CQC report explained · a nursing home
What the CQC found at Holme House Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2023
Rated Good; inspectors found effective, personalised and well-managed care, with end-of-life planning still being reviewed.
This was an unannounced focused inspection on 9 February 2023. Inspectors checked Effective, Responsive and Well-led. They spoke with people, relatives, staff and professionals, and reviewed care records and management documents.
The home was rated Good for all three areas inspected. Inspectors found that people received personalised care, had suitable food and drink, and were supported to access healthcare. Staff had relevant training and knew people's needs.
Activities had improved, complaints were handled effectively, and relatives and professionals spoke positively about the management and staff team. The home was also making changes to its dining, shopping and end-of-life care arrangements.
The overall rating changed from Requires Improvement to Good. Safe and Caring were not inspected in this visit, so this report does not provide new findings or ratings for those areas.
Personalised care
Care plans recorded people's preferences and how they wanted their care delivered. Relatives were involved in reviews and decisions.
“People received personalised care. Care plans documented how people wanted their care to be delivered.” from the report
Food and healthcare
People had varied meal choices, food was served on time and at the right temperature, and fluid intake was monitored when there were concerns.
“People were supported to eat and drink enough to maintain a balanced diet and access health care services to improve their health and well-being.” from the report
Activities
The home offered activities linked to people's interests, including walks, music, church and social events. Inspectors said activities had improved.
“A weekly timetable was in place which offered a range of activities. Social and cultural events were celebrated at the service.” from the report
Complaints handled well
The home had a complaints system and used complaints to make improvements. Relatives said concerns were responded to promptly.
“Learning was identified and implemented following complaints or concerns.” from the report
Positive management
Inspectors found clear management arrangements, regular feedback and effective quality checks. Staff and relatives described the management as supportive and approachable.
“Effective quality assurance systems were in place and audits were taking place.” from the report
End-of-life planning still under review
minorThe home was reviewing everyone's future end-of-life plans and arranging further training for staff. Ask what has now been completed and how plans are kept up to date.
“The service was undergoing a review of everyone's plans for the future; staff were receiving further training around end of life care.” from the report
- 01How far has the review of people's end-of-life plans progressed?
- 02What further end-of-life training have staff completed since the inspection?
- 03What activities are available for someone with my relative's interests and needs?
- 04How will you monitor food and fluid intake if my relative is at risk of not drinking enough?
- 05What were the Safe and Caring ratings at the previous inspection, and what has changed since then?
This was a focused inspection of Effective, Responsive and Well-led only; Safe and Caring were not inspected and the overall rating used earlier ratings for those areas. This explanation was written from the published report of 15 March 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2021
Rated Requires Improvement overall; inspectors found good safety and leadership, but this focused inspection did not reassess all areas of care.
This was a focused inspection following an earlier breach about governance. Inspectors visited the home on 18 January 2021 and reviewed further information up to 10 February 2021. They spoke with people, relatives and staff, observed care, and checked care, medicines, staffing and management records.
The home was rated Good for Safe and Well-led. Inspectors found that medicines were given safely, risks were assessed, staff were safely recruited, and the home was clean. They also found that management systems had improved and the previous governance breach had been resolved.
The overall rating remained Requires Improvement because the ratings for the other key questions were carried forward from the previous comprehensive inspection. This inspection did not reassess Effective, Caring or Responsive.
Safer medicines practice
Medicines were received, stored, given and disposed of safely. Records and protocols had improved since the previous inspection.
“Medicines were received, stored, administered and disposed of safely.” from the report
Improved management systems
The provider had acted on the previous inspection findings. Audits, supervision and checks gave managers a better overview of quality and safety.
“At this inspection we found improvements had been made and the service was no longer in breach of this regulation.” from the report
Clean environment
Inspectors found the home clean, with extra cleaning during the COVID-19 pandemic. Staff had received infection-control training.
“The home was clean, with additional cleaning being introduced due to the COVID-19 pandemic.” from the report
Kind care observed
People and relatives described staff as caring. Inspectors saw kind interactions and found staff understood people's needs.
“We observed kind and caring interactions on the day of our inspection.” from the report
Staffing could be tight
needs fixingFeedback was mixed about whether there were always enough staff, particularly when staff were off sick at short notice. Inspectors saw people's needs being met during the visit.
“Most staff told us there were sometimes insufficient staff when there was last minute staff sickness.” from the report
PPE practice was not fully consistent
needs fixingInspectors found that one new staff member removed their mask without social distancing and two staff were unclear about putting on and removing PPE. The manager addressed this during the inspection.
“We were somewhat assured that the provider was using PPE effectively and safely.” from the report
Feedback had not been requested recently
minorThe provider had not recently asked residents and relatives for feedback, although a survey was planned.
“The provider had not recently requested feedback from residents and relatives.” from the report
- 01How do you maintain safe staffing levels when there is last-minute sickness?
- 02What checks now make sure every staff member follows the correct PPE procedure?
- 03What were the previous ratings for Effective, Caring and Responsive, and when will these areas next be inspected?
- 04Have you completed the planned survey of residents and relatives, and what changes resulted from the feedback?
- 05How are medicines room and medicines fridge temperatures checked so that there are no missed records?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 19 March 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Holme House Care Home
7 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2021Requires improvementstayed Requires improvementWell-led: Good
- May 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2017Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: InadequateResponsive: Requires improvementWell-led: Inadequate
- January 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- November 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 21 April 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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