Homefield

Updated 7 March 2024

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 2 inspectors and a specialist nurse advisor.

Service and service type

Homefield is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. 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 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 also checked the information we had about the service including notifications they had sent us. A notification is information about incidents or events that providers are required to inform us about. We asked the local authority commissioning and safeguarding teams for any information they had about the service. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people using the service about their experience of the care provided. We carried out observations of the support provided to people in communal areas. We also spoke with 9 relatives of people using the service and asked them for their experiences. We spoke with 11 members of staff including the registered manager, clinical director, nursing staff, care staff, kitchen staff, activities coordinator and the maintenance team. We reviewed a range of records including 10 people’s care and medicines records, staff records in relation to recruitment and training and other records relating to the management of the service, such as audits and policies and procedures.

Updated 7 March 2024

About the service

Homefield provides nursing and personal care and support to older people, some of whom were living with dementia. At the time of the inspection, there were 41 people using the service.

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

People were not always protected from risks associated with their care and support. Risks were not always comprehensively assessed and documented within care plans and records. The service did not always work within the principles of the Mental Capacity Act (MCA). Systems and processes in place for managing and administering medicines was not always safe. We have made a recommendation to the provider referring to best practice for medicines management.

Care plans did not always identify and or reflect details of individual preferences or contain correct information about people’s needs, wishes and the support they needed to make decisions. Systems and processes in place for monitoring the quality and safety of the service were not effective in identifying the issues and concerns we found at this inspection. Actions were taken during and after the inspection to address these issues and concerns.

People told us they felt safe. Staff knew what action to take if they had any concerns. Accidents and incidents were managed and acted on. Safe recruitment practices were in place. People were protected from the risk of infection. Staff were supported through training and supervision. People were supported to maintain a healthy diet and had access to health care professionals when required.

People told us staff were caring and kind and they respected their dignity and independence. Care records were reflective of individuals needs and preferences. People were aware of the complaints procedures and knew how to raise a complaint. The provider worked in partnership with health and social care professionals to ensure people's needs were planned and met.

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

Rating at last inspection

The last rating for this service was Good (published 18 November 2019)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified breaches in relation for the need for consent, safe care and treatment and good governance. We have also made a recommendation about safe medicines management.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standard of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.