Hurst Park Court

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.

Hurst Park Court is a residential care home providing personal care to 40 older people, some living with dementia at the time of the inspection. The service can support up to 52 people.

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

Risks to people were assessed and their safety was monitored. Staff understood the risks people faced and they monitored and managed risk in line with people’s individual risk management plans. Regular safety checks were carried out on the environment, utilities and equipment.

There were effective systems to protect people from the risk of abuse. Staff knew of their responsibilities for keeping people safe from abuse and how to report any concerns they had about people’s safety. People told us they felt safe with staff and were treated well.

People received care and support from the right amount of suitably skilled and experienced staff. Staffing levels were maintained to make sure people received safe care and support from a consistent group of staff. Staff were recruited safely; their fitness and suitability were checked before they were offered a job.

Safe infection prevention and control (IPC) measures were followed to minimise the risk of the spread of infection, including those related to COVID-19. The premises were clean and hygienic throughout.

Medicines were managed safely. Staff responsible for managing people’s medicines were suitably trained and competent. Regular checks were carried out on medication stocks and medication administration records (MARs) to make sure people received their medicines as prescribed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and promoted their independence. The service worked in accordance with the principles of the Mental Capacity Act 2005.

Staff received the training and support they needed for their role. New staff completed induction training and there was an ongoing programme of relevant training for all staff. Staff received support through regular one to one and group meetings, they described the registered manager as “Very supportive.”

People were supported to maintain a healthy and balanced diet. People’s nutritional needs were understood and met. People were offered a choice of food and drinks and staff provided people with the support and assistance they needed at mealtimes.

There was a complaints procedure which was shared with people and their family members. Whilst people and their family members had no complaints, they were confident about complaining should they need to, and they felt they would be listened to. The registered manager explained how they would use complaints or concerns to improve the quality of the service.

People were provided with opportunities to engage in a range of meaningful activities and to maintain important relationships. Family members spoke positively about the service and how they were made to feel welcome and encouraged to join their relatives in celebrations and events at the service.

People’s communication needs were understood, and staff communicated with people effectively. Staff made sure people made use of any aids and adaptations to aid their communication.

There was a personalised approach to planning peoples care. Care plans contained details about people’s individual needs, choices and preferences. Regular reviews of people’s care took place with their involvement and relevant others such as family members. Staff were knowledgeable about people and provided them with the right care and support.

The service worked effectively with other agencies to ensure people received the healthcare support they needed. Healthcare professionals praised managers and staff for working well with them to ensure people received effective care and support with their health and wellbeing.

Staff treated people with kindness, compassion and respect. Positive and caring relationships had been developed between people and staff. People’s independence was encouraged as much as possible and their rights to privacy and dignity were understood and respected.

There were effective systems and processes for assessing, monitoring and improving the quality and safety of the service. Risks to the health, safety and welfare of people were identified and mitigated quickly and records were well maintained. The registered manager was constantly looking at ways to further improve the service.

The culture of the service was person-centred and positive. People and family members provided positive feedback about the way the service was managed, describing the registered manager as very supportive, approachable and caring. They also praised the staff for their kindness and compassion towards their relatives.

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

Rating at last inspection and update

This service was registered with us on 06 May 2021 and this is the first inspection under the providers new registration.

Why we inspected

This was a planned inspection.

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.

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.