Holmhurst is a small care home providing support and accommodation for up to nine people with mental health conditions and complex needs. The home has eight rooms located in the main building and a separate self-contained annexe within the grounds. At the time of our inspection nine people were living in the home.

The inspection took place on 24 January 2017. This was an unannounced inspection and the home's first rated inspection. A registered manager was in post when we inspected 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 2008 and associated Regulations about how the service is run. The registered manager was present and approachable throughout our inspection.

The administration and recording of medicines was being safely managed, however the storage of medicines was not always safe. One person who was self-administering had no lockable facility in their room to store their medicines safely. We saw that a medicines fridge was not in place for people that may require their medicines to be kept at a refrigerated temperature. The registered manager rectified this during the inspection and put one in place.

The home employed sufficient levels of staff to support people and meet their needs. During our inspection we saw staff were visible to support people; however at times opportunities to interact with people were not always taken up, leading some people to walk from room to room without being offered the choice to engage. When staff were interacting with people they did so in respectful ways and showed good understanding of people’s needs.

The provider had systems in place to manage risk and protect people from abuse. Staff had a good understanding of safeguarding and whistle-blowing procedures. They also knew how to report concerns and had confidence in the manager that these would be fully investigated to ensure people were protected.

During our inspection records showed that some staff’s training had expired which needed renewing and this had not yet been arranged. New staff had completed an induction programme before working on their own and told us they were well supported and received regular one to one meetings with their manager.

We saw that consent had not been recorded for staff to take responsibility for two people’s cigarettes. Staff kept these in the office so they could monitor the amount people smoked and ensure people did not smoke in the home and cause a fire risk.

People and their families praised the staff and registered manager for the kindness and the support given to people and families alike. Comments included “I am very happy about the care, the staff all need to be commended” and “The staff are caring, they work as a team, there’s a lot of laughter, it’s a lovely atmosphere they care very much”. The care records demonstrated that people’s care needs had been assessed and considered their emotional, health and social care needs.

People were able to choose what activities they took part in and suggest other activities they would like to complete. In addition to group activities people were able to maintain hobbies and interests and staff provided support as required.

People, their relatives, staff and health professionals spoke positively about the improvements the registered manager had made to the service commenting “When the manager took over she’s done so much work here, there has been a big difference with her coming in”, “I get the impression that since the new manager, things have significantly improved” and “The manager has done very well in what she’s achieved”.