29 September 2021
During an inspection looking at part of the service
Hydon Hill is registered to provide accommodation and personal care for up to 46 people who may have a nursing need, a disability, learning disability or an acquired brain injury. There were 38 people living at the service at the time of our inspection
People’s experience of using this service and what we found
Systems to monitor people receiving their medicines in line with their prescriptions were not always effective. This meant the provider was unable to assure themselves that medicines were being administered correctly. People and relatives told us there was a core team of staff who knew them well. However, due to difficulties in recruitment there was a large number of agency staff used which on occasions impacted on how people received their care.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Based on our review of key questions Safe and Well-Led the service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. The model and size of the service was not in line with current best practice guidance for people with learning disabilities. Hydon Hill is a large service in a rural area with limited access to community resources. The provider had implemented additional training and support planning systems for some people, but this had not acknowledged this should be applied to all people with a learning disability living at the service.
Risks to people’s safety had been assessed and where people had complex needs which put them at a high risk support was provided by regular staff. Staff had worked alongside healthcare professionals and implemented guidance on how to support people safely. Staff had received training in safeguarding people from abuse and people were given the opportunity to raise any concerns.
People told us that staff were kind and caring and that the management team were available to them. People and staff had the opportunity to feedback their views of the service through regular resident and staff meetings.
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
The last rating for this service was Requires Improvement (6 October 2020). We carried out an unannounced comprehensive inspection of this service on 14 October 2019. Breaches of legal requirements were found. The provider completed an action plan to show what they would do and by when to improve. We carried out a focussed inspection of the key questions Safe and Well-led in August 2020 and found the breaches in these areas had been met. At this inspection we found additional concerns and the provider is in breach of regulations.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Inadequate to Requires Improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Hydon Hill - Care Home with Nursing Physical Disabilities on our website at www.cqc.org.uk
Why we inspected
The inspection was prompted in part due to concerns received about risks to people’s care in relation to support with eating. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found the provider had implemented systems and worked with healthcare professionals to implement guidance and minimise further risks.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to the safe management of medicines, staffing and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.