Homefield House

Updated 15 December 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector, a medicines inspector and an Expert by Experience. An Expert by Experience also spoke to relatives by telephone the following day. 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

Homefield House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Homefield House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service and 8 relatives to ask about their experience of the care provided. We also spoke with the registered manager, the deputy manager, the cook and a domestic along with 5 members of care staff and 2 professionals. We looked at 4 care files along with a range of medication administration records (MARs). We looked at other records relating to the management of the service including recruitment, staff training, supervision and systems for monitoring quality.

Updated 15 December 2022

About the service

Homefield House is a residential care home providing personal and nursing care up to a maximum of 24 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 20 people using the service.

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

People views were not actively sought, and they were not always involved in the dining experience. Choices were limited and the environment was not well presented. We have made a recommendation about improving the dining experience for people who use the service.

The service required some decorating works completing and new flooring was required, this had already been identified by the provider and work would commence shortly.

People did not always receive their medication as required. ‘As and when’ (PRN) protocols were not in place for everyone. The deputy manager rectified this immediately and ensured all people had protocols in place. Staff had received medication training and we observed safe practice in the administering of medicines.

The service had effective safeguarding systems, policies and procedures in place. Staff have a good understanding of abuse and knew what to do to keep people safe. Staff had received safeguarding training.

Risk assessments were person centred and reviewed regularly. Staff were aware of people’s risks and how to manage them. Staff understood their responsibility to raise concerns and were supported to do so.

There was enough competent staff on duty and the service regularly reviewed staffing levels and adapted them to meet people’s changing needs. Staff told us staffing was much better and people were getting the care they needed.

Staff completed an induction and did not work unsupervised until they felt confident to do so. Staff had the right qualifications to carry out their duties and received regular supervision and appraisals.

Assessments of people’s needs were completed and regularly reviewed and updated. Referrals to external services were made to ensure people’s needs were met.

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 empowered to make choices and be as independent as possible. People were encouraged and supported to carry out person centred activities. One relative told us [Person’s name] plays games and paints, they also take [Person] out once a week and [Person] her bake, [Person] loves it.”

People’s complaints were listened to and responded to in good time. People and their relatives told us they felt confident if they complained they would be listened to and taken seriously.

The provider had an effective governance system in place. Information from governance meetings and action plans support to drive improvement and improve outcomes for people.

The service has a positive culture that is person centred, open and empowering. People and their families are involved in the service in a meaningful way. The service engages and involves staff and ensures their views are acted on to shape the culture of the service.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 27 July 2022) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we also recommended the provider made improvements in providing staff with the necessary training for infection prevention and control (PPE). Processes required improving in how the provider responded to and learnt from complaints and guidance in relation to Accessible Information Standards (AIS). At this inspection we found the provider had acted on the recommendations and all staff had received training in PPE, processes had improved for responding to complaints and the provider was meeting people’s communication needs.

This service has been in Special Measures since 27 July 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced inspection of this service on 29 April 2022 and 4 May 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve in safe care and treatment, safeguarding service users from abuse and improper treatment, good governance and staffing.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions, safe, effective, responsive and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from inadequate to good based on the findings of this inspection.

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 read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Homefield House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.