14 March 2023
During a routine inspection
Holme Lea is a residential care home providing personal care to up to 48 people. The service is based over 2 floors and has 3 units. The service provides support to people who have physical, mental health and sensory needs, people living with dementia and younger and older adults. At the time of our inspection there were 46 people using the service.
People’s experience of using this service and what we found
Medicines were not always managed safely. People told us they felt safe in the service. Systems and processes were in place to protect people from risk of abuse. The service had safe staffing levels. People and families told us there was enough staff. Staff were recruited safely; we made a recommendation to improve pre-employment checks. Systems were in place to identify and manage risk. Environmental checks were taking place. Infection control processes were in being followed.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Peoples’ needs were assessed on admission. People had care plans in place to cover a range of needs. Staff received regular training and supervision. People had a positive mealtime experience. The service was monitoring and acting on weight loss. The service was making referrals to health professionals to maintain peoples’ health.
People were treated with dignity and respect. Staff were described as caring by people and their families. People and families were involved in decisions around their care.
People had care plans that was individual to their needs. The service was aware of ways to ensure information can be communicated and accessible. People had limited activities however the service was proactive at trying to improve the wellbeing of residents whilst recruiting an activities co-coordinator. People and families know how to complain and told us the service was responsive to issues raised. We made a recommendation around ensuring all complaints are correctly logged.
Governance systems were in place but were not always effective. We made a recommendation around this. The service had policies and procedures in place to guide staff. The provider was aware of duty of candour responsibilities and was being transparent around areas of improvement. People and families provided positive feedback on the service and the management. Staff told us morale was variable within the team, however they felt the management was approachable and listened to them. Peoples’ views were being sought and learning was being communicated.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 27 August 2021, and this is the first inspection. The last rating for the service under the previous provider was good (published on 17 May 2019.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Holme Lea on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to medicine management at this inspection. We have made recommendations around employment checks, logging complaints and around ensuring effective audits.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.