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.