CQC report explained · a residential care home
What the CQC found at Holmhurst
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe. Inspectors found effective safeguarding systems, current risk assessments, enough staff and safe medicines arrangements.
- Effective?
- Good
- People's needs were assessed and staff worked with health professionals. Improvements had been made to consent arrangements and the completion of staff refresher training.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff supported people to make decisions and develop their independence.
- Responsive?
- Good
- Care plans were personal and regularly reviewed. People were supported with communication, relationships, activities, employment and complaints.
- Well-led?
- Good
- The home was described as well run, with effective checks on care, medicines, staff practice and records. The results were used to plan improvements.
What inspectors found, October 2019
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced planned inspection. One inspector spoke with three people living at the home and four staff members. Records about care, medicines, staffing and management were also checked.
The home supported seven people with mental health support needs and could support up to nine people. People said they felt safe and were happy with their care. Inspectors found enough trained staff, safe medicines systems, up-to-date risk assessments and clean surroundings.
Care was tailored to people's needs, choices and goals. Staff supported people with food, health appointments, activities, relationships and independence. People were treated with kindness, privacy and respect.
The overall rating was Good, with Good ratings in all five areas. The Effective rating improved from Requires Improvement at the previous inspection because consent arrangements and staff refresher training had improved. The other four ratings stayed Good.
People felt safe
People said they felt safe and staff understood how to protect them from harm. Risks were assessed with people's involvement and kept up to date.
“People told us they felt safe at Holmhurst.” from the report
Personalised support
Care plans reflected people's preferences, routines, goals and communication needs. People regularly reviewed their plans with staff.
“People had clear support plans, which set out how their individual needs should be met.” from the report
Kind and respectful care
Inspectors saw friendly and respectful interactions. People were supported to make choices, maintain privacy and build independence.
“We observed staff interacting with people in a friendly and respectful way.” from the report
Support for independence
People were supported to manage medicines where safe, go out alone, work, join community activities and prepare meals.
“People were supported to be as independent as possible, including support to manage their medicines independently, go out alone and take part in voluntary work.” from the report
Effective management checks
The provider used checks, feedback and observations of staff practice to identify and make improvements.
“The provider had effective quality assurance systems in place.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you support my relative's particular mental health needs and recovery goals?
- 02How do you involve people and their families when care plans and risk assessments are reviewed?
- 03How would you support my relative to manage medicines or other daily tasks independently, where this is safe?
- 04What activities, work or community opportunities would be available for my relative?
- 05How would you support my relative's communication needs, including if their mental health changed?
This was an unannounced planned inspection covering all five CQC questions, including accommodation and the care provided. This explanation was written from the published report of 26 October 2019 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 2017
Rated Good overall; inspectors found kind, personalised care, but staff training and some consent records required improvement.
This was an unannounced inspection on 24 January 2017. It was the home’s first rated inspection. The inspector spoke with people living there, staff, the manager, relatives and a health professional, and reviewed care and management records.
The home was rated Good overall. Safe, caring, responsive and well-led were rated Good. Inspectors found enough staff, safe medicine administration, respectful care, personalised support and a positive approach from the manager.
Effective was rated Requires Improvement. Some staff training had expired and consent had not been recorded for staff holding two people’s cigarettes. Inspectors also found that a lockable medicine cabinet was needed for one person, but the manager arranged improvements during or shortly after the inspection.
Kind and respectful care
People and relatives described the staff as caring and supportive. Inspectors saw staff treating people with dignity and respect.
“The relationships between staff and people receiving support demonstrated dignity and respect at all times.” from the report
Personalised support
Care plans included people’s likes, dislikes, life stories, communication needs and goals. Staff used this information to provide individual support.
“Care, treatment and support plans were personalised and reflected people's needs and choices.” from the report
Activities and independence
People could choose activities and continue hobbies. The home supported people with work, volunteering, holidays and developing independent living skills.
“People had access to activities that were personal and important to them.” from the report
Positive leadership
The manager was described as approachable and had made improvements to the home. Staff, relatives and health professionals reported better communication and stability.
“The registered manager promoted a positive culture in the home and had worked hard to make improvements in the service.” from the report
Good health support
People had access to health and social care professionals, including GPs, dentists and opticians. Health action plans recorded the support people needed.
“People had access to health and social care professionals.” from the report
Out-of-date staff training
needs fixingSome staff training had expired and renewal had not yet been arranged. The manager said the training was rebooked after the inspection.
“During our inspection records showed that some staff's training had expired which needed renewing and this had not yet been arranged.” from the report
Consent records
needs fixingStaff kept two people’s cigarettes in the office to control smoking and reduce fire risk, but consent had not initially been recorded. Signed consent forms were sent to CQC after the inspection.
“We saw that consent forms were in place for most decisions relating to consent to receiving care, photos being taken and support with medicines.” from the report
Missed interaction opportunities
needs fixingAlthough staff were visible and staffing levels were sufficient, inspectors saw occasions when people were not offered a choice to engage and walked from room to room.
“At times opportunities to interact with people were not always taken up, leading some people to walk from room to room without being offered the choice to engage.” from the report
Medicine storage
needs fixingOne person who managed their own medicines did not have a lockable facility in their room. A separate locked medicines fridge was put in place during the inspection.
“One person, who managed their own medicines, did not have a lockable facility in their room to keep their medicines safe.” from the report
Food information
minorThe home did not record menu plans or food preferences. Inspectors asked the manager to record this information for new staff or if someone later could not explain their choices.
“There were no menu plans in place or recorded food preferences and staff informed us this was because they knew what people liked or people were able to say.” from the report
- 01How do you now check that all staff training is current before it expires?
- 02How do you record and review consent when staff hold people’s cigarettes or support them with other restrictions?
- 03What lockable medicine storage is now available for people who self-administer their medicines?
- 04How do staff make sure people are offered interaction and meaningful choices throughout the day?
- 05What changes have been made to the garden and outdoor activities since relatives said the facilities were limited?
This was an unannounced first rated inspection covering all five CQC questions, based on visits, conversations and reviews of care and management records. This explanation was written from the published report of 28 March 2017 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 Holmhurst
2 rated inspections over 3 years: the service has held its Good rating throughout.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2016
Registered with the Care Quality Commission on 10 October 2016.
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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