CQC report explained · a residential care home
What the CQC found at Holmes House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2023
Holmes House Care Home was rated Requires Improvement; inspectors found risks with medicines, infection control, the building and management systems.
This was an unannounced, focused inspection on 15 and 16 November 2022. Inspectors spoke with people, relatives, staff and professionals. They reviewed care records, medicine records, staff files and management records.
The home was not always safe. Medicines were not consistently managed, parts of the building were unsafe, and infection control was poor. Safeguarding incidents were reported, but they were not always reviewed properly, so lessons were not always learnt.
Management systems had improved after a recent change in management, but audits had missed important problems. Relatives were not always involved in planning and reviewing care. Staff recruitment was safe and there were enough staff to meet people's assessed needs.
The overall rating fell from Good at the previous inspection in 2018 to Requires Improvement. This inspection looked only at Safe and Well-led. The ratings for the other questions were carried forward from the previous inspection.
Staffing and recruitment
Inspectors found enough suitably trained staff. Recruitment checks were completed before staff started work.
“There were enough suitably trained staff deployed to safely meet people's needs.” from the report
Falls and pressure care
Risks linked to falls and pressure areas were assessed and managed well. Specialist equipment was used where needed.
“Risks relating to falls and pressure area care were assessed and managed well.” from the report
Mental capacity practice
The home was working within the principles of the Mental Capacity Act. The report says required legal authorisations were in place where needed.
“We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place” from the report
Recent management action
The provider had begun new audits and a review of past incidents after the management change. Staff described recent improvements.
“The provider had taken some action prior to our inspection to address the management of the service.” from the report
Medicines
seriousSome creams and liquid medicines were not dated when opened. Medicine stock counts were inaccurate, and one prescribed medicine was left in a bedroom without staff knowing why it was there.
“Medicines were not managed safely. This placed people at risk of not receiving their prescribed medicines safely.” from the report
Infection control
seriousSome areas and furniture were visibly dirty. Stained pillows and cushions, jewellery worn by staff, rust and a lack of hot water created infection risks.
“People were at risk of infection due to poor infection prevention and control practices.” from the report
Building safety
seriousSome windows did not lock, one broken window fell from its frame, and damaged doors and radiator covers created risks. Limescale had also not been dealt with.
“Windows had not been maintained, we found some would not lock and another window that was broken and fell off the frame when opened.” from the report
Management oversight
seriousAudits did not consistently identify problems with medicines, infection control or building maintenance. Some incidents were not reviewed or notified to CQC, so lessons could be missed.
“The provider failed to monitor and drive service improvement in order to provide safe care.” from the report
Family involvement
needs fixingRelatives were not always involved in care planning or reviewing care. People and relatives had not been asked what improvements they wanted.
“People and their relatives were not always involved in shaping the service.” from the report
- 01What has been done to make sure all medicines are dated, counted correctly and given as prescribed?
- 02Have the broken and unlocked windows, damaged doors, radiator covers, rust and limescale now been repaired or removed?
- 03How are cleaning standards and infection control practice checked now, including the condition of pillows and cushions?
- 04How are safeguarding incidents and altercations reviewed so that lessons are acted on and incidents do not happen again?
- 05How will relatives be involved in planning and reviewing their family member's care?
This was a focused inspection of Safe and Well-led only; the other ratings were carried forward from the previous inspection in 2018. This explanation was written from the published report of 20 January 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 2022
Inspected but not rated; inspectors found good infection control and safe visiting arrangements during a targeted COVID-19 review.
This was an unannounced, targeted inspection on 24 February 2022. It looked at infection prevention and control during the COVID-19 pandemic, and asked about staffing pressures.
Inspectors found clear visiting arrangements, safe use of protective equipment, regular cleaning and effective systems for managing infection outbreaks. They were also assured that testing, admissions, social distancing and the infection control policy were being managed appropriately.
The home was inspected but not rated. This was not a full inspection of the quality of care, so it does not provide an overall Good, Requires Improvement or Inadequate rating.
Visiting arrangements
The home had clear visiting protocols that followed the guidance in place at the time.
“The service had clear visiting protocols in place for visitors to the service.” from the report
Safe use of PPE
Staff used protective equipment safely and followed current guidance.
“Staff used Personal Protective Equipment (PPE) safely. Their practice was in line with current guidance and good practice.” from the report
Infection control
Inspectors found regular cleaning and effective arrangements for preventing and managing infection outbreaks.
“The systems in place for managing outbreak of infections were effective.” from the report
Inspectors raised no specific concerns in this report.
- 01How are the visiting protocols working now, and have they changed since the inspection?
- 02How do you currently manage infection outbreaks in the home?
- 03What impact are staffing pressures having on people's care and daily routines?
- 04How are people using the service and staff currently supported with COVID-19 testing?
- 05How do you check that staff and visiting professionals follow the current infection control arrangements?
This was a targeted inspection of infection prevention and control and COVID-19-related staffing pressures; the service was inspected but not rated overall. This explanation was written from the published report of 22 March 2022 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 Holmes House Care Home
4 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- January 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2022Inspected but not ratedSafe: Inspected but not rated
- January 2021Inspected but not ratedSafe: Inspected but not rated
- January 2018Goodstayed GoodSafe: Requires improvementWell-led: Good
- November 2015Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- January 2014
Registered with the Care Quality Commission on 2 January 2014.
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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