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Archived: Hampden Hall Care Centre Requires improvement

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Reports


Inspection carried out on 11 June 2019

During a routine inspection

Hampden Hall Care Centre is a nursing home providing personal and nursing care to 109 people aged 65 and over at the time of the inspection. The service can support up to 120 people in one adapted building.

Accommodation is provided on three floors. People living with dementia reside on the ground floor. Nursing care is provided on the first floor with both nursing and residential care on the second floor.

People’s experience of using this service and what we found

Some people told us they felt safe living in the service, whilst others did not. We found the service was in breach of regulation 12 (Safe care and treatment) of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was due to poor medicine management and a lack of accurate up to date recordings in relation to health needs and risk assessments.

People and their relatives told us “One of the problems is there's not enough staff.” They were concerned about the welfare of the staff and that people may not receive care in a timely way. The provider was aware and was attempting to address this issue by offering financial incentives to staff. Staff were knowledgeable about infection control and safeguarding people from abuse.

Records related to the risk of people suffering from malnutrition and/or developing pressure ulceration were not accurately completed. There were concerns about the competence of staff to provide catheter care, and to accurately record or set air mattresses correctly. Nursing staff were not able to demonstrate correct knowledge and expertise in dealing with diabetic hypoglycaemia (low blood sugar levels). People had access to a GP and other health professionals when necessary.

The ground floor environment was not conducive to caring for people with dementia because the environment was noisy and lots of people were gathered in the same area. 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 was a mixed response from people with regards to how they were treated by staff. Some people told us they weren’t always treated in a respectful way by staff. Others praised the staff for their kindness and support. People told us how their dignity was protected, others felt the attitude of some staff was “off.” Communication between staff and people was not always positive or skilled. We have made a recommendation about how to improve the care for people living with dementia.

There was a mixed response from people regarding the activities in the service. The activities were not always person centred or meaningful to people. We observed people being left for long periods without any stimulation and conversely enjoying a glitz and glamour day with staff and visitors.

The provider had tools in place to meet people’s communication needs. Complaints were dealt with in a timely way. We received positive feedback from the relatives of people who had died. People and staff were treated equally, and people’s cultural needs were catered for.

The service was going through a period of change and it was clear from our findings there had been a lack of oversight of records, and the support offered to people daily. Quality assurance audits had not identified the areas of concern we found. The provider was open and honest with us about the challenges the staff and people faced to improve the service. Plans were in place to improve the service to people. The provider had been proactive throughout the inspection to rectify what areas they could.

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

Rating at last inspection

The last rating for this service was good (published 13 October 2017).

Why we inspected

The inspection was prompted in part due to the number of safeguarding notifications we had received. A de

Inspection carried out on 11 September 2017

During a routine inspection

Hampden Hall Care Centre is a care home with nursing and provides care for older adults, people with dementia and palliative care. There are three floors. In accordance with the current registration, the care home can accommodate up to 120 service users. At the time of our inspection 113 people lived at Hampden Hall Care Centre.

At our last inspection on 5 May and 6 May 2015, the service was rated good .

At this inspection we found the service remained good.

Why the service is rated good:

People were protected from abuse and neglect. We found staff knew about risks to people and how to avoid potential harm. Risks related to people’s care were assessed, recorded and mitigated. The management of risks from the building were also considered. We found appropriate numbers of staff were deployed to meet people’s needs, although there were a number of vacant posts for care workers. We made a recommendation about staffing deployment. Medicines management was safe, but minor improvements were required. We made a recommendation about medicines management.

Staff training and support was good. Staff had the necessary knowledge, experience and skills to provide appropriate care for people. The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People’s nutrition and hydration was closely monitored. Appropriate access to community healthcare professionals was available. A refurbishment programme had commenced to further enhance people’s experience of living at the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

We consistently received complimentary feedback about the service. People and others told us staff were kind and caring. People and relatives were able to participate in care planning and reviews and some decisions were made by staff in people’s best interests. People’s privacy and dignity was respected.

Care plans were thorough, personalised and reviewed regularly. There was a satisfactory complaints system in place which included the ability for people and others to raise concerns. People and relatives told us they had no complaints, but knew the process for alerting staff to any issues.

Management and operation of the service was good. We found staff worked as an effective team to improve care, ensure people were safe and focus on the quality of the service. The service had good working partnerships with external agencies and were honest in their approach. We made a recommendation about statutory notifications for safeguarding allegations.

Further information is in the detailed findings below.

Inspection carried out on 5 & 6 May 2015

During a routine inspection

Hampden Hall Care Centre provides residential nursing care for up to 120 people this included people with physical disabilities, older people and people who were living with dementia. The home is purpose built with a lift to transport people between the three floors.

This inspection took place on the 5 and 6 May 2015. It was unannounced on the first day, we informed the provider we would be returning on the second day.

At the time of the inspection a manager was in post. They had commenced working at the home in February 2015 and had begun the process of becoming the registered manager. 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.

