This inspection took place on 11 and 12 June 2018 and was unannounced. This was the first inspection of this service under the current provider.

Holmside Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide support for up to 39 people over two storey accommodation. Nursing care is not provided. At the time of the inspection there were 35 people using the service, including three people who were staying at the home on a short term basis.

The home had a registered manager who had been registered since May 2017. 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 2008 and associated Regulations about how the service is run.

People told us they were safe living at the home and we found safeguarding issues had been dealt with appropriately and referred to the local safeguarding vulnerable adults team. Maintenance of the premises had been undertaken and safety certificates were available. Three window restrictors were missing. These had been removed for maintenance and we were later told they had been replaced. Accidents and incidents were recorded and monitored. However, there was limited evidence to show these issues were looked at in terms of prevention and ‘lessons learned.’

A range of checks and risk assessments were in place at the home. At night time there were three staff on duty and the registered manager had assessed how quickly an evacuation to a safe zone in the home could be made. We found these estimates of time to be over optimistic and that risks associated with night time emergencies had not been fully considered. Risks associated with care delivery were not always fully considered and not effectively documented in care plans.

Suitable recruitment procedures and checks were in place, to ensure staff had the right skills. All staff had been subject to a Disclosure and Barring Service check (DBS). People and staff members told us there were enough staff on duty at the home during the day. The registered manager used a dependency tool to help determine staffing levels.

Medicines at the home were managed appropriately. Medicines were safely stored and regular checks were made on stock levels and administration. We observed the home was maintained in a clean and tidy manner.

Staff had an understanding of issues related to equality and diversity and what it meant for people using the service. They told us they had access to a range of training and records confirmed this. They confirmed they had access to regular supervision and an annual appraisal.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005 (MCA). These safeguards aim to make sure people are looked after in a way that does not inappropriately restrict their freedom. We found the registered manager had a system in place to monitor and review DoLS applications. People were asked for their consent on a day to day basis. Where this was not possible there was some evidence of best interests decisions being made. Where relatives held lasting power of attorney or had been appointed deputies by the Court of Protection this was recorded in people’s file.

People were happy with the quality and range of meals and drinks provided at the home. Special diets were catered for and staff had knowledge of people’s individual dietary requirements. People’s health and wellbeing was monitored and there was regular access to general practitioners and other specialist health staff. Health professionals told us the home was proactive in monit