Background to this inspection
Updated
15 December 2020
The inspection
This was a targeted inspection on specific risks we had identified due to the registered manager leaving and concerns received related to manual handling.
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 completed by two inspectors visiting the service and two assistant inspectors who supported the inspection remotely.
Service and service type
Homefield House Nursing 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 did not have a manager registered with the Care Quality Commission at the time of the inspection. The service was being managed in the interim by the deputy manager with support from the provider.
Notice of inspection
The inspection took place on 30 October 2020 and was unannounced. We contacted the service prior to entering to establish whether there were active COVID-19 cases in the home and establish required infection control protocols for inspectors.
What we did before the inspection
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 reviewed information we had received about the service since the last inspection. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service on the inspection and six relatives about their experience of the care provided by telephone. One person’s relative sent written feedback to CQC. We spoke with 10 members of staff including three directors, the nominated individual, deputy manager, a nursing team lead, and day and night care workers.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also made observations in communal spaces within the home. We observed during lunch to see how staff interacted with people, supported them to move around safely and to eat and drink.
We reviewed a range of records. This included three people’s risk assessment records related to moving and handling and falls. We looked at a variety of records relating to the management of the service, including policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
15 December 2020
About the service
Homefield House is a residential care home providing nursing and personal care to 23 people at the time of the inspection. The service can support up to 24 people. The care home accommodates people in one large single storey building with four distinct areas, two of which were for people living with more significant nursing needs.
People’s experience of using this service and what we found
People and relatives told us the service was safe. Staff understood signs of possible abuse and the safeguarding procedures to follow. Risks to people were assessed and known by staff.
People were supported by staff who had undergone appropriate recruitment checks. Medicines were administered appropriately. Incidents and accidents were thoroughly investigated.
People and relatives told us that staff were effective. People experienced good outcomes because staff were skilled and involved the appropriate healthcare professionals. Staff experienced effective
support by senior staff and the registered manager, this enabled them to provide good quality, effective care. People's hydration and nutritional needs were met.
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.
Staff provided caring and compassionate support in a warm and welcoming environment. One relative told us, “[The home is] very homely, relaxed, friendly.” People were encouraged to remain as independent in their daily activities as possible. People and relatives confirmed to us that they were always treated with dignity and respect.
People's needs were holistically assessed and met by the care provided. The provider was in the process of improving the care records to be more concise and contain more information about people’s histories and interests. The service was not providing any end of life care at the time of the inspection but had appropriate support plans in place with people’s wishes. Complaints were well managed and responded to appropriately.
We received positive feedback about the management of the service. The registered manager promoted an open and honest culture within the service and understood their regulatory responsibilities. There were appropriate systems in place to monitor and improve the service. People, relatives and staff were involved in the development of the service appropriately.
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 July 2017). Since this rating was awarded the provider has altered its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was a planned inspection following the change in the provider’s registration.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.