CQC report explained · a residential care home
What the CQC found at Holmwood Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found effective risk assessments, safeguarding systems, enough staff and good infection control. They also found incomplete fire evacuation plans, one medicines-recording problem and recruitment records that were not all available.
- Effective?
- Good
- This area was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found audits, person-centred care plans, staff training and feedback systems. They also found that fire safety shortfalls had not been identified before the inspection, although immediate action was taken.
What inspectors found, September 2023
Rated Good overall; inspectors found caring, person-centred support, but identified fire safety, medicines and recruitment issues.
This was an unannounced focused inspection on 20 and 21 April 2023. Inspectors looked at Safe and Well-led because concerns had been raised after serious incidents. They spoke with people, relatives, staff and professionals, and checked care plans, risk assessments, medicines, safety records and recruitment files.
The home was rated Good for Safe and Good for Well-led. Inspectors found enough staff, prompt responses to call bells, effective risk assessments, safeguarding systems and good infection control. People and relatives said they felt safe and supported.
There were some shortfalls. Some fire evacuation plans lacked important detail, one person's medicines guidance was not correctly recorded on the electronic medicines system, and recruitment records were not all available during the visit. The home took immediate steps to address these matters during or after the inspection.
This was a focused inspection of Safe and Well-led only. The ratings for the other three areas were carried forward from the previous inspection, so this report does not give new findings about Effective, Caring or Responsive.
People felt at home
People and relatives described the home positively and said people were supported well.
“People and their families told us that they felt they lived in a "real home", and they felt people were supported well.” from the report
Risk management
Inspectors found effective risk assessments for matters including falls and smoking. Relatives also said people were supported safely.
“People had effective risk assessments in place for risks such as falls and smoking.” from the report
Person-centred care
Care plans included people's likes and dislikes, and staff showed person-centred support in practice.
“The registered manager ensured that people had person centred care plans with comprehensive information about their likes and dislikes.” from the report
Learning and oversight
The home used audits and reviewed accidents and incidents to look for patterns and improve care.
“There was a record of incidents and accidents which were reviewed for themes and trends to try to reduce a recurrence of issues.” from the report
Fire evacuation plans
seriousSome people's personal emergency evacuation plans were incomplete. This could have delayed safe evacuation during a fire, although the plans were reviewed during the inspection.
“Some people's emergency evacuations plan (PEEPs) had not been fully completed and were missing detail on how to safely support them if they needed to evacuate.” from the report
Medicines guidance
seriousOne person's electronic medicines record did not contain the right instructions about when to use their medicines. The provider amended the guidance during the inspection.
“One person did not have appropriate guidance recorded on the electronic medicine system (E-MAR) as to when to use their medicines” from the report
Recruitment records
needs fixingRecruitment was not always in line with current legislation, and not all recruitment documents were available during the visit. Further records were sent to the CQC afterwards.
“Staff recruitment was not always in line with current legislation.” from the report
Special diet support
needs fixingOne person's medically identified dietary need had not been fully put into practice. The registered manager reviewed the support after inspectors raised it.
“One person had been identified by a medical professional as needing a specific diet. However, this had not been embedded.” from the report
- 01How have you completed and checked each person's personal emergency evacuation plan since the inspection?
- 02How do you check that medicines instructions are correctly recorded on the electronic medicines system as well as in care plans?
- 03What recruitment checks and records are now completed before staff start work?
- 04How do you make sure medically required diets are followed every day?
- 05Which parts of the service have not been reviewed since the previous inspection?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 27 September 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, May 2020
Rated Good; inspectors found kind, person-centred care, but some records, cleaning and end-of-life plans needed improvement.
Inspectors visited on 10 and 17 December 2019. The first day was unannounced. They spoke with people living at the home, relatives, staff and a health and social care professional. They also checked care records, medicines records, staff recruitment files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People told inspectors they felt safe, were treated kindly and were happy with their care. There were enough staff, medicines were generally managed safely, and people had access to food, activities and health professionals.
Inspectors found some shortfalls. Less visible areas were not always clean. Two people's medicines were not given in a timely way. Some fluid, repositioning and care records were incomplete or inaccurate. People's personal wishes about end-of-life care were not always recorded in their care plans.
The overall Good rating means the inspection found the service met the relevant standards and provided consistently good care. The last rating was also Good, published on 25 May 2017.
Enough staff
Inspectors found enough staff to support people safely and saw that people were supported in a timely way.
“There were enough staff to support people safely.” from the report
Kind and respectful care
People were treated with kindness and compassion. Staff promoted privacy, dignity and independence.
“People were treated with kindness and compassion. There were many friendly interactions and kind aspects of support.” from the report
Choice and activities
People could follow their own routines, choose food alternatives and join a range of activities inside and outside the home.
“A varied activity programme was in place. This was arranged by designated activity staff and included both in house and external activities.” from the report
Positive leadership
Inspectors found a positive culture, regular quality checks and a management team focused on improving care.
“There were audits to assess the quality and safety of the service.” from the report
Cleaning shortfalls
needs fixingMost areas were clean, but some less visible areas had debris and worn or stained seals. A delayed deep clean was given as the reason, and some shower repairs were completed during the inspection.
“The majority of home was clean, but some less visible areas were not.” from the report
Medicine timings
needs fixingMedicines were generally managed safely, but two people's medicines were not administered in a timely way.
“People's medicines were safely managed although two people's medicines were not being administered in a timely manner.” from the report
Incomplete care records
needs fixingSome fluid monitoring and repositioning records were incomplete. Inspectors found no evidence that anyone had suffered dehydration or pressure ulceration as a result.
“However, not all monitoring records were fully completed.” from the report
Training still outstanding
minorSome staff had not completed all training the provider considered mandatory. They were expected to complete it by the end of December 2019.
“However, records showed some staff had not completed all their training deemed mandatory by the provider.” from the report
End-of-life wishes
needs fixingTreatment escalation plans were in place, but personal wishes about end-of-life care were not always included in support plans.
“Personal wishes however, regarding end of life care, were not detailed within people's support plans.” from the report
- 01How do you now check that medicines are given at the right time?
- 02What checks are in place to make sure fluid intake and repositioning records are complete?
- 03How often are less visible areas, kitchen surfaces and shower seals deep-cleaned?
- 04How will you record and regularly review my relative's personal wishes about end-of-life care?
- 05Did all staff complete the mandatory training that was outstanding at the inspection?
This was a planned inspection covering all five CQC questions, with the first day unannounced; all five ratings remained Good from the previous inspection. This explanation was written from the published report of 27 May 2020 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 Holmwood Care Home
4 rated inspections over 8 years: the service has held its Good rating throughout.
- September 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2020Goodstayed GoodSafe: GoodWell-led: Good
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 28 January 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about two hours of Wiltshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,340 a week. 82 can care for a couple. 12 years' experience on average.
“Linet became her carer and all changed, my daughter started eating, taking her medications and more important her happiness came back.”
“I cannot recommend Prisca highly enough, she is one in a million.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.