Holmer Care Home with Nursing

Updated 12 February 2020

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector, a Specialist Advisor who was a specialist in nursing care, and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Holmer Care Home with Nursing is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. 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.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, Healthwatch and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with 15 people who used the service, four relatives and one visitor about their experience of the care provided. We spoke with 14 members of staff including the registered manager, governance and quality lead, clinical leads, nurses, senior care workers, care workers, auxiliary staff and the chef. 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. This included five people’s care records and multiple medication records. We looked at one staff file in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two staff who worked nights at the home.

Updated 12 February 2020

About the service

Holmer Care Home with Nursing is a residential care home providing personal and nursing care to 34 people aged 65 and over at the time of the inspection. The service can support up to 40 people.

People’s experience of using this service and what we found

People were supported by knowledgeable staff who understood how to keep them safe and protect them from avoidable harm. People had their risks assessed and had up to date guidance to support people safely. The numbers of staff had been increased and was under review to ensure staff were deployed effectively to meet people's needs. People received their medicines regularly and systems were in place for the safe management and supply of medicines. Staff understood how to prevent infection and followed best practice guidelines. Incidents and accidents were investigated, and actions were taken to prevent recurrence.

People's needs were assessed, and care was planned and delivered to meet legislation and good practice guidance. Staff were well trained and knowledgeable about people's needs and wishes. People enjoyed the meal time experience, and additional training had been arranged to keep staff updated with improved practice. 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.

People were supported by compassionate staff who knew people well and championed their rights. The atmosphere within the home was friendly and welcoming. People and their relatives felt welcomed, involved and supported in decision making. People's privacy was respected, and their dignity maintained.

People were supported by staff who knew them well and supported them as an individual. Staff spent time with people, and there was a program of interesting events for people to join if they wished. Staff were completing additional training to improve people’s involvement in daily pastimes. Complaints were investigated, and outcomes agreed, and improvements made when needed. When people needed support at the end of their lives staff were skilled and had links with community support.

The registered manager and her management team were open, approachable and focussed on providing person centred care. Systems were in place to monitor the quality of care provided. Improvements such as communication between staff, had been identified and actions to improve this were being established. Staff said they were well supported and encouraged to share ideas for improvements. The registered manager and staff had established community links to improve people’s well-being.

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 24 January 2019 and this is the first inspection.

The last rating for this service was good (published 30 October 2016). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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