Background to this inspection
Updated
15 July 2021
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by two inspectors and a specialist nurse advisor.
Service and service type
Hugh Myddleton 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 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.
Notice of inspection
We carried out the inspection visit on 15 June 2021. This inspection was unannounced.
What we did
Before our inspection, we reviewed the information we held about the home which included statutory notifications and safeguarding alerts and the Provider Information Return (PIR), which the provider completed before the inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
In addition, we reviewed recent communications and statutory notifications received by CQC from the service.
During our inspection we spoke with the registered manager, deputy manager, the training lead, three nurses and four care assistants. We also spoke with the chef and head of housekeeping.
We spoke with 10 people who lived at the service and two-family carers who were visiting the service.
We looked at five care records, four of these included nursing notes and Medicine Administration Records (MAR) and three staff files.
We looked at various documents relating to the management of the service which included infection control measures and audits; building and fire safety documents and training and supervision records.
After the inspection we reviewed quality audits and additional supporting documentation including safeguarding and complaints records.
We received feedback from two additional relatives and from five health and social care professionals.
Updated
15 July 2021
About the service
Hugh Myddleton House is a residential care home providing accommodation and personal care for up to 48 people. At the time of the inspection there were 38 people living at the service.
On the ground floor there is capacity for 19 elderly frail people. On the first floor there is capacity for 19 people living with dementia and on the second floor there is capacity for ten younger people with disabilities.
People’s experience of using this service and what we found
Most people told us staff were kind and caring and they felt safe. We received positive feedback from health and social care professionals regarding the kindness of the staff and their competence in providing care. Relatives confirmed this was the case.
We found one person had been prescribed and been given more than the recommended dose of a medicine, although this had not adversely impacted on their health. This error was immediately addressed by the service; and appropriate advice was sought from health professionals. However, this illustrated a failure of staff to follow systems in place to safeguard people from harm.
Although food was plentiful and freshly cooked, a number of people told us they could not influence the menu. This issue has now been addressed following the inspection.
Care plans were person centred, up to date and together with risk assessments provided staff with detailed guidance in how to care for people safely.
The home was clean and odour free. There were increased infection control measures, including daily audits, in response to the coronavirus outbreak.
Staff recruitment processes and procedures were safe. Essential checks on staff had taken place on staff before they started working for the service. Staff received the training and support to carry out their role effectively. Staff were busy at all times, but the service used a dependency tool to review staffing levels, and staff confirmed there were enough staff. We have made a recommendation in relation to staffing levels.
Staff understood how to safeguard people from abuse. The registered manager understood their obligations to notify relevant bodies of safeguarding concerns.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
There had been significant changes in staff personnel and management over the last year, however by the time of this inspection a newly established management team and recruitment of staff had taken place. Provider representatives supported the service in a number of ways, for example, undertaking audits and providing clinical and training support. Local audits in key areas took place.
Rating at last inspection
At the last inspection we rated this service Good. The report was published on 2 February 2018.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
We carried out a full inspection of this service on 15 June 2021. This was a planned inspection based on the previous rating.
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 inspection programme. If we receive any concerning information, we may inspect sooner.