• Care Home
  • Care home

Homeleigh

Overall: Good read more about inspection ratings

3 Sondes Road, Deal, Kent, CT14 7BW (01304) 380040

Provided and run by:
Homeleigh Care Limited

All Inspections

22 March 2022

During an inspection looking at part of the service

About the service

Homeleigh is a residential care home providing personal care to up to 18 people who have mental health needs in one adapted building. At the time of our inspection there were 17 people living at the service.

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

People told us they were happy and felt safe living at the service and staff supported them in the way they preferred.

People received their medicines as prescribed and improvements had been made in the management of people’s medicines. Staff worked with other healthcare professionals to make sure people received the support they needed to live their lives to the fullest.

Potential risks to people’s health and welfare had been assessed and there was guidance in place for staff to reduce the risks. People were supported to take positive risks, people decided when they needed staff to support them when they went out.

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.

There was enough staff, who had been recruited safely, to support people with their needs. People had been involved in decisions about the service including infection control and how they could support each other to remain safe. Staff understood how to keep people safe from discrimination and abuse.

Checks and audits had been effective in monitoring the quality of the service. Action had been taken when shortfalls had been found to rectify them.

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 requires improvement (published 8 April 2018). 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.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 21 March 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.

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 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 Requires Improvement to Good. This is based on the findings at this inspection.

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

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.

Follow up

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

21 March 2019

During a routine inspection

About the service:

Homeleigh is a residential care home that accommodates up to 18 adults who have mental health needs. At the time of the inspection 17 people were living at the service.

People’s experience of using this service:

• People received their medicines as prescribed, however, medicines were not always managed safely, this put them at risk.

• Checks and audits were completed on the quality of the service people received. However, the medicines audit had not included checks on all aspects and had not identified the shortfalls found.

• People lived in a building adapted to meet their needs and was maintained to make sure people were safe.

• People were supported to take risks, staff completed risk assessments to ensure people were as safe as possible.

• People told us they were involved in planning their support and their future.

• People and staff were asked their opinions on the service and made suggestions that were acted upon. People told us they knew how to complain.

• People told us there were enough staff and they were supported to do activities when they wanted.

• Staff received training and supervision to develop their skills, people were supported by staff who understood their needs.

• People were supported to be as independent as possible, develop new skills and live a healthy lifestyle.

• We observed people being treated with kindness and respect. People’s decisions were respected and they were supported to access health professional when required.

• People benefited from an open and relaxed atmosphere in the service. They appeared to be comfortable in the company of the registered manager, who understood their needs.

Rating at last inspection:

Good (report published 20 September 2016).

Why we inspected:

This was a planned inspection planned on the rating of the last inspection. We found that the service no longer met the characteristics of Good. The domains of safe and well led are rated Requires Improvement. The overall rating is now Requires Improvement.

Follow up:

We will work with the provider following this report being published to understand and monitor how they will make changes to ensure the service improves their rating to at least Good.

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

16 August 2016

During a routine inspection

This inspection took place on 16 August 2016 and was unannounced.

Homeleigh provides accommodation and personal care for up to 16 people who need support with their mental health. The service is situated in the town centre of Deal where all amenities are close by. There were 12 people living at the service at the time of the inspection. The care and support needs of the people varied greatly. There was a wide age range of people living at the service with diverse needs and abilities. As well as needing support with their mental health, some people were living with dementia and other people required more care and support related to their physical health. Some people were able to make their own decisions about how they lived their lives. They were able to let staff know what they wanted and were able to go out on their own.

There was registered manager working at the service. The registered manager was supported by a deputy manager and team of staff. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. On the day of the inspection both the registered manager and the deputy manager where on annual leave for one week. A senior care worker supported the inspectors throughout the visit. We spoke with the registered manager after the inspection.

At the last inspection in August 2015 we found breaches of regulations. At this inspection improvements had been made.

Major building work was being under taken at the time of the inspection. Environmental risk assessments for most areas that were being affected by the work were in place to keep people as safe as possible during the building works. These were reviewed regularly to make sure they remained current. The fire risk assessment had not been reviewed or updated since 2014 and fire risks had not been considered in relation to the building work being done. We asked the local fire officer to visit the service. The fire officer visited the service and recommended that the fire risk assessment be updated. This was organised by the staff and an external company completed the assessment. Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do. Safety checks were carried out regularly throughout the building and there were regular fire drills so people knew how to leave the building safely. Some personal emergency evacuation plans (PEEPS) needed more information.

