Hampton Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The registered manager promoted a learning culture throughout the team. Lessons learnt from accidents, incidents and near misses were discussed with nurses at clinical meetings and with care staff at general meetings. Staff were encouraged to complete reflective records after events. Reflective meetings were arranged to discuss adverse events that occurred. This enabled staff to review their actions and feelings and the registered manager to identify any learning.

Leaders of departments coordinated spot checks following incidents. These focused on specific areas such as checking lockable cupboards, checking the opening dates of medicines applied to skin and observing mealtimes. This information enabled the registered manager to confirm whether changes following lessons learned had been embedded into staff practice or if additional actions were required.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People were supported to transition into the service safely. The process of admission into the care home included reviewing referrals and assessments to identify people’s needs. The service then undertook a preassessment with people, their relatives and healthcare professionals. This was to determine whether the service could meet people’s needs and preferences. Where equipment was required, for example low profile beds or pressure relieving mattresses, these were in place before people arrived. Following admission people were allocated a key member of staff, registered with a GP and their needs were reassessed. This was reflected in people’s care plans, which were reviewed and updated one month later.

When people were readmitted to the service following hospital admission, staff liaised with the hospital’s nurse in charge and body maps were completed. This was done to ensure issues such as pressure sores were identified. Additionally, reassessments were undertaken shortly after people’s return to the service following stays in hospital. These were undertaken to identify any changes in people’s care and support needs. For example, people’s mobility needs may have increased. These were discussed at daily staff meetings and reflected in people’s care plans.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The provider protected people from abuse and avoidable harm. Staff were trained to identify the signs of abuse and understood the actions they should take to keep people safe if they suspected it. The provider had a whistle-blowing policy in place and posters were displayed in staff areas explaining it. This meant staff had guidance on reporting any concerns they had about people’s welfare.

When safeguarding concerns had been raised, the registered manager conducted an initial investigation and informed the local authority and CQC. The provider participated in any subsequent local authority enquiries and shared learning with the team. One healthcare professional told us, “Safeguarding concerns are raised in a timely and transparent fashion: lessons are learnt and there is a clear culture of candour.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that the provider had DoLS policies and procedures in place. Where people were subject to restrictions to keep them safe, details of the deprivation, the assessments supporting them and the duration they applied for, were stated in care records.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People were protected from avoidable harm. Staff assessed people’s needs, and plans were in place to mitigate them. For example, where people were assessed as being at risk of falling from their beds they were offered a range of options including low profile beds and senor mats attached to the care homes’ call bell system.

The provider protected people’s skin integrity. People at risk of pressure sores were assessed and monitored. Monitoring included people’s fluid and food intake. People who had developed pressure sores were referred to tissue viability nurses and staff worked in partnership with them. Care records detailed the support people received to manage pressure sores. This included air flow mattresses, pressure relieving cushions, repositioning schedules and changing of dressings.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People lived in a safe care home environment. The cleanliness and safety of the service were checked frequently. For example, staff checked to confirm pressure reliving mattresses were set to the correct weight, and a range of health and safety inspections were conducted. Where repairs were required, these were carried out by the maintenance team and reviewed. One healthcare professional told us, “The home environment is clean and uncluttered, and all external doors require keypad release to open.”

The service maintained a readiness to keep people safe in the event of an emergency. Fire alarm systems, emergency lighting and fire doors were regularly checked and building evacuations were rehearsed. Key members of staff were appointed ‘fire marshals’ and people had individual personal emergency evacuation plans (PEEPs) in place. PEEPs detailed the specific support individual people required to leave the building in an emergency. This meant that the service was ready to respond in the event of an emergency to keep people safe.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

At our last inspection we found the service was heavily reliant upon agency care staff and nurses due to vacancies. At this assessment we found that all of the nursing posts had been filled and the use of agency staff had dropped significantly. This meant people received care and support from a stable staff team familiar with their needs.

At this assessment we found there were usually enough staff available to keep people safe. The registered manager completed a dependency tool to ensure staffing levels. One healthcare professional told us, “I have observed all 3 floors have safe staffing levels… I have observed the day staff nurses and carers effectively meeting their residents’ needs with medication, eating and drinking and meeting personal hygiene needs.” Staff told us there were enough care staff and nurses to meet people’s needs. One staff told us, “We have enough to support. Sometimes we are short, but we are full most times.” Another member of staff said staffing levels were, “Correct most of the time.” We carried out an observation of people in a communal area. This showed that whilst there were enough staff to keep people safe, additional numbers would enhance the timeliness and therefore quality of people’s care.

The provider ensured that staff were suitable to provide care and support safely. Comprehensive checks were undertaken before staff were employed. This included checking identities, employment histories, the right to work and criminal records. New staff completed a probation period after which their suitability for permanent employment was determined.

People received their care and support from trained and supervised staff. New staff completed a 12-week induction programme and thereafter continuous training. All staff received training in areas such as first aid, safeguarding and dementia. The provider ensured that staff received additional training applicable to their roles. For example, nurses received training in catheterisation and care staff received training in catheter care. Staff also received training to meet people’s specific needs. For example, staff were trained around urinary tract infections (UTIs). This meant that staff had the knowledge to reduce UTI risks and identify UTI symptoms quickly. This ensured timely referrals to the GP.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People were protected from the risk and spread of infection. The service was clean throughout because of the hygiene and cleaning programme followed by housekeeping staff. Staff wore single use gloves and aprons when providing personal care to prevent cross contamination. One healthcare professional told us, “I have had no concerns regarding infection prevention and control pathways being followed by staff.”

Laundry was processed appropriately with colour coded laundry bins used to ensure infection risks were controlled. Staff were trained in food safety and kitchen staff followed appropriate practices when storing, preparing and serving food.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People received their medicines safely. Medicines were administered to people by nurses and senior care staff. The provider ensured that medicines training was on-going and medicines competence was routinely audited. Accurate medicines records were maintained and staff had clear guidance in medicines records to administer ‘when required’ medicines. Medicines were stored safely within the clinical rooms on each floor, and these rooms were secured to prevent unauthorised access.