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Inspection Summary


Overall summary & rating

Good

Updated 11 July 2018

Hartcliffe Nursing Home 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. Hartcliffe provides accommodation with nursing and personal care for up to 66 people. At the time of our inspection 50 people were living in the home.

At the last inspection on 28 and 29 March 2017 the service was rated Requires Improvement. We found a repeated breach of the regulation relating to Consent to Care and we issued a Warning Notice. We also found breaches of the regulation relating to safe care and treatment. Following the inspection, the provider sent us an action plan telling us how they would make the required improvements.

We carried out a comprehensive inspection on 30 and 31 May 2018. At this inspection, we found improvements had been made and the legal requirements had been met. We found further improvements were needed to make sure that care was always delivered and recorded in line with people’s assessed and changing needs.

Overall, the service has improved to Good.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Sufficient numbers of staff were deployed at the time of our visit. Staff performance was monitored. Staff received supervision and training to ensure they could meet people’s needs.

Medicines management shortfalls were promptly acted upon and actions taken to make improvements.

Staff demonstrated a good understanding of safeguarding and whistle-blowing and knew how to report concerns.

People were helped to exercise support and control over their lives. People were supported to consent to care and make decisions. The principles of the Mental Capacity Act (MCA) 2005 had been followed.

Risk assessments and risk management plans were in place. Improvements were needed to make sure care was consistently delivered in line with assessed needs and that accurate monitoring records were maintained.

Incidents and accidents were recorded and showed that actions were taken to minimise the risk of reoccurrence.

People’s dietary requirements and preferences were recorded and people were provided with choices at mealtimes.

Staff were kind and caring. People were being treated with dignity and respect and people’s privacy was maintained.

A range of activities were offered and provided people with entertainment both in and out of the home.

Systems were in place for monitoring quality and safety. Where improvements were needed the provider took action to address identified shortfalls.

Inspection areas

Safe

Good

Updated 11 July 2018

The service has improved to good.

Improvements had been made to the management of medicines. Where shortfalls were identified the provider took prompt action.

People were protected from abuse because staff had received training and knew how to identify and act on concerns.

Staff were safely recruited and staffing levels were sufficient to meet the needs of people living in the home.

Accidents and incidents were reported and actions taken to reduce recurrences.

Recruitment procedures were in place and appropriate checks were completed before staff started in post.

Effective

Requires improvement

Updated 11 July 2018

The service remains Requires Improvement.

Improvements were needed to make sure healthcare needs were met in line with assessed needs and that care monitoring was accurately recorded.

The service had made improvements and complied with the requirements of the Mental Capacity Act 2005 (MCA). People were asked for consent before care was provided. Where best interest decisions were made, these were fully recorded.

People were provided with sufficient food and fluids. Nutritional needs and preferences were recorded and people were given choices at mealtimes.

Staff received training and support to enable them to meet people’s needs.

People had access to a GP and other health care professionals.

Caring

Good

Updated 11 July 2018

The service remains good.

Responsive

Good

Updated 11 July 2018

The service remains good.

Well-led

Good

Updated 11 July 2018

The service has improved to Good.

Systems were in place to assess, monitor and mitigate risks to people. Systems needed to be strengthened to make sure shortfalls, such as those in care and monitoring records, were promptly identified and acted upon.

A registered manager was in post. People spoke positively about the leadership in the home and were able to provide feedback and express their views.

The registered manager recognised their responsibilities with regard to notifications required by the Commission.