Latest Inspection
This is the latest available inspection report for this service, carried out on 21st June 2010. CQC found this care home to be providing an Good service.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
For extracts, read the latest CQC inspection for Holmers House.
What the care home does well People can choose how they wish to spend their day and are supported to take part in activities if they wish. Staff retention is good and managers and staff have time therefore, to get to know residents and their families. Managers are responsive to comments, concerns or complaints by families. The organisation has thorough arrangements in place for the investigation of serious concerns where required. Heritage Care maintain a good programme of staff training and development and theregistered manager supports staff in attending training events. The training programme includes modules on the care of people with dementia. What the care home could do better: Standards of care planning, implementation and review should be improved. This should aim to achieve greater consistency in standards of care. Managers should explore, and address where necessary, the communication problems which were reported to us during our visit - in particular those which are likely to have an impact of the quality of care to residents. Random inspection report
Care homes for older people
Name: Address: Holmers House Holmers Farm Way Cressex Road High Wycombe Bucks HP12 4PU two star good service 16/06/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Mike Murphy Date: 2 1 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Holmers House Holmers Farm Way Cressex Road High Wycombe Bucks HP12 4PU 01494769560 01494769566 alison.pulley@heritagecare.co.uk www.heritagecare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Lorraine Coe Type of registration: Number of places registered: Conditions of registration: Category(ies) : Heritage Care Ltd care home 48 Number of places (if applicable): Under 65 Over 65 0 48 0 dementia old age, not falling within any other category physical disability Conditions of registration: 48 0 48 The maximum number of service users to be accommodated is 48. The registered person may provide the following category of service only:Care home personal care - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Physical disability (PD) Old age- not falling within any other category (OP) Date of last inspection 1 6 0 6 2 0 0 9 Care Homes for Older People Page 2 of 9 Brief description of the care home Homers House is a purpose built residential home. It is owned and managed by Heritage Care. Accommodation is provided in single rooms. The home is divided into smaller units, each with its own sitting room, dining room and kitchenette. the home is adapted to meet the needs of people with disabilities. There are safe, accessible gardens to the rear and side of the property and car parking to the front. The home is in a residential area of High Wycombe, which has all the amenities of a large market town and has good commuter links. Public transport is accessible and there are leisure facilities nearby. There is a large national department store and national chain supermarket in the same area as the home. Service users are registered with general (GP) practitioner practices and all service users have access to local national health services through GP referrals. Community Nurses visit the home and provide support to the home as needed. Care Homes for Older People Page 3 of 9 What we found:
This Random inspection was carried out by one inspector in June 2010. The inspection included an unannounced visit to the home on Monday 21 June 2010. The inspection process included an interview with a district nurse visiting the home that morning, individual conversations with a team leader in charge at the start of the inspection, and with a senior care worker. The process also included brief conversations with five residents, two visitors, examination of two care plans, observation of practice, and brief inspection of the environment. The inspection concluded with a meeting with the registered manager, towards the end of which we were joined by the deputy manager. A care plan was in place for each person living in the home (resident). We looked at two care plans on this brief inspection. Care plans were comprehensive and well structured. Assessments were considered to appropriately address peoples needs. However, standards of completing care plans were uneven and the home should aim to achieve a more consistent standard across all three units. This may require further staff training and guidance on care planning for people with dementia, a clear statement of standards, monitoring by senior staff and managers, staff supervision, and periodic audit and review of practice. Early signs of a person living in the home developing a pressure sore were appropriately noted in one care plan in October 2009. Staff to whom we spoke during our visit appeared aware of the current position regarding the care needed to avoid a deterioration in the condition. A district nurse was involved in the persons care. However, the care plan did not appear to have been reviewed since October 2009. The Waterlow risk assessment on file was undated. Care plans included documents which were partly completed, not completed at all or not dated. These included the MUST (a screening tool for malnutrition), a form headed Medical/Health, the Waterlow risk assessment mentioned above, and a monitoring sheet which was simply dated March. The frequency of care plan reviews, and the interval between such reviews, varied. At the same time however, one of the care plans we looked at included an excellent personal history. This communicated a very real picture of the person before the onset of dementia. Such examples of good practice should be encouraged - particularly in a home for people with dementia. We heard a good deal of praise for the new manager. Staff teamwork was reported to have improved, opportunities for training were said to have increased, and staff told us that they now had more of the equipment they needed to carry out their work. Staff supervision was reported to be taking place on a regular basis - every four to six weeks. Staff told us that the manager is usually around the home and offers support where needed. Staff turnover was reported to have reduced and staff retention increased.
Care Homes for Older People Page 4 of 9 While in general there was agreement that the home was improving (a fact reflected in the rating in its last key inspection in June 2009), we also heard that there were still communication problems between staff. On occasions it was felt that these did have an impact on the quality of care to residents - whether because of delays in ordering medication or in attending to the detail of the care of individual residents (such as ensuring that a hearing aid is fitted and working or ensuring that a good standard of personal care is maintained). We discussed with the registered manager a staffing issue which had been brought to our attention. The manager informed us of the action that had been taken by Heritage Care some of which was continuing. We have had sight of documents relating to that issue and are satisfied that this is being appropriately addressed, both by the home and by the wider organisation. Residents seemed comfortable living in the home. We observed activity around lunch time. Two residents were perusing a newspaper, other sat in the lounge listening to music, one or two appeared to be having a light sleep, others sat in the dining room getting ready for lunch. The atmosphere was relaxed and none of the residents we saw showed any distress. There appeared to be sufficient staff on duty to support residents over lunch. Lunch was appropriately served to residents, with staff offering assistance if required - although in one case the lunch was left with the person without the member of staff returning to check if the person wished to eat it. In time a senior carer came to check and on hearing that the person did not wish to eat the lunch, provided an alternative. While we did not notice any obvious pressures on staff during the course of our relatively brief visit that day, we were told that on occasions staff do not have the time to provide that extra quality care that might be desirable. One person told us that there have been occasions when staff havent been visible on the floor. This home is continuing to provide a good service. There are matters for managers and staff to address. These are outlined above. If they are effectively addressed then we see no reason why the home should not continue to retain its present rating. If they are not addressed then they will compromise the good work taking place in the home. What the care home does well:
People can choose how they wish to spend their day and are supported to take part in activities if they wish. Staff retention is good and managers and staff have time therefore, to get to know residents and their families. Managers are responsive to comments, concerns or complaints by families. The organisation has thorough arrangements in place for the investigation of serious concerns where required. Heritage Care maintain a good programme of staff training and development and the
Care Homes for Older People Page 5 of 9 registered manager supports staff in attending training events. The training programme includes modules on the care of people with dementia. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 9 of 9 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
