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Hamilton Park Nursing Home Requires improvement

Inspection Summary

Overall summary & rating

Requires improvement

Updated 21 August 2019

About the service

Hamilton Park Nursing Home provides accommodation and nursing care for up to 34 people. Accommodation is arranged over three floors and all bedrooms are single occupancy. The home is staffed 24 hours a day and a registered nurse is always on duty. The service provides 14 Home First pathway places, which are commissioned by Somerset County Council and Clinical Commissioning Group (CCG.) There is a full team of NHS therapists based at the home from Monday to Friday. The therapy team consists of a physiotherapist, occupational therapist, social worker and reablement assistants. The Home First pathway provides a period of rehabilitation and reablement with the aim of the individual returning home. 24 people were using the service at the time of the inspection, including seven people who were using the Home First Pathway.

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

The provider’s current systems to monitor the quality and safety of the service people received, had not been effective at identifying issues and driving improvement. Some records requested during the inspection were not available.

The management of medicines did not always adhere to best practice guidelines published by the National Institute for Health and Social Care (NICE). Improvements were required to ensure medicines were safely managed.

Risks to people’s health and wellbeing were not always managed safely, for example risks relating to the prevention of pressure ulcers, weight loss and certain health conditions. Care records lacked specific details to guide staff on how to meet people’s needs.

People’s feedback was mixed in relation to staffing levels. The current arrangements for determining staffing levels did not reflect the need for nursing staff or other factors to ensure staffing consistently met people’s needs. Not all staff had received core training or updated their training to ensure they worked safely.

People had mixed views about the quality and variety of the meals provided.

Parts of the environment required redecoration and refreshment to ensure it was homely.

We received mixed feedback from people about staff’s attitude and approach. Some people found some staff to be abrupt and unfriendly. Observations during the inspection showed some staff had developed positive and friendly relationships with people. Some staff were exceptional in their approach.

People were offered opportunities to take part in regular activities, however relatives and staff felt activities were an area for further improvement.

People felt they were protected from the risk of abuse and told us they felt safe. People had access to various health care professionals, except for a domiciliary dentist. The registered manager was working to find an appropriate service for those people who would not be able to visit a dental practice.

Improved information was being developed for people using the Home First service, to ensure they fully understood the nature of this service.

Systems were in place to ensure equipment was safe and in good working order. The premises were clean and free from odours.

The registered manager was motivated to improve partnership working with other health and social care professionals for the benefit of people using the service.

People were supported to have 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.

Rating at last inspection: Good (Report published April 2017)

Why we inspected

The inspection was prompted in part due to concerns received about the safe management and prevention of pressure ulcers; the management of people’s medicines; staff attitude and approach; staffing levels; the quality of food; record keeping; cleanliness and the governance and management of the service. A decision was made for us to inspect and examine those risks.

Due to t

Inspection areas


Requires improvement

Updated 21 August 2019

The service was not always safe.

Details are in our safe findings below.


Requires improvement

Updated 21 August 2019

The service was not always effective.

Details are in our effective findings below.


Requires improvement

Updated 21 August 2019

The service was not always caring.

Details are in our caring findings below.


Requires improvement

Updated 21 August 2019

The service was not always responsive.

Details are in our responsive findings below.


Requires improvement

Updated 21 August 2019

The service was not always well-led.

Details are in our well-Led findings below.