CQC report explained · a residential care home
What the CQC found at Homefield House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found effective safeguarding systems, regularly reviewed risk assessments, enough staff and safe medicines administration. They did identify missing instructions for some as-needed medicines, but these were put in place during the inspection.
- Effective?
- Good
- Staff were trained and supported, people's needs were assessed and reviewed, and the home worked with health professionals. Inspectors recommended improving the dining experience because meal choices were limited and the setting was not always pleasant.
- Caring?
- Good
- This question was not covered by this focused inspection and no rating was given in this report.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed. People were supported with communication, activities, relationships and complaints.
- Well-led?
- Requires improvement
- The management team had improved systems and staff spoke positively about the leadership. However, audits had not identified some problems with medicines management and the dining experience.
What inspectors found, December 2022
Rated Good overall after improving from Inadequate; inspectors still found concerns about dining, medicines checks and leadership.
This was an unannounced focused inspection on 22 November 2022. Inspectors spoke with people living in the home, relatives, staff and professionals. They reviewed care files, medicines records, staff records and quality monitoring systems.
The home was rated Good overall. Safe, Effective and Responsive were rated Good. Inspectors found enough staff, suitable risk assessments, trained staff, personalised care and improved complaints and communication processes.
There were still weaknesses. People had limited choices at mealtimes, the environment needed decorating and new flooring, and some as-needed medicines did not have clear instructions. These medicine instructions were corrected during the inspection.
The home was rated Requires Improvement for Well-led because audits had not identified all the problems inspectors found. The home had previously been rated Inadequate and placed in Special Measures, but it was no longer in breach of regulations or in Special Measures after this inspection.
Staffing and safety
Inspectors found enough staff to provide safe care. Staff understood safeguarding and people's risks.
“There were enough staff to ensure people received safe care.” from the report
Personalised support
Care plans reflected people's needs, preferences and health conditions. Staff knew people's likes and dislikes.
“Each person had a care and support plan which was individual to their needs.” from the report
Activities and relationships
People were supported to choose activities and maintain links with their families and the community.
“People had their own interests and chose the activities they engaged in.” from the report
Communication support
Communication needs were recorded and staff understood how to communicate effectively with people.
“People's communication needs were identified and reflected in their care plans.” from the report
Limited meal choices
needs fixingPeople were not always involved in planning meals and inspectors found that choices were often limited. The dining setting was not always homely or pleasant.
“People were not involved in planning their meals and options were often limited.” from the report
Medicines instructions
seriousSome people did not have clear protocols for as-needed medicines. The deputy manager corrected this during the inspection, but it shows that medicines checks had not been fully reliable.
“People did not always receive their medication as required.” from the report
Condition of the environment
minorCommunal areas needed decorating and new flooring was needed in the lounge and corridors. The provider had identified the work and said it was planned.
“The service required some decorating works in communal areas and new flooring in the lounge and corridors.” from the report
Quality checks
needs fixingThe home had regular audits, but they did not identify all the problems found by inspectors. This is why the Well-led rating remained Requires Improvement.
“The registered manager completed regular audits to improve the safety and quality of the service, however, they had failed to identify some of the issues we found on our inspection.” from the report
- 01What choices do residents now have when planning and choosing their meals?
- 02What checks are now in place to make sure every as-needed medicine has clear instructions?
- 03Have the decorating and flooring works been completed, and if not, when will they be finished?
- 04How do managers check that audits identify problems with medicines and the dining experience?
- 05What evidence is available from the latest inspection or review of the Caring key question?
This was a focused inspection of Safe, Effective, Responsive and Well-led; the Caring key question was not covered, and the overall rating used ratings from the previous inspection for any key questions not inspected. This explanation was written from the published report of 15 December 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.
What inspectors found, July 2022
Rated Inadequate and placed in special measures; inspectors found serious risks involving medicines, staffing, safeguarding and management.
Inspectors visited without notice on 29 April and 4 May 2022. One inspector spoke with staff, reviewed six people's care and medicines records, examined three staff records and checked documents about safety and quality.
They found people were at risk of avoidable harm. Medicines were not always given safely, staffing levels were too low, staff training was out of date and safeguarding concerns were not properly recorded or reported. Infection control arrangements, including the use of protective equipment, also needed improvement.
Care was not always effective or personal. Care plans lacked important information, people did not always receive timely help with food, drink or healthcare, and there were limited meaningful activities. The home was rated Inadequate for Safe, Effective and Well-led, and Requires Improvement for Responsive.
The overall rating had fallen from Good at the previous inspection, published in May 2019. The home was placed in special measures, meaning the CQC would keep it under review and normally re-inspect within six months.
Consent and least restrictive care
The home sought consent for care and treatment. Where people were deprived of their liberty, the report says the required applications and authorisations were in place.
“The provider had sought consent from people for their care and treatment.” from the report
Recruitment checks
Pre-employment checks were carried out to help ensure suitable staff were recruited.
“The provider and registered manager carried out pre-employment checks to ensure they were recruiting suitable staff.” from the report
Visiting arrangements
The home was following the current guidance for visits at the time of the inspection.
“The provider was following current guidance for visiting at the time of the inspection.” from the report
Medicines were not safe
seriousSome prescribed medicines were missed. One medicine continued to be given for two weeks after staff had been told to stop it, and some staff lacked current training or competency checks.
“People did not always receive their prescribed medicines, including eye drops and inhalers.” from the report
Too few staff
seriousStaffing levels did not meet people's needs. People had to wait for help with eating and drinking, and staff had raised concerns about staffing without enough action being taken.
“There was not enough staff to safely meet people's care and support needs.” from the report
Weak safeguarding
seriousNot all staff knew how to report safeguarding concerns. The manager did not keep a record of concerns or follow local safeguarding procedures.
“Not all staff had received safeguarding training and did not know how to record and report safeguarding concerns.” from the report
Poor management oversight
seriousAudits and quality checks did not identify or address the problems found. Records were incomplete and there was little evidence of learning from incidents or complaints.
“Audits were ineffective and did not identify or prompt action to address the concerns we found in the safety and quality of the service.” from the report
Care plans and activities
needs fixingCare plans did not always contain current information about people's needs. People were not properly consulted about activities, and opportunities for meaningful activities were limited.
“Care plans did not always reflect people's current care and support needs.” from the report
- 01What has changed since the inspection to make sure every person receives the right medicines at the right time?
- 02How many staff are now on duty on each shift, and how do you check that staffing matches people's changing needs?
- 03Have all staff completed safeguarding, medicines, dementia and diabetes training, and how are their skills checked?
- 04How are care plans now kept up to date, including information from health professionals and people's communication and end of life wishes?
- 05What evidence can you show that accidents, complaints and feedback are now reviewed and used to improve care?
This was an unannounced inspection on 29 April and 4 May 2022 that examined the overall quality and safety of the home, including infection control; no separate Caring rating is shown in the report text provided. This explanation was written from the published report of 27 July 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 Homefield House
4 rated inspections over 6 years: the service has held its Good rating throughout.
- December 2022Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2022InadequateSafe: InadequateEffective: InadequateResponsive: Requires improvementWell-led: Inadequate
- November 2020Inspected but not ratedSafe: Inspected but not rated
- March 2019Goodstayed GoodSafe: GoodEffective: GoodResponsive: GoodWell-led: Requires improvement
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 13 April 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.
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12 live-in carers within about an hour of North East Lincolnshire
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 £980 to £1,350 a week. 10 can care for a couple. 7 years' experience on average.
“What truly stands out is how mindful and attentive she is to all of my medical needs, always going above and beyond to ensure I’m comfortable and well cared for.”
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
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.