Archived: Holmwood Care Centre

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity, and respect.

At our last inspection we rated this key question good. At this assessment we assessed a total of 5 quality statements from this key question, and the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for and treated with dignity and respect.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Some people shared their negative experiences in relation to the agency staff. One person said, “Two lots of staff, permanent mostly brilliant, agency staff, some [are] awful.” While another person told us when agency staff supported them for the day, they could spend the day with nobody to talk with as agency staff would not speak.

Prior to our visit we had received concerns from relatives in relation to people’s dignity not being maintained. At our visit, one relative did share there had been times when their family member had been distressed as their continence needs had not been met in a timely way.

The provider had a dependency tool which was used to determine staffing levels based on people’s physical dependency requirements. A provider representative confirmed that staffing levels were in line with the dependency tool. However, staffing levels had not been reviewed against people’s emotional support needs. The representative advised that while 2 staff may be needed to support someone to a commode, the second carer could leave to support another person and then return when the person was ready. However, this approach is task focused, and had not taken into account the negative impact this may have on people’s dignity and wellbeing. Staff did not adopt this approach, and worked in pairs where they could, however this meant there were delays in continence care being provided as two staff were not always available at the same time to mobilise people.

This was a breach of regulation 10 (Dignity and Respect) of the Health and Social Care Act 2008 (Regulated Activities). Regulations 2014

We saw permanent staff and most agency staff were kind and caring towards people and staff spoke to people in a compassionate way. We saw staff worked hard to meet people’s needs and some staff felt frustrated that they were not able to meet people

People’s individual needs and preferences were understood by staff who supported them, and this was reflected in their care, treatment, and support. People told us they were supported to continue to practice their faith and have friends, neighbours and family visit when they wished.

Staff told us they worked hard to support people and meet their individual needs.

We saw most staff supported people sensitively and staff interaction with people was positive.

Staff understood people’s individual needs well and how they wished to be supported day to day. However, staff felt there were many days where they were not always able to uphold people’s choices around their care. Staff told us that there were delays in care being given, particularly during busier periods, such as the morning, which meant people were left in bed longer than they would like.

A relative told us they raised their concern with the manager that their family member was not being supported in the morning at their preferred time. They told us that since raising this, improvements had been made, and their family member was now supported in the morning in line with their preference.

People told us staff promoted their independence as far as possible. One person said, “Do what I can for myself, I manage to dress myself.

Care plans contained information for staff to promote people’s independence in areas such as mobility and communication. Regular reviews were held involving people and their relatives to discuss any changes or suggestions. Where changes had taken place relatives and staff confirmed this had remained consistent.

People’s immediate needs and comfort could not always be given priority. On the first day of our visit we saw people who lived on the middle floor had a negative experience of care and support. We saw times where people were calling for help and people’s dignity had been compromised. However, the second day of our visit we saw improvements to people’s needs being met to maintain their dignity.

People told us they felt permanent staff understood them, however most people told us, and we saw, that agency staff did not understand people or the permanent staff who were guiding them. This meant that should someone require immediate help, some staff may not be able to respond promptly.

The provider supported the wellbeing of their staff through inclusivity, listening, and open conversations. A staff member told us how they had been supported since their return to work to enable them to do their job well and to be well.

All staff we spoke with found the management team to be approachable, listened to what they had to say, and acted where improvements or suggestions were made to promote their wellbeing.