15 August 2023
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.
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.
The first day of inspection was carried out by 2 inspectors and an expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The second day of inspection was carried out by 2 inspectors.
Service and service type
Hurst Park Court is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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
The first day of inspection was unannounced and the second day was announced.
What we did before the inspection
We reviewed all the information we held about the service. We also obtained information about the service from the local authority and local safeguarding teams. We used all of this information to plan our inspection.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. This information helps support our inspections.
During the inspection visit
We spoke with 6 people, 7 family members and a visitor about their experience of the care provided. We spoke with a visiting healthcare professional, the registered manager, deputy manager, 6 care staff, a housekeeper, maintenance person and the cook. We also spoke with a regional support manager, a district manager and a care quality advisor.
We reviewed a range of records. This included 10 people’s care records and a selection of people’s medication records. We looked at recruitment records for 2 staff members employed. A variety of other records relating to the management of the service, including audits and checks were reviewed.
15 August 2023
About the service
Hurst Park Court provides accommodation and personal care over 2 floors for up to 41 people some; of whom live with dementia. At the time of our inspection 41 people were living at the service.
People’s experience of using this service and what we found
There was a lack of robust assessment, monitoring and management of aspects of people’s care where there was a potential risk to their health, safety, and welfare. Risks such as falls and long-term health conditions were not routinely monitored to ensure timely intervention should the person’s condition deteriorate and require further risk management to prevent deteriorating health.
Medicines were safely stored and administered by staff with the right skills and ability. However, records for the use of medicines prescribed to people when required known as PRN were not always maintained. This included guidance for staff on the safe use of PRN medicines with a record detailing the actual times and the reason the medicine was given.
Consent to care was not always obtained in line with the Mental Capacity Act (MCA). Consent was not always obtained in line with the MCA for restrictions placed on people. These included restrictions posed by the locking of bedroom doors after people had left their rooms and the provision of 1-1 care and support.
People’s needs and choices were not always thoroughly assessed with the involvement of people and relevant others to ensure effective care planning for people. Some people’s assessment documents were incomplete and lacked details about their needs and how they were to be met. In addition, some peoples care plans lacked guidance for staff on the signs and symptoms which may indicate a decline in the persons health and wellbeing.
The provider had comprehensive systems and processes for reviewing, assessing, and monitoring the quality and safety of the service, however, they were not always used effectively. Audits and checks were not always completed at the required intervals, and they failed to identify and mitigate risk and bring about improvements to the service.
Records relating to people’s care and the management of the service were not always maintained to ensure effective delivery of care. Some people’s personal care records were left unattended in communal areas making them accessible to unauthorised others.
We have made a recommendation about the environment. The environment was spacious and bright, and fitted with adaptions to aid people’s mobility, however, there was a lack of focal points to support meaningful stimulation for people living with dementia.
People told us they were happy living at Hurst Park Court, were treated well and felt safe. Family members told us they were confident their relative was kept safe. Staff knew of their responsibilities for keeping people safe from abuse. They told us they would not hesitate to speak up if they had any concerns about people’s safety.
Staff had access to a good supply of the right standard of personal protective equipment (PPE) and they used and disposed of it safely. People were monitored for signs of infection.
People received safe care and support from the right amount of suitably skilled and experienced staff who were safety recruited. Staff responded quickly to people’s requests for care and support.
Staff were provided with the training and support for their role. All staff were inducted into their roles and provided with ongoing training for their role. Staff told us they felt well supported, they described the managers as very supportive and approachable.
People received the support they needed to access healthcare services and to eat and drink. People were offered a choice of food and drink which was prepared and served to meet their needs.
People and family members described the registered manager as ‘Very approachable,’ ‘Very helpful’ and ‘Responsive.’
Rating at last inspection and update
The last rating for this service was good (published 30 July 2022).
Why we inspected
We received concerns in relation to people’s safety and the leadership of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence the provider needs to make improvements. Please see the safe, effective, and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
The provider acted promptly during and following the inspection to mitigate risks to people.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hurst Park Court on our website at www.cqc.org.uk.