CQC report explained · a nursing home
What the CQC found at Holmewood Manor Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines were not always managed safely. There were problems with training, stock records, trolley security and cleaning of medicine pots, although inspectors found no evidence that anyone had been harmed.
- Effective?
- Good
- This question was not inspected at this visit. The report says the previous rating was used because no area of concern had been identified.
- Caring?
- Good
- This question was not inspected at this visit. The report says the previous rating was used because no area of concern had been identified.
- Responsive?
- Requires improvement
- This question was not inspected at this visit. The report says the previous rating was used because no area of concern had been identified.
- Well-led?
- Requires improvement
- Quality checks did not identify the medicine problems found by inspectors. People also reported limited activities, limited choice about personal care and problems with laundry.
What inspectors found, December 2021
Holmewood Manor Care Home was rated Requires Improvement; inspectors found unsafe medicines management and weaknesses in leadership, although people generally felt safe and staff were kind.
Inspectors visited without notice on 23 November 2021. They spoke with people, a relative, staff and other professionals. They reviewed care records, medicine records, staff files and management records.
The main safety problem was medicines. Staff were not all properly trained to use the new electronic system. Inspectors found medicine stock discrepancies, broken trolley locks and dirty medicine pots. People were at risk of not receiving medicines as prescribed, although no harm was found.
The home was clean and staff recruitment was safe. There were enough care staff to meet people's care needs, but kitchen and laundry staffing were not enough. People felt safe and staff were described as kind, but activities, personal choices and laundry arrangements needed improvement.
The overall rating fell from Good at the last comprehensive inspection in 2019 to Requires Improvement. This inspection rated only Safe and Well-led. The other ratings were carried forward from earlier inspections because inspectors found no areas of concern in those questions.
People felt safe
People told inspectors they felt safe. Staff had safeguarding training and knew how to report concerns.
“People were safe from the risk of abuse.” from the report
Enough care staff
Inspectors found enough staff on duty to meet people's care needs. Staff recruitment checks were completed safely.
“People were supported by enough staff to meet their needs.” from the report
Kind and attentive care
Inspectors saw staff comfort someone who was upset. A relative said staff were attentive and acted when the person was in pain.
“They [staff] have always been very attentive to [person] and quizzed her about her pain for clarity, and have taken appropriate action to remedy it.” from the report
Action after medicine errors
After the inspection, the provider audited medicines, introduced daily stock checks, sought extra training and told affected people and relatives about the errors.
“Following our inspection, the provider carried out a full audit of medicines, re-introduced daily stock checks, requested additional medicine training for staff and referred this to the local safeguarding team.” from the report
Medicines were not safe
seriousMedicine records and stock did not always match. Some staff had not received robust training, trolleys had broken locks and medicine pots were dirty.
“People's medicines were not always managed safely.” from the report
Few meaningful activities
needs fixingPeople said they were bored and inspectors did not see people taking part in meaningful activities. An activities co-ordinator had recently been appointed but checks were still pending.
“During the inspection we saw people were not engaged in any meaningful activities and people told us they were 'bored'.” from the report
Personal choices were not always followed
needs fixingPeople said their preferences, including whether to have a bath or shower, were not always taken into account.
“This meant people's needs and preferences were not always met.” from the report
Laundry problems
needs fixingPeople, relatives and staff reported missing clothes and clothes being given to the wrong people. There was only one laundry worker, who mainly supported another service.
“Relatives told us that items of clothing had gone missing or that people wore clothes not belonging to them.” from the report
Unpleasant odours
minorThe home was generally clean and tidy, but inspectors noticed unpleasant smells in some areas.
“The home looked generally clean and tidy, however there was an unpleasant odour in certain places throughout the home.” from the report
- 01What changes have been made to medicines training, electronic medicine records and daily stock checks since the inspection?
- 02How are medicine trolleys kept locked and how are reusable medicine pots now cleaned and decontaminated?
- 03How many staff now work in the kitchen and laundry, and how are missing or wrongly allocated clothes prevented?
- 04What activities are currently available, and how are they matched to each person's interests?
- 05How do staff record and follow people's choices about baths, showers and other day-to-day personal care?
This was a focused inspection of Safe and Well-led; the other ratings were carried forward from previous comprehensive inspections. This explanation was written from the published report of 17 December 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.
What inspectors found, February 2021
Holmewood Manor Care Home was inspected but not rated; inspectors found strong infection-control arrangements but gaps in touch-surface cleaning and audits.
This was an unannounced, targeted inspection on 2 February 2021. It looked only at infection prevention and control because of the coronavirus outbreak response.
Inspectors found good arrangements for visitor checks, personal protective equipment, testing, staffing and reducing infection risks between floors. They were assured about most infection-control measures.
There were gaps in cleaning touch surfaces between planned cleaning times. Some bathrooms had mobility equipment stored in them, and infection-control audits had not been completed regularly. The provider reviewed these areas after the inspection.
Visitor safety
The home had planned checks for visitors, including questionnaires, temperature checks and rapid tests, ready for when visits resumed.
“These involved questionnaires, temperature checks and lateral flow tests. which provided a rapid test result.” from the report
PPE and testing
Staff had training and access to the PPE they needed. People living in the home and staff were tested regularly, with daily checks to support early action.
“The staff had received training to ensure they understood how to use their personal protective equipment (PPE).” from the report
Staffing arrangements
Inspectors found enough staff to meet people's needs, with plans to use agency staff if there was sickness or annual leave. Staff were separated between floors to reduce infection risk.
“There were sufficient staff to support people's needs and contingency arrangements to block book agency staff in the case of annual leave or sickness.” from the report
Touch-surface cleaning
needs fixingTouch surfaces were not cleaned continuously between planned cleaning times. Inspectors were only somewhat assured about the safety of the premises' cleaning arrangements.
“We were somewhat assured that the provider was promoting safety through the layout and hygiene practices of the premises.” from the report
Irregular infection-control audits
needs fixingAudits had not been completed regularly enough to identify and deal with outstanding concerns.
“Audits in relation to infection control had not been completed regularly to address any outstanding areas of concern.” from the report
Equipment in bathrooms
minorSome bathrooms contained mobility equipment, which could make it harder to use those rooms effectively.
“Some bathrooms contained mobility equipment which could impact on the effective use of these rooms.” from the report
- 01How often are touch surfaces now cleaned between the planned cleaning times?
- 02What changes have been made to remove mobility equipment from bathrooms where it affects their use?
- 03How regularly are infection-control audits now completed, and how are outstanding concerns followed up?
- 04What infection-control checks are currently in place for visitors, staff and people living in the home?
This was an unannounced targeted inspection of infection prevention and control only; the other four key questions were not assessed and the service was not rated. This explanation was written from the published report of 26 February 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 Holmewood Manor Care Home
4 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- December 2021Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2021Inspected but not ratedSafe: Inspected but not rated
- May 2019Goodstayed GoodSafe: GoodWell-led: Good
- January 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 2 December 2010.
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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