Holmewood Manor Care Home

Updated 17 December 2021

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 so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and 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

Holmewood Manor 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 did not have a manager registered with the Care Quality Commission. However new manager had been appointed who told us they will submit appropriate application to become registered with CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service and one relative about their experience of the care provided. We spoke with seven members of staff including the provider, peripatetic manager, the manager, senior care worker, maintenance person, domestic staff and one visiting district nurse.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We requested feedback from seven relatives via email and received response from three. We spoke over the phone with three staff members and three relatives of people living at Holmewood Manor.

Updated 17 December 2021

About the service

Holmewood Manor Care Home is a residential care home that provides personal care for up to 40 people, some of whom are living with dementia. At the time of inspection 23 people were using the service. The accommodation is in a purpose-built home split over two floors. Each floor contained bedrooms, a communal lounge and a dining area. There were accessible outdoor spaces.

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

People’s medicines were not always managed safely, and people were at risk of not receiving their prescribed medicines. The home was clean; however, it was not free from unpleasant odours. There were enough care staff to meet people’s needs, however more staff were needed to work in the kitchen and laundry. People told us they felt safe living at the care home. Risk’s to people and environmental risks had been assessed and managed. Staff had been recruited safely.

People told us they liked living at the home, however they felt there was not a lot of activities to keep them occupied. The provider had systems in place to monitor the quality and safety of the service. However, these had not always been effective in identifying medicine issues. Staff felt supported by the management team. Staff told us they enjoyed working in the home and were committed to ensuring people received high quality care

People were not always supported to have maximum choice and control of their lives. People told us their preferences in regard to their personal care were not always considered. Staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice.

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 from our last comprehensive inspection was Good (Report published 11 May 2019). We also carried out targeted inspection to look at infection prevention and control systems however the service was not rated at that time (Report published 26 February 2021).

Why we inspected

The inspection was prompted in part due to concerns about safeguarding, staffing and infection control we found during our last inspection at another service under the same provider. A decision was made for us to inspect and examine those risks at Holmewood Manor Care Home.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvements. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to safe management of medicines at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. 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.