Holmes House Care Home

We reviewed five quality statements in the Safe domain so we could assess if the provider had made the required improvements following our previous assessment. The provider had made sufficient improvement in relation to safe care, medicines, and the environment although some additional improvement was required. However, the provider was responsive and resolved these during and immediately following the assessment. People were protected from the risk of harm and abuse by effectively trained staff to carry out their role safely. Risks to people’s health and welfare had been assessed, monitored, and managed safely by staff who knew them well. Systems and processes for monitoring and responding to risk were robust. People’s health and well-being was promoted and guidance followed from external partners and other professionals to ensure people's changing needs were met.

We reviewed four quality statements in the Well-Led domain so we could assess if the provider had made improvements following our previous assessment. The provider had made sufficient improvement and is no longer in breach of regulations however, some minor shortfalls remained. Provider and managerial oversight had increased overall which meant the service was monitored more effectively reducing the risk of harm to people we identified previously, for example medicines and managing risk. Audits were now generally more robust overall but a small number still required more detail to allow prompt action to be taken when a concern was identified. The providers internal quality assurance process had identified some of minor shortfalls we found but these had not been addressed at the time of the assessment. The nominated individual informed us they were changing the systems and processes in place in relation to audits and quality assurance, and a date for implementation of these had been set. Senior leaders and managers were open and transparent with the assessment process, accepting of our findings, and immediately acted to resolve the issues identified during the inspection. There was an inclusive and positive culture and leaders were visible in the service offering support and guidance to staff. Managers were accessible to people and their relatives. The service had positive relationships with other stakeholders and visiting health professionals who were complimentary about the leadership and their joint working arrangements. Staff said they received support from managers in their roles and could speak up if they had any concerns. People and relatives overall view and experience of the service was positive.