Archived: Holmers House

Updated 17 October 2019

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.

Inspection team

The inspection was carried out by two inspectors, one pharmacist inspector and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Holmers House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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, who was registered with the Care Quality Commission. The registered manager 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 unannounced and took place on 3 September 2019.

What we did before the inspection

We used the information the provider sent us in the provider information return. 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. This information helps support our inspections. We also looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law. We also contacted the local authority commissioners to obtain their views about the service.

During the inspection

We spoke with seven people who used the service and two relatives to get their views about their experience of the care provided. We spoke with ten members of staff, including the regional manager, registered manager, the deputy manager, two senior care staff, two care staff, housekeeping and kitchen staff. We also spoke with two visiting, external professionals.

We reviewed a range of records. This included four people’s care records and people’s medicine records. We looked at two staff files in relation to recruitment, supervision and training. A variety of records relating to the management of the service, including accidents log, safeguarding logs and the audits were also viewed.

Updated 17 October 2019

About the service

Holmers House is a residential care home providing accommodation and personal care to people predominantly aged 65 and over, including those living with dementia. The service comprises of three separate wings; Willow, Mimosa and Juniper. Each of which has separate adapted facilities. The service can support up to 48 people and there were 34 people living at the home at the time of the inspection.

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

People were safe at the home. Staff ensured appropriate measures were in place to manage any risks identified to people. Staff adhered to good infection control practices. The registered manager aimed to ensure adequate staffing levels to keep people safe, however, we received mixed feedback from people about staffing.

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 were supported to eat well, and they had help with accessing healthcare services. Staff received ongoing training that was relevant to their roles.

People told us staff were kind. Staff treated people with dignity and respect. People were supported to be independent and encouraged to take positive risks. People’s confidentiality was respected. Staff were committed to valuing people’s and each other’s diverse and cultural needs.

People received support that met their care needs although it was at times led by tasks rather than led by people’s individual preferences. The provision of activities needed improving as the activities were not always meaningful and did not reflected that people’s cultural and social needs were explored. People’s care plans reflected people's assessed care needs and support they had.

There was a new registered manager in post who worked to improve the culture at the home. Staff were encouraged to attend team meetings and be involved in the running of the service. The team worked well with partners and external professionals who were complimentary about the improvements made.

Rating at last inspection and update:

The last rating for this service was requires improvement (published 7 March 2019) and there were four breaches of regulation found. We issued a Warning Notice around two regulations; around the records, quality assurance and keeping people safe from harm including management of medicines. The provider was required to achieve compliance with these two regulations by 4 April 2019. We also issued a requirement notice around regulations around safeguarding of people and person-centred care. The provider completed an action plan to show what action the planned to take to address these concerns.

At this inspection we found improvements had been made; people were safe, protected from harm and had their medicines as prescribed. People were supported to have their needs met and the team worked hard to improve the culture at the home.

We identified one breach of the regulations. The provider did not have oversight to ensure improvements were implemented well within the service.

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

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will request an action plan from the provider to understand what they will do to improve. As this is repeated requires improvement rating we will also meet with the provider following this report being published. This is to discuss how they will make changes to ensure they improve their rating to at least Good. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.