CQC report explained · a nursing home
What the CQC found at Homefield Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, May 2023
Requires Improvement; inspectors found risks around eating, drinking and medicines, and weaknesses in management checks.
This was an unannounced focused inspection on 23 and 24 March 2023. Inspectors spoke with people, relatives and staff, reviewed care and medicine records, and checked how the home was managed.
The home was rated Requires Improvement overall. Safe and well-led were rated Requires Improvement. Inspectors found that risks linked to malnutrition, dehydration and swallowing were not always managed safely. Some medicines records and equipment checks also had weaknesses.
Effective was rated Good. People described the food positively, said they had choices and access to drinks, and inspectors found staff were trained and worked with health professionals. The overall rating fell from Good at the previous inspection in December 2021.
Staffing and recruitment
Inspectors found enough staff with suitable skills and experience. Recruitment checks had been completed safely.
“People were supported by staff who had been recruited safely and there were enough staff, with the right skills and experience to meet people's care and support needs.” from the report
Training and healthcare
Staff had induction, ongoing training and support. The home worked with other professionals to support people's health.
“Staff had completed an induction and had on-going training and support that enabled them to carry out their roles effectively.” from the report
Food and choice
People spoke positively about the food and its choice. Staff knew about dietary preferences, allergies and special diets.
“People spoke positively about the quality and choice of food.” from the report
Respectful care
Inspectors saw staff offering choices, listening to people and respecting their decisions. Mental capacity and best-interest processes were being followed.
“We observed staff providing choices to people, listening, and respecting their decisions.” from the report
Eating, drinking and swallowing risks
seriousCare plans did not always set out practical steps for people at high risk of malnutrition or dehydration. One person at high risk of choking had food within reach that did not match their safe swallowing plan.
“Risks to people associated with malnutrition, dehydration and swallowing were not always managed safely.” from the report
Medicines instructions
seriousSome medicines prescribed for use when needed did not have clear protocols. Inspectors also found that a required pain chart had not been completed.
“Protocols were not always in place that provided staff with information needed to ensure they were administered consistently and appropriately.” from the report
Equipment and infection control
needs fixingSome bed bumpers were torn or damaged, making them difficult to clean properly. The home arranged replacements during the inspection.
“We found some bed bumpers were torn and damaged which would prevent effective cleaning.” from the report
Management checks
seriousQuality checks had not found the problems with nutrition, hydration, choking and equipment. Some statutory notifications had also not been sent to CQC.
“Quality assurance processes had not been successful in identifying shortfalls in the management of risks to people.” from the report
- 01What has changed in the care plans and daily checks for people at risk of malnutrition or dehydration?
- 02How do staff make sure each person's food and drink matches their swallowing and choking plan?
- 03Are protocols now in place for every medicine prescribed to be given when needed, including medicines for pain or agitation?
- 04How are pain charts completed and checked for people who cannot clearly describe their pain?
- 05Who is currently responsible for management, and what progress has been made in appointing a registered manager?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward from the last inspection. This explanation was written from the published report of 6 May 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, December 2021
Rated Good; inspectors found safe, kind and personalised care, with a small medicines-recording issue dealt with during the visit.
This was an unannounced inspection on 10 November 2021. Inspectors spoke with people living in the home, relatives and staff. They observed care and checked care plans, medicines records, recruitment files and management records.
The home was caring and person-centred. Staff knew people well, respected privacy and dignity, supported choices and provided activities linked to people's interests. Care plans reflected people's needs and were reviewed when needs changed.
Inspectors found good arrangements for safety, staffing, training, medicines, food and drink, infection control and healthcare support. The home also had effective checks on quality, complaints and incidents.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This was the first inspection since the service registered in June 2020. The previous provider had also been rated Good in a report published in January 2018.
Kind and respectful care
Staff knew people well and supported them at their own pace. Inspectors observed privacy, dignity and independence being respected.
“We observed friendly, positive interactions between staff and people.” from the report
Personalised support
Care plans recorded people's needs, choices and lifestyles. Staff adapted communication and offered people meaningful day-to-day choices.
“People had person centred care plans that detailed their care needs and choices, were reflective of lifestyle choices and understood by the staff team.” from the report
Activities and relationships
The home offered daily activities linked to interests and hobbies, as well as one-to-one support for people who stayed in their rooms.
“A varied activity programme was available for people to join in with every day including sensory experiences such as guess the flavour or a mystery box of touch.” from the report
Strong quality monitoring
The management team used audits, surveys and meetings to identify issues, share learning and check that improvements lasted.
“Quality assurance systems and processes were multi-layered, aligned with regulatory requirements and effective at improving quality of care.” from the report
Extra monitoring of pain relief patches
minorInspectors advised the home to monitor and record that pain relief patches remained in place between applications. The home added a daily check during the inspection.
“We advised monitoring and recording that the patch remained in place between applications.” from the report
Change in registered management
minorThe registered manager had started the process of deregistering, while a new home manager had been in post for five weeks and had begun applying to register.
“A registered manager was in post but had started the process of deregistering.” from the report
- 01How will you make sure pain relief patches are checked and recorded between applications?
- 02How will care remain consistent while the registered manager changes?
- 03How do you support people living with dementia, including communication, activities and independence?
- 04How will you support my relative's eating, drinking and healthcare needs, including any allergies or health-related diet?
- 05How will my relative and family be involved in end of life planning and decisions about care?
This was an unannounced planned inspection covering all five key questions, with infection prevention and control specifically checked as part of Safe. This explanation was written from the published report of 14 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.
Every inspection of Homefield Grange
6 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- May 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2021GoodSafe: GoodEffective: GoodWell-led: Good
- March 2021Inspected but not ratedSafe: Inspected but not rated
- January 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2017Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- April 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Registered with the Care Quality Commission on 30 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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37 live-in carers within about an hour of Bournemouth, Christchurch and Poole
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 £1,000 to £1,300 a week. 26 can care for a couple. 11 years' experience on average.
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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.