The registered manager and staff carried out other environmental and health and safety checks to ensure that the environment was safe and that equipment was in good working order. There were systems in place to review accidents and incidents and make any relevant improvements as a result.

At the last inspection not all risks to people had been kept to a minimum. At this inspection improvements had been made. Risks to people's safety were assessed and managed appropriately. Risk assessments identified people's specific needs, and showed how risks could be minimised. When new risks had been identified the registered manager had taken action to prevent them from re-occurring. Staff had updated risk assessments and passed the information to staff so that people would be safe.

A system to recruit new staff was in place. This made sure that the staff employed to support people were fit to do so. At the last inspection recruitment processes were not fully adhered to. At this inspection improvements had been made but there was an area that needed further improvement. There were sufficient numbers of staff on duty throughout the day and night to make sure people were safe and received the care and support that they needed.

People felt safe in the service. Staff understood how to protect people from the risk of abuse and knew the action they needed to take to report any concerns in order to keep people safe. Staff were confident to whistle-blow to the registered manager if they had any concerns and were confident appropriate action would be taken. The registered manager responded appropriately when concerns or complaints were raised. People were cared for in a way that ensured their safety and promoted their independence.

Staff had completed induction training when they first started to work at the service and had

completed other basic training provided by the company. There was also training for staff in areas that were specific to the needs of people, like epilepsy and end of life care. At the last inspection staff had not received all the specific training they needed. At this inspection improvements had been made. Staff still needed some specific training like dementia and mental health awareness. These courses had been booked for the coming months.

People received care and support from a dedicated team of staff that put people first and were able to spend time with people in a meaningful way. Staff received regular one to one meetings with the registered manager and an annual appraisal to discuss their training and development needs. Staff were supported by the registered manager and felt able to raise any concerns they had or suggestions to improve the service.

At the last inspection decisions about care, support and treatment had not been made in line with the legislation. At this inspection improvements had been made. The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. DoLS applications had been made to the relevant supervisory body in line with guidance and had been approved.

People said that they enjoyed their meals. People were offered and received a balanced and healthy diet. They had a choice about what food and drinks they wanted. If people were not eating enough or needed specialist diets they were seen by dieticians or their doctor and a specialist diet was provided. People received their medicines safely and when they needed them and they were monitored for any side effects. If people were unwell or their health was deteriorating the staff contacted their doctors or specialist services.

Before people decided to move into the service their support needs were assessed by the registered manager to make sure the service would be able to offer them the care that they needed. People said they were satisfied and happy with the care and support they received. People received care that was personalised to their needs. People's care plans contained information and guidance so staff knew how to care and support people in the way they preferred. People or their relative /representative had been involved in writing their care plans. Everyone had an allocated key worker. Key workers were members of staff who took a key role in co-ordinating a person's care and support and promoted continuity of support between the staff team. The service was planned around people's individual preferences and care needs.

People were put at the centre of the service. They told us they received care that was individual to them. They felt staff understood their specific needs. Staff had built up relationships with people and were familiar with their life stories, wishes and preferences. This continuity of support had resulted in the building of people’s confidence to enable them to make more choices and decisions themselves and become more independent. People were involved in activities which they enjoyed. People talked animatedly about social events they had taken part in or were planning. Contact with people’s family and friends who were important to them was well supported by staff.

People were settled, happy and contented. Throughout the inspection people were treated with dignity and kindness. People's privacy was respected and they were able to make choices about their day to day lives. Staff were respectful and caring when they were supporting people. People were comfortable and at ease with the staff. Staff encouraged and involved people in conversations as they went about their duties, smiling and chatting with people. Staff spent time with people.

People, staff, relatives and visiting professionals told us that the service was well led and that the management team were supportive and approachable and that there was a culture of openness and transparency within the service. Staff were clear about their roles and responsibilities and felt confident to approach senior staff if they needed advice or guidance. They told us they were listened to and their opinions counted.

The aims and vision of the service was to provide quality care and support for people adults with

mental health needs. Their aim was to provide a safe and fulfilling life for adults with mental health needs. People told that they felt safe and they lived their lives the way they wanted to.

There were quality assurance systems in place. Audits and health and safety checks were regularly carried out action was taken when shortfalls were identified. The registered manager had formally sought feedback from people, their relatives and other stakeholders about the service. Their opinions had been captured, and analysed to promote and drive improvements within the service.