People told us they were well cared for and liked living in the home. Their needs were met, and the staff were kind and caring. A new manager was in post and the staff had confidence in their abilities. They supported each other and worked as a team. Staff received induction, training and supervision and appraisals. This was an area the home were improving on.

We found minor concerns regarding the records related to medicines, we have made a recommendation regarding medicines. Training had not been provided to staff to enable them to support people whose behaviour may be challenging, including how to deal with situations that may require physical intervention. The manager planned to consider this training as part of their future training programme.

Questionnaires had been sent to staff to check their knowledge regarding the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The manager planned to use the results to improve staff knowledge and skills through training.

People’s health needs were monitored and where necessary specialist healthcare professionals were involved in the planning of care. Risk assessments were in place for each person to ensure the risks associated to their care and the environment were minimised. Care plans and records were reviewed regularly.

Audits had taken place to ensure the environment was safe for people, staff and visitors. Food was prepared in such a way that it was safe for the person to eat it. For example, it was the right temperature and the right consistency. Where necessary people received support to enjoy their meals. People told us they liked the food offered in the home and choices were available to people if they did not want what was offered on any particular day. We observed there were insufficient staff numbers at lunchtime to help support everyone at the same time. The manager was reviewing the staffing levels to address this issue.

Activities were available to people to ensure their social needs were met. A variety of services including a manicurist and chiropodist visited regularly, along with a resident hairdresser, to meet people’s requirements. Family and friends were welcomed into the home to spend time with people and to assist where appropriate with their care.

Inspection carried out on 21 November 2013

During an inspection looking at part of the service

When we visited the service on the 26th and 29th July 2013 we found areas of non-compliance. We asked the provider to send an action plan within seven days outlining how they would become compliant. We visited the service on the 21st November 2013. We found the provider had addressed the issues raised at the previous visit.

We saw people were respected and involved in their care. A range of activities were made available to people who used the service. Staff had read and signed the provider�s confidentiality policy to ensure people�s privacy and dignity was upheld. The provider had ensured people�s capacity to make decisions was assessed in line with the Mental Capacity Act 2005 (MCA). Staff had also received MCA training since our last visit.

We saw care plans reflected people�s needs and were reviewed and updated monthly. The provider had reviewed their staff training plans and all staff had completed training, or were expected to complete training by December 2013. We spoke with staff about the service. One member of staff told us �It�s much better now, we are working as a team.� One relative told us �Staff are fantastic.� The provider had introduced life history books for people who used the service which included information about people�s lives and personal histories. Staff were responsible for creating and maintaining these documents. This enabled staff to provide more personalised care to people within the service.

Inspection carried out on 26, 29 July 2013

During an inspection in response to concerns

We spoke with seven people and six relatives of people who lived in the home. They told us they were happy with the care that was provided. One person told us the most positive thing about living in the home was, �They�re kind, it�s clean and the staff are nice.� A relative told us �I think the care is excellent.�

People were generally treated with respect by staff and their privacy and dignity was protected. We observed the care on all three floors of the home. We observed how the staff interacted with people. We saw positive interaction between people and the staff members on the first and second floor; however we saw examples of poor interactions between staff and people on the ground floor. The Mental Capacity Act 2005 had not been applied to the care that was being provided to people who lived on the ground floor; this placed them at risk of being deprived of their human rights and liberty.

We examined records relating to care of people and staff recruitment, supervision and training. We found that recruitment records were up to date and appropriate, however this was not reflective of the records in all other areas we inspected.

We noted that staff training and supervision was not up to date and in line with the provider's policy on training and supervision.

Inspection carried out on 26 November 2012

During a routine inspection

People told us they were involved in their care plan and its updating. They said, �Staff provided them with choices and respected their privacy and dignity.� People told us they were provided with choices at meal times. They said there were set times for meals with hot and cold drinks provided during the day. People said the home was clean and their laundry was appropriately maintained.

We found people received the appropriate care and support that met their needs. People were provided with adequate nutrition and hydration. The premises were kept clean and there were no untoward odours. Staff were appropriately trained, supervised and appraised. There was a system in place to ensure complaints were investigated and resolved satisfactorily.

Inspection carried out on 23 March and 16 May 2011

During a routine inspection

People told us that staff involved and consulted them about their care and treatment. They said that their privacy and dignity were respected. Staff assisted them with their personal care in the privacy of their bedrooms. They were able to choose what clothes they wished to wear and whether or not they wished to participate in activities.

People said that their health care needs were looked after. They were registered with the service�s general practitioner (GP) and the GP visited the service regularly. They said that staff were very good and informed their relatives of any changes to their health care needs.

People told us that there was a variety of food choices. They said that the meals provided were tasty and the portions were adequate. There were facilities available for their visitors to make their own drinks.

People said that they felt safe in the service and they knew whom to speak to if they were not happy with a situation. They told us they had been provided with the service�s complaints procedure.

They said that their bedrooms were cleaned daily and the laundry facilities were good.

People said that there was always sufficient staff on duty to help them. They said that they had their own named carer and nurse.

Reports under our old system of regulation (including those from before CQC was created)