CQC report explained · a residential care home
What the CQC found at Homewood Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2017
Rated Good; inspectors found kind, safe care, but some feedback raised concerns about stimulation and community activities.
Inspectors visited the home without warning on 10 August 2017. Seven people were living there, and the home can support up to eight people with learning disabilities, autism or physical disabilities. Inspectors observed care, spoke with staff, relatives and professionals, and checked care records, medicines, recruitment files, training records and quality checks.
The inspectors found a friendly home where staff knew people well and supported them with kindness, respect and patience. People were protected from abuse, risks were assessed, medicines were managed safely and staffing levels met people's needs. Staff had relevant training and supported people's health, communication, choices and independence.
All five areas were rated Good: safe, effective, caring, responsive and well-led. There was mixed feedback about activities and access to the community. The home had bought a new vehicle and changed its staffing arrangements to improve flexibility.
Kind and respectful care
Staff built positive relationships with people and respected their privacy, dignity, choices and communication needs.
“Staff were kind and compassionate towards people. Staff knew people well and respected their privacy and dignity.” from the report
Safe staffing and medicines
Inspectors found enough staff to support people, with extra staffing available for activities. Recruitment checks and medicines systems were in place.
“There were enough staff to meet people's needs and provide personalised care and support with activities.” from the report
Personalised support
Care plans reflected people's preferences and gave staff guidance about individual needs and communication.
“Care plans were written in a personalised way, including what and who was important to the person.” from the report
Active improvement
The provider and manager reviewed incidents, audits and feedback, and made changes to improve support and the environment.
“The provider and the registered manager were promoting an open and inclusive culture and continued to look for ways to improve the service.” from the report
Activities and stimulation
needs fixingOne relative was concerned that people had too much television and not enough activities outside the home. A professional also said some people wanted more spontaneous community access.
“However, another relative told us they were concerned about a "Lack of stimulation". They said while staff were "All very dedicated and extremely kind", there was "Too much watching TV and not enough activities" for people.” from the report
Use of agency staff
minorTwo permanent staff were on long-term absence and agency staff were covering these posts. The home was recruiting more casual staff to improve consistency.
“Two full time staff were on long term absences and these positions were being covered by regular agency staff as much as possible to promote continuity of care.” from the report
- 01How will you make sure the person has enough activities and stimulation each week?
- 02How often can residents go out into the community, and what happens if they want to go out spontaneously?
- 03How many agency staff are currently working at the home, and how do you make sure they understand each person's needs?
- 04How do you make sure staff are trained to give any emergency medicines needed during trips out?
- 05How are residents and relatives involved in reviewing care plans and giving feedback?
This was an unannounced inspection of all five rating areas, including observations, discussions with staff, relatives and professionals, and checks of care, staffing, medicines and quality records. This explanation was written from the published report of 11 October 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.
What inspectors found, September 2016
Rated Requires Improvement; inspectors found kind, personalised care, but recruitment, staff training and reporting systems were not always strong enough.
This was an unannounced inspection on 26 and 27 July 2016. Inspectors spoke with people, relatives and staff, observed care and meals, and checked care plans, medicines records, recruitment files, training records, rotas and quality checks.
People were generally treated with kindness and respect. Staff understood people's needs, supported their independence, helped them take part in activities and sought medical help when needed. Medicines, staffing levels and risk assessments were found to be safe.
The home needed to improve its recruitment checks and systems for keeping staff training up to date. Staff had not received formal British Sign Language training where this was needed. The manager had also failed to notify the CQC about five incidents that should have been reported. The overall rating was Requires Improvement, with Caring and Responsive rated Good.
Kind and respectful care
Staff built warm relationships with people and supported them in a gentle, respectful way. People were given time to communicate and make choices.
“Staff were compassionate and caring in their approach with people supporting them in a kind and sensitive manner.” from the report
Personalised support
Care plans included detailed information about people's histories, preferences, health needs and routines. Staff used this information in daily care.
“People received personalised and respectful care from staff who understood their care needs.” from the report
Safety arrangements
There were enough staff, risks were recorded with guidance for managing them, and medicines were administered by trained staff whose competence was checked.
“People were assisted by sufficient numbers of staff to be able to meet their needs safely.” from the report
Activities and independence
People were supported to take part in community activities and maintain relationships. Staff encouraged people to do things for themselves.
“People were supported to participate in horse riding, shopping, going to the gym, swimming and to go into the local community to enjoy social groups.” from the report
Food and healthcare
People chose meals and received support with eating and drinking. Staff sought professional healthcare advice when needed and followed health guidance.
“People received the food and drink they required, and requested, in order to maintain a balanced diet.” from the report
Recruitment checks
seriousSome staff files did not contain full employment histories, and gaps had not always been explained. The new manager had begun correcting this, but the improvement was not yet established.
“Robust recruitment procedures were not always completed to ensure people were assisted by staff who were of suitable character.” from the report
Communication training
needs fixingStaff had not received formal British Sign Language training for a person who preferred this method. This created a risk that staff could not communicate in the person's preferred way.
“The provider did not supply staff with training in British Sign Language (BSL) to enable them to support people who preferred to use this method of communication.” from the report
Training records
needs fixingThe home could not reliably show which staff training was current or when it needed updating. A new training tracker was being introduced.
“The details in people's training folders did not accurately reflect the dates on their certificates of when they last received their training.” from the report
Incidents not reported to CQC
seriousFive incidents since April 2016 should have been reported to the CQC but were not. They had been referred to other authorities, including the police and safeguarding authority.
“We identified that since April 2016 there had been five incidents which should have resulted in a notification to the CQC.” from the report
Limited activity choices
minorSome relatives felt more activities should be available inside and outside the home. The manager was seeking funding and staff to expand the activities offered.
“Some relatives we spoke with felt that more activities could be conducted both within and outside of the home.” from the report
- 01What checks are now completed before staff start work, including full employment histories and explanations for gaps?
- 02Which staff have received British Sign Language training, and how is the home checking that this training remains current?
- 03How does the home now make sure all incidents that must be reported to the CQC are notified without delay?
- 04What extra activities are now available, both inside and outside the home, following relatives' feedback?
- 05How often are staff training records and quality audits checked, and what happens when a shortfall is found?
This was an unannounced comprehensive inspection of the overall quality of the home, including all five CQC questions; the previous inspection on 24 April 2014 found no concerns. This explanation was written from the published report of 1 September 2016 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Homewood Care Home
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- October 2017Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 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.
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