Archived: Holme Lea

Updated 4 May 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Prior to the inspection we were notified about a serious incident in which a person using the service died. This incident is not subject to a criminal investigation. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of falls from beds. This inspection examined those risks.

Risk List (non-exhaustive)

• Falls from beds

Inspection team:

The inspection was undertaken by one adult social care inspector on both days and an expert-by experience on day one. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert had experience in dementia care in residential and community-based health and social care settings.

Service and service type:

Holme Lea is a residential care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

This inspection was unannounced and was carried out on 27 and 28 March 2019.

What we did:

We reviewed information we had received about the service since the last inspection in April 2018. This included details about incidents the provider must notify us about, such as abuse. We contacted the local authority commissioning team to gather information about the service and feedback we received from them was positive. We had requested the service to complete a provider information return (PIR) which we received; this is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection, we spoke with seven people who used the service and four relatives to ask about their experiences of the care provided. We also spoke with the registered manager, the area director and three staff members. In addition, we spoke with three healthcare professionals who were visiting the home at the time of the inspection.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We reviewed a range of records including four people's care records, risk assessments and medication administration records (MARs). We also looked at four staff personnel files including staff recruitment, training and supervision records. We reviewed records relating to the management of the service, audits, and a variety of policies and procedures developed and implemented by the provider.

Updated 4 May 2019

About the service:

Holme Lea is a purpose built, two-storey building in its own grounds. It offers accommodation for up to 48 older people in single bedrooms, many of which have en-suite facilities. At the time of the inspection 44 people were living at the service.

The building is situated in a residential area of Stalybridge and is close to a main road offering public transport links and views across the foothills of the Pennines. Car parking is shared with the adjacent home, Stamford Court. The home is run by Meridian Healthcare Limited which operates several other care homes mainly in the North West of England.

People’s experience of using this service:

The service had an open and supportive culture. Systems were in place to monitor the quality and safety of care delivered. There was evidence of improvement and learning from any actions identified.

There were sufficient numbers of trained staff to support people safely. Recruitment processes were robust and helped to ensure staff were appropriate to work with vulnerable people.

People’s needs were thoroughly assessed before starting with the service. People and their relatives, where appropriate, had been involved in the care planning process.

Staff were competent and had the skills and knowledge to enable them to support people safely and effectively. Staff received the training and support they needed to carry out their roles effectively. Staff received regular supervisions and annual appraisals were planned.

Staff had awareness of safeguarding and knew how to raise concerns. Steps were taken to minimise risk where possible.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff supported people to access other healthcare professionals when required. Staff supported people to manage their medicines safely.

People’s outcomes were consistently good, and people’s feedback confirmed this.

Staff worked with other agencies to provide consistent, effective and timely care. We saw evidence that the staff and management worked with other organisations to meet people’s assessed needs.

We observed positive interactions between staff and people. Staff had good relationships with people and were seen to be caring and respectful towards people and their wishes.

People were supported to express their views. People we spoke with told us they had choices and were involved in making day to day decisions.

The provider and registered manager followed governance systems which provided effective oversight and monitoring of the service.

The premises were homely and well maintained. We observed a relaxed atmosphere throughout the home.

The service met the characteristics of Good in all areas.

Rating at last inspection:

At the last inspection of the service (published 04 April 2018) the home was rated Requires Improvement overall and there was one breach of regulations in relation to good governance. At this inspection the overall rating has improved to Good.

Why we inspected:

This was a planned inspection based on previous the rating. Prior to the inspection we were notified about a serious incident in which a person using the service died. We looked at risks associated with this. Further information is in the full report.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk