• Care Home
  • Care home

Archived: Hamilton House

Overall: Requires improvement read more about inspection ratings

21-23 Houndiscombe Road, Mutley, Plymouth, Devon, PL4 6HG (01752) 265691

Provided and run by:
E Dawson

Latest inspection summary

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Background to this inspection

Updated 6 June 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection team consisted of an inspector, an assistant inspector and an expert by experience. An expert by experience is a person who has personal experience of using services or cares for someone who lives with dementia.

Service and service type: Hamilton House 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 is registered to provide support to 36 people. At the time of the inspection there were 35 people living at the service.

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.

At the time of the last inspection in 2018 the service had been put up for sale due to the provider retiring after 35 years in the sector. At this inspection, we were told the service had been sold and the sale was due to complete in the coming weeks. The necessary applications had been submitted to the Commission

Notice of inspection: This inspection was unannounced.

What we did: We looked at notifications they had made to us about important events. In addition, we reviewed all other information sent to us from other stakeholders for example the local authority and members of the public.

During the inspection we contacted and spoke to:

12 people and/or their relatives

The registered manager

The registered provider

Nine members of staff

Plymouth City Council, Quality assurance and improvement team (QAIT) and commissioning team

Healthwatch Plymouth

We used our Short Observation Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the view of people who are not able to talk to us.

We looked at:

Policy and procedures

Five people's care records

Records of complaints

Training records for all staff

Three personnel records

Equipment and building servicing records

Fire records

Because of concerns identified at the inspection, we spoke with the local authority quality assurance and improvement team (QAIT) and commissioning team and raised four safeguarding alerts with the local authority adult safeguarding team.

Overall inspection

Requires improvement

Updated 6 June 2019

About the service: Hamilton House provides care and support to older people who have a diagnosis of dementia and/or mental health.

People’s experience of using this service: People and their families told us they received good care and support, and were complimentary of the environment, staff and leadership of the service.

Overall, staff treated people with dignity, kindness and respect. However, we found some staff did not display such values, and there was, at times an institutionalised and task orientated culture, rather than a person-centred culture.

There were enough staff to meet people’s physical needs. However, people’s social needs were not always met. There were aspects of the providers recruitment processes which meant staff were not fully recruited safely.

Some staff told us they did not feel they had the skills and knowledge to provide care and support to people living with dementia and/or complex mental health. Whilst some staff received training in moving people safely, staff did not always put their training into practice. The provider’s training records showed significant gaps in staff training relating to mental health, dementia care, and behaviour that could challenge. Some staff also told us they did not feel adequately skilled to meet people’s individual needs.

Staff and the registered manager continued to have a limited understanding of the Mental Capacity Act 2005, which meant people’s human rights were not always protected. Deprivation of liberty safeguards (DoLS) applications were not always being followed.

There were variable opportunities for social stimulation, and on the first day of our inspection people sat around the edges of the lounge with nothing to do. Those living with dementia were not always supported by best practice principles relating to dementia care.

People’s risks associated with their health, social care and the environment had not always been assessed to help keep them safe. We reported one environmental concern to the local fire service.

The provider had limited oversight of the ongoing quality and safety of the service, and whilst there were some systems and processes in place to help monitor the service, these continued to not be effective.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014; we also made recommendations relating to staffing, the Accessible Information Standard (AIS), best practice principles relating to dementia care and for the provider to use the National Institute for Clinical Excellence (NICE) guidance.

More information is in Detailed Findings below.

Rating at last inspection: Requires improvement (Report published 12 December 2018).

Why we inspected: This was a planned inspection.

Enforcement: Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

Follow up: We will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated Requires improvement.

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