Archived: The Hamiltons Care Home

Updated 21 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on the 09 and 10 January 2018. The first day was unannounced. This meant the provider did not know we would be visiting the home on this day. The second day was announced.

The inspection team consisted of one adult social care inspector from the Care Quality Commission (CQC).

The Hamiltons 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.

As part of our inspection planning we reviewed all the information we held about the home. This included previous inspection reports, action plans and any notifications sent to us by the home including safeguarding incidents. This helped us determine if there were any particular areas to pursue during the inspection.

Prior to the inspection the provider had completed a Provider Information Return (PIR). This 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.

At the time of the inspection there were 17 people living at the home. During the day we spoke with the registered manager, deputy manager, two visiting professionals, five people who lived at the home and three care assistants. As part of the inspection, we looked around the building and viewed records relating to the running of the home and the care of people who lived there. This included four care plans and six staff personnel files.

Throughout the day we observed how staff cared for and supported people living at the home and observed lunch being served to see if people’s nutritional needs were being met.

Updated 21 February 2018

This comprehensive inspection took place on the 09 and 10 January 2018. The first day was unannounced. This meant the provider did not know we would be visiting the home on this day. The second day was announced.

The Hamiltons 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; both were looked at during this inspection.

The Hamiltons provides personal care for up to 18 people. The service has bedrooms and communal rooms including bathrooms to the ground floor and to the second floor further bedrooms and bathrooms are situated. It has a passenger lift between the floors and a large stair case at each side of the building for easy access between both floors.

As part of the homes registration conditions it is required to have a registered manager employed to oversee the day to day running of the service. A registered manager has been in post at the service since February 2017.

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.

At the last comprehensive inspection on 01 and 02 December 2016 we found one continuing breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, safe care and treatment. We recognised that although medicines practice had significantly improved since our previous inspection in April 2016 the service was still required to improve on areas such as missing signatures on medicine records and a lack of omission codes being used for medicines which were prescribed as, ‘when necessary’ (PRN).

At this inspection we found the service was now compliant in this area. Medicines records were now completed appropriately including PRN, as required and staff were now using the correct coding system. Medicines audits were robust and identified any errors. Medicines were kept secure and staff were appropriately trained to administer medicines in a competent way.

Safeguarding policies and procedures were in place to ensure people, staff and visitors were aware how to raise concerns if needed and what constitutes abusive practice. Staff received training in this area and a record of safeguarding referrals was kept securely.

Risk assessments were in place in people’s files to recognise individual risk taking and also environmental risk assessments were completed for both internal and external areas. Appropriate checks were done by registered external tradespersons on areas such as gas appliances, fire equipment, electrical appliances, hoists and lifts.

Business continuity plans were in place to offer information and guidance in the case of adverse weather or any other unforeseen circumstances which could affect the day to day running of the service. People had personal evacuation plans and fire audits were completed by both external agencies and internally by the maintenance person.

The service had recently undergone a decorating schedule, mainly in the communal areas which made the environment brighter. We observed no malodour around the building during the inspection.

During the inspection the service had an outbreak of upper respiratory infection which meant a number of people using the service were required to be cared for in their bedrooms. The service dealt with this well and contacted the relevant authorities to seek advice and guidance.

People had care files which contained person centred information. Each care file was written in a way which reflected the individual and only contained documents relevant to the person. People’s human rights and diverse needs were reflected within each plan and we received positive feedback during the inspection which evidenced people were being treated fairly and in line with their personal preferences.

The home was working within the requirements of the Mental Capacity Act (MCA). Deprivation of Liberty Safeguards, (DoLS) applications were made where people were deemed to lack capacity to make their own choices and decisions about their care.

Staff interacted and engaged well with people. Staff were caring, respectful and understanding in their approach and treated people as individuals. They promoted privacy and dignity and supported people to maintain control over their lives. People’s opinions were routinely sought and acted upon by means of questionnaires and residents meetings. This enabled people to provide influence to the service they received.

Recruitment processes were robust and designed to protect people using the service by ensuring appropriate steps were taken to verify a new employee’s character and fitness to work.

The service had a sufficient number of staff to support the operation of the service and provide people with safe and personalised care. People told us they never felt rushed and staff were responsive to their needs.

Staff received training appropriate to their roles and prior to becoming an established member of staff they were subject to a period of induction, training and supervision.

Positive feedback was received from people who used the service and staff about the management structure. People told us they were able to ask for assistance from the registered manager when required and people also informed the registered manager was present throughout the day in the communal areas. Staff also said they felt well supported and they could approach management with any concerns.