Hampton Grange Nursing Home

Updated 25 October 2019

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 Care Act 2014.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Hampton Grange Nursing 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 service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This was an unannounced inspection.

What we did before the inspection

Before the inspection visit, we reviewed information we had received about the service since the last inspection. This included information about incidents the provider must notify us of, such as any allegations of abuse. We sought feedback on the service from the local authority and local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

During the inspection

We spoke with three people who used the service and one relative about their experience of the care provided. We also spoke with the registered manager, operations manager, a nurse, a nursing assistant, five care staff and two domestic staff.

We reviewed a range of records. This included seven people’s care records, medicines records, staff training records, and three staff recruitment records. We also reviewed incident and accident records, and records relating to the safety of the premises and management of the service.

After the inspection

We spoke with four relatives and two community health and social care professionals about their experiences of people’s care. We also reviewed additional information provided to us by the registered manager and operations manager.

Updated 25 October 2019

About the service

Hampton Grange Nursing Home is a residential care home providing personal and nursing care for up to 42 people within one large adapted building. It specialises in the care of people living with dementia and older people requiring general nursing care. At the time of our inspection, there were 29 people living at the home.

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

The provider’s quality assurance systems and processes were still not as effective as they needed to be. We found unexplained gaps in recording on people’s topical medicines application records, and incident records had not always been signed off by the registered manager to confirm all necessary actions had been taken. Most of the care staff we spoke with experienced a lack of clear leadership and direction on shift. People’s relatives continued to express mixed views about the management of the service.

Staff understood how to recognise and report potential abuse involving the people who lived at the home. The risks associated with people’s individual care needs were assessed and plans were in place to manage these. The provider carried out a range of checks to ensure the safety of the premises and the equipment within it. The provider checked the suitability of prospective staff before they were allowed to work with people at the home. They took steps to minimise the impact of agency staffing upon people’s care. Systems and procedures were in place designed to ensure people received their medicines safely and as prescribed. The provider had procedures in place enabling staff to record and report any accidents or incidents involving people who lived at the home. Domestic staff helped care staff maintain the hygiene and cleanliness of the home, and staff were provided with personal protective equipment to reduce the risk of cross-infection.

The registered manager sought to engage effectively with people’s relatives and staff through, for example, organising regular meetings with them. The majority of staff spoke positively about the support they received from the registered manager. The registered manager took steps to keep themselves up to date with legislative changes and current best practice guidelines. Staff and management worked with a wide range of community professionals to meet people’s individual care needs.

Rating at last inspection

The last rating for this service was Requires improvement (report published 17 April 2019) and there were breaches of regulation. An additional condition has been imposed on the service’s registration requiring the provider to supply us with a monthly report on how they were meeting Regulation 17 (Good governance). At this inspection enough improvement had not been made and the provider was still in breach of Regulation 17.

Why we inspected

We received concerns in relation to moving and handling practices, staffing, risk management and medicines. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection. The overall rating for the service has remained the same.

We have found evidence that the provider needs to make improvement. Please see the Well-led section of this full report.

Enforcement

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.