbeing, including the risk of abuse and unsafe care. There were sufficient suitable staff deployed to support people safely. The provider had effective processes to make sure people’s medicines were stored and administered safely, and to make sure people were supported in a clean, hygienic environment which reduced the risk of the spread of infection.

People were supported by staff with the relevant skills and knowledge. People's assessments and care plans were detailed and thorough. Arrangements were in place to support people to have a healthy diet. The provider worked with other services and agencies to make sure people had access to the healthcare services they needed. The provider took account of the legal protections in place for people who lacked mental capacity. 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.

There were positive, caring relationships between people and the staff who supported them. The provider supported people to be actively involved in decisions about their care and support. Staff respected and promoted people’s privacy, dignity and independence.

People’s care and support reflected their needs and preferences. People could access leisure activities and interests both independently and with support from staff. People were satisfied with the service they received, but knew how to complain if they needed to.

There were effective management systems in place, and staff were motivated in a calm, supportive, empowering atmosphere. There were internal and external systems and a business improvement plan to monitor, improve and sustain the quality of service people received. People who used the service were engaged positively by the provider. The provider worked actively with other agencies where this could lead to improvements in the service people received.

Further information is in the detailed findings below.

We found that suitable arrangements were in place for the management of prescribed and non-prescribed medicines. Staff were following the procedures for the recording of medicines and checks were in place to verify this.

People who used the service told us they were satisfied with their care and support. One said, 'They look after us very well.' Another said, 'It's a reasonable place. I have no problems.' They said staff explained what they were doing and obtained their consent. They told us they were able to come and go as they wished. They were confident they would be listened to if they raised any problems. People said there were enough staff to deliver their care and that staff had the necessary skills and knowledge.

We found the service made efforts to ensure people consented to their care and support, and followed processes where people's capacity to make decisions was in doubt. People's care needs were assessed and care was delivered according to plans based on their needs. There were enough staff to provide the required level of care and support, and staff were supported by management. People were cared for in a clean environment. There was an effective complaints process and the service notified us of relevant incidents. Improvements had been made to the management of medicines, but essential standards were still not being met.

We found that people using the service were respected and that they were cared for and supported on the basis of very thorough and inclusive care plans. The staff members we spoke with had a good awareness of people's needs, preferences and rights. We found that procedures were in place to protect people from the risk of abuse, and that staff had developed appropriate strategies for managing challenging behaviours and mitigating risks.

We saw that the required checks were made to ensure that people were cared for by suitably qualified and experienced staff and that processes were in place to monitor and assure the quality of the service provided. We found that some incidents were not being reported to the Care Quality Commission as required by regulations, and that some of the practices involving the management of medicines did not fully protect people against the associated risks.