Services that provide health and social care to people are required to inform the Care Quality Commission, (the CQC), of important events that happen in the service. This is so we can check that appr

6 & 7 August 2015

During a routine inspection

Homeleigh provides accommodation and personal care for up to 16 people who need support with their mental health. The service is situation in the town centre of Deal where all amenities are close by. There were 14 people living at the service at the time of the inspection. The care and support needs of the people varied greatly. There was a wide age range of people living at the service with diverse needs and abilities. The youngest person was in their 40’s and the oldest is 80 years old. As well as needing support with their mental health, some people had dementia and other people required more care and support related to their physical health. Some people were able to make their own decisions about how they lived their lives. They were able to let staff know what they wanted and were able to go out on their own.

There was registered manager working at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager was not fully aware of a judicial review which widened and clarified the definition of a deprivation of liberty. The registered manager and staff had a lack of understanding about their responsibilities under the Mental Capacity Act 2005 and DoLS. Mental capacity assessments had not been consistently completed by the staff to decide whether or not people were able to make decisions themselves. At the time of the inspection the registered manager had not applied for DoLs for people who did need them. When people did not have the capacity to make complex decisions, which were usually for medical procedures or issues regarding finances, the registered manager made sure best interests meeting were arranged. People were supported by relatives, doctors and other specialists involved in their care and treatment to make a decision that was in their best interest.

Before people decided to move into the service their support needs were assessed by the registered manager to make sure they would be able to offer them the care that they needed. The care and support needs of each person were different and each person’s care plan was personal to them. People or their relative /representative had been involved in writing their care plans. Most of the care plans recorded the information needed to make sure staff had guidance and information to care and support people in the safest way and in the way that suited them best. People were satisfied with the care and support they received. Potential risks to people were identified but full guidance on how to safely manage the risks was not always available. This left people at risk of not receiving the interventions they needed to keep them as safe as possible. People had regular reviews of their care and support when they were able to discuss any concerns or aspirations and goals they wanted to achieve.

People had their needs met by sufficient numbers of staff. Staff numbers were based on people’s needs, activities and health appointments. People received care and support from a dedicated team of staff that put people first and were able to spend time with people in a meaningful way.

Staff had support from the registered manager to make sure they could care safely and effectively for people. Staff said they could go to the registered manager at any time and they would be listened to. Staff had received regular one to one meetings with a senior member of staff. Staff had received an annual appraisal and had the opportunity to discuss their developmental needs for the following year. Staff had completed induction training when they first started to work at the service and had gone on to complete other basic training provided by the company. There was also training for staff in areas that were specific to the needs of people, like epilepsy and end of life care. However, there were shortfalls in training in areas such as dementia and mental health, which were areas very specific to people at the service.

Staff were not always recruited safely. The provider had policies and procedures in place for when new staff were recruited, but these were not always followed. All the relevant safety checks had not been completed before staff started work. Some application forms did not show a full employment history and gaps in employment had not been explored when staff were interviewed.

Emergency plans were in place so if an emergency happened, like a fire the staff knew what to do. The checks for the fire alarms were done weekly and there were regular fire drills so people knew how to leave the building safely. Safety checks on the water temperatures in people’s bedrooms and bathrooms were carried out monthly. The checks for May and July 2015 indicated that the temperature of the water was too high and that some people may be a risk of being scalded if they used the hot water.

People were protected from the risk of abuse. Staff had received safeguarding training. They were aware of how to recognise and report safeguarding concerns both within the company and to outside agencies like the local council safeguarding team. Staff knew about the whistle blowing policy and were confident they could raise any concerns with the provider or outside agencies if needed. The registered manager responded appropriately when concerns were raised. They had undertaken investigations and taken action. The registered manager monitored incidents and accidents to make sure the care provided was safe. The registered manager followed clear staff disciplinary procedures when they identified unsafe practice.

People had an allocated keyworker who were involved in their assessments and reviews. A key worker was a member of staff who takes a key role in co-ordinating a person’s care and support and promotes continuity. Throughout the inspection people were treated with kindness and respect. Everyone told us their privacy was respected and they were able to make choices about their day to day lives.

People were put at the centre of the service. They told us they received care that was individual to them. They felt staff understood their specific needs. Staff had built up relationships with people and were familiar with their life stories, wishes and preferences. This continuity of support had resulted in the building of people’s confidence to enable them to make more choices and decisions themselves and become more independent. People’s individual religious preferences were respected and staff supported people to attend church services and meetings.

People were involved in activities which they enjoyed. People participated in voluntary work, and did gardening and art and crafts, as well as other leisure activities. People talked animatedly about social events they had taken part in or were planning. Contact with people’s family and friends who were important to them was well supported by staff. Staff were familiar with people’s likes and dislikes, such as if they liked to be in company or on their own and what food they preferred. Staff knew how people preferred to be cared for and supported and respected their wishes.

People said that they enjoyed their meals. People were offered and received a balanced and healthy diet. They had a choice about what food and drinks they wanted. If people were not eating enough or needed specialist diets they were seen by dieticians or their doctor and a specialist diet was provided. People received their medicines safely and when they needed them and they were monitored for any side effects. If people were unwell or their health was deteriorating the staff contacted their doctors or specialist services.

The complaints procedure was available and assessable. People felt comfortable in complaining and when they did complain they were taken seriously and their complaints were looked into and action was taken to resolve them. People had opportunities to provide feedback about the service provided both informally and formally. Feedback received had all been very positive.

There were quality assurance systems in place. Audits and health and safety checks were regularly carried out but prompt action was not always taken when shortfalls were identified. The registered manager had formally sought feedback from people, their relatives and other stakeholders about the service. Their opinions had been captured, and analysed to promote and drive improvements within the service. Informal feedback from people, their relatives and healthcare professionals was encouraged and acted on wherever possible. Staff and people told us that the service was well led and that the registered manager was supportive and approachable and sometimes worked alongside the staff. There was a culture of openness and transparency within Homeleigh which allowed them to suggest new ideas which were acted on and discuss any concerns.

The registered manager had a vision, to be a leading a service, providing quality care and support for adults with mental health needs. Their aim was to provide a safe and fulfilling life for adults with mental health needs. Staff were very aware of these and they were followed through into practice.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

21 November 2013

During a routine inspection

We found the service to be clean, with a pleasant and calm atmosphere. People who used the service told us that they were happy with the care and support they received. One person told us 'I am very happy here the staff are kind and have helped me cope better with things'. Another person we spoke to told us, the food is really good; there is lots of choice and plenty of it.

We found that the service had participated in a training pilot scheme for understanding dementia and that staff focused on practicing the least restrictive options when delivering care or support. We observed that staff worked in a person centred manner and we saw that they were courteous, caring and effective whilst they maintained people's dignity when working with them.

People who used the service told us that they felt safe and well cared for. Staff demonstrated, through discussion, that they knew how to protect people from abuse and we saw that they had been trained in safeguarding.

We found that people could help themselves to hot and cold drinks throughout the day and saw people who used the service helping in the kitchen at meal times. The Manager told us that they had a 'can do approach' in that 'The focus is not on what people can't do' but on how we can facilitate them to do the things they want to do in a safe way'.

We found that the Home had robust systems in place to check and maintain the quality of the service.

16 March 2013

During a routine inspection

There were 14 people using the service. We met and spoke with some of them and everyone we spoke with said or indicated that they were happy living at Homeleigh.

People told us that they felt safe and well looked after. People told us that they could express any problems to the staff who would listen and act.

People said that they thought the staff were kind and caring. One person said 'It is alright here. The food is absolutely lovely. The staff are alright and we have a laugh, we all get on fine. The manager asks us what we want to do and what we want done to the house. We choose and she gets it done.'

Staffing was planned around individual needs and activities. This meant that people had the support they needed when they needed it. Everyone was involved and included in the running of the service. Personal hobbies and interests were supported.

People looked relaxed in the company of each other and staff. We saw that people took part in a range of community based activities that they enjoyed and were involved in the local and wider community. One person said 'I am quite happy here. The staff are alright and I am happy with my room. I have no complaints.' Another person said 'I am going out for lunch today with my family.'

People's health needs were supported and the service worked closely with health and social care professionals to maintain and improve people's health and well being.

11 November 2011

During a routine inspection

People who use services said that the staff treated them with respect, listened to them and supported them to raise any concerns they had. They said that they received the health and personal care they needed and that they were comfortable in their home. One person said, 'the place is okay for me, I've no complaints about it and I get on with the staff and they're okay with me'.