Hamilton Rest Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this provider. This key question has been rated Good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Systems were in place to monitor accident, incidents and concerns. An analysis of the records helped to identify any themes or patterns so appropriate action could be taken. Where necessary further advice and support was requested to help minimise further incidents. People’s records were reviewed and updated ensuring information and learning from the incident was reflected in the persons care and risk management plans. Learning was also shared through meetings, handovers, supervisions, competency assessments and policy updates.

A range of systems were in place ensuring staff were kept informed and updated. Staff spoken with confirmed changes in care were communicated to them and alerted them to any changes in people’s records.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Staff worked closely with external health professionals, so people had access to appropriate healthcare and clinical support when needed. This included the GP and community nursing team. Information and guidance received was reflected in people's care records.

A service user guide was available. This contained relevant information to support people when moving into the home and what they could expect. One relative said they had been supported by the registered manager when considering a home for their family member. They told us, “We came last year, we looked at a few places in the area and straight away just knew this was right. [Registered manager] thought [person] would fit in well. It’s a more intimate home.”

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. Concerns had not always been shared quickly and appropriately.

A recent concern had been raised with CQC and the local authority, which was currently under review. Records also showed allegations and concerns had been raised with the management team. Whilst action had been identified to address the concerns, this information had not been reported to CQC, as required. It is important that all notifiable incidents and concerns are reported promptly in line with regulatory requirements to ensure confidence in the service's governance arrangements.

Policies and procedures were in place to help protect people and uphold their rights. Training records showed staff had completed training in safeguarding, Mental Capacity Act and the deprivation of liberty safeguards (DoLS). Staff spoