Archived: Hampton Court Care Home

We spoke with visitors to the home, they told us that generally they were satisfied with the service but commented on the changes to the nursing and care staff and the many agency staff on duty. One visitor told us that they thought the staffing levels had increased in recent times but stated staff were still very busy.

We saw that work had begun on reviewing the care of all people who used the service and some care plans and risk assessments had been completed. We spoke with staff about the care and support they provided to people each day, the care plans and records did not accurately correspond with what the staff told us.

People told us they enjoyed the meals and they could have meals either in their own rooms or in the dining room. We saw that some people required help and support with eating and drinking. We saw some documents that were used to record the daily amounts offered to people but as some of these were partially completed we were unable to fully determine if this monitoring was effective.

Staff told us they understood and were aware of their responsibility to report any concerns they may have with regard to people's safety. We were unable to determine if staff had received training in safeguarding vulnerable adults as records were not available.

We saw some improvements had been made in relation to some of the equipment used. Staff were receiving training and guidance in the safe use of bed rails.

We were unable to look at the way the service recruits staff as records were unavailable. The interim manager told us they were checking the files to find out which checks and information were missing and then actioning the findings.

People told us that the regular staff were very good to them but they were always very busy because they were not enough of them.

We found that the majority of the records needed for the running of a care home were incomplete, not up to date or unavailable for inspection.

We spoke with 11 people who used the service, three visitors, the interim care manager, care and ancillary staff. We observed the activity happening in all areas of the home. Some people were unable or unwilling to speak with us; we spoke with their visitors who told us that generally they felt the care provided was good.

People who used the service told us they felt the staff were good and helpful but there were occasions when they had to wait for help and assistance. They told us they enjoyed the food and could eat in their preferred place. We saw some people used the dining facilities whilst others had their meal taken to them in their own rooms.

We were aware and staff told us that a full review is ongoing to update assessments and care plans of people who used the service. They told us this was work in progress. We looked briefly at the care documentation and saw some monitoring documents were not completed fully. This meant that for some people there was a risk of receiving inconsistent or unreliable care.

People who used the service and spoke with us told us that the regular staff were very good but there was not enough of them. They told us that at times they had to wait for support and help from the staff. Two people told us they felt very lonely as they did not see many people and stayed in their rooms for the majority of the day.

Visitors told us their relative appeared comfortable and settled but went on to say that they 'never complained'. Another visitor told us the level of the quality of the service had decreased over a period of time. Another visitor told us they had had cause to complain to the provider about the delay in their relative getting help from staff and their relative had been uncomfortable for over an hour whilst waiting.

Staff told us they were always very busy and we saw staff supporting and helping people. We saw that the majority of people remained in their own rooms; they were either asleep in bed or watching the television. A group of five people were in one of the lounges, the television was on but people appeared to be disinterested in the programme. We did not see any opportunity for people to participate in structured activity.

We spent time sitting in the communal areas observing how staff and people got on with one another. We saw that many people stayed in their own rooms for most of the day this being their personal preference, their ill health and frailty. No structured activity was arranged for people to participate in and enjoy.

Some people were able to discuss how they wished their care to be provided. Some people were unable to do so. We spoke with some visitors who told us that generally they were satisfied with the care provided but felt that the standard of care had decreased.

We spoke with staff about the care and support they provided to people each day. We looked at a selection of care plans and records and found that the information did not correspond with what the staff had told us.

People told us the meals provided were okay but not much choice or variety. Staff told us that people could have whatever they wanted to eat and drink. We saw this not to be the case when we observed the main midday meal. We saw that where people had been assessed as being at risk of malnutrition the monitoring forms had not been updated or completed.

People who used the service were not always protected from the risk of abuse or harm. Staff we spoke with were unsure of the procedures for dealing with any concerns or suspicions of abuse.

People were not protected from unsafe equipment. We found essential items of equipment to be faulty, not fitted correctly, unsafe, and not fit for purpose.

There were not enough qualified, skilled and experienced staff to meet people's needs.

We were unable to gain access to the main office where the records for the running of the home were kept, so we were unable to determine the way the service monitored the safety and quality of the service.