Hampton Court

Updated 8 March 2023

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

This inspection was carried out by 2 inspectors.

Service and service type

Hampton Court is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under 1 contractual agreement dependent on their registration with us. Hampton Court is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before 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 reviewed information we had received about the service since the registration date. We used all of this information to plan our inspection.

During the inspection

We spoke with 2 people who used the service and 5 relatives about their experience of the care provided. We spoke with 8 members of staff including the registered manager, regional manager, senior care workers and care workers.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included 6 people’s care records, and 10 people’s medication records. We looked at staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 8 March 2023

About the service

Hampton Court is a residential care home providing personal care and accommodation for up to 26 people. The service provides support to older people and people who are living with Dementia in one adapted building. At the time of our inspection there were 23 people living at the home.

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

Medicines were not always managed or stored safely. Medicines administered covertly (given without the person's knowledge) were not always administered safely. Stock control of medicines was not robust.

Risks to people's health, safety and wellbeing were not always safely managed which placed people at a risk of harm. Staff did not always have access to information about how to manage people's identified risks and support them safely. The registered manager updated some care records during the inspection.

Infection control procedures were not consistently followed to reduce the risk of the spread of infection. We found some areas of the home were not clean. The cleaning schedules were not adequate.

Governance processes were in place and the registered manager and provider had oversight of essential aspects of the service. However, these processes were not always used effectively and some issues we identified at this inspection, such as medicines, had not been identified by the providers checks.

Some people who required specific diets were not always supported to follow these. Some people were diabetic and were assessed as needing ‘reduced sugar’ diets. Kitchen staff told us, and records showed that this was not always followed. The registered manager told us some health professionals had assessed the diets did not need to be followed, but this was not recorded anywhere. We made a recommendation about this.

Relatives told us they were usually able to visit people at any time. However, during a recent COVID-19 outbreak all visits had been stopped. This is in contradiction to current guidance on managing COVID-19 outbreaks in care homes. We made a recommendation about this.

People were supported by kind and caring staff who treated people as individuals and with dignity and respect. However, we raised a concern about the use of some language in the home which didn’t follow best practice approaches for people living with dementia. We made a recommendation about this.

Staff spoke knowledgeably about the systems in place to safeguard people from abuse. Staff knew people well and people received care and support which was responsive to their needs. People’s choices regarding their care and how they were supported were respected, and there were enough staff to support this.

People and family members knew how to complain, and they were confident about complaining if they needed to. Complaints were used to improve the service.

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.

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

Rating at last inspection

This service was registered with us on 20 August 2021 and this is the first inspection.

The last rating for the service under the previous provider was good, published on 19 September 2018.

Why we inspected

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

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.

Enforcement and Recommendations

We have identified breaches in relation to medicines management, infection control procedures, risk management and governance processes at this inspection.

Please see the action we have told the provider to take at the end of this report.

We have made recommendations about the appropriate use of language, visiting during COVID-19 and supporting people with specific dietary needs.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards 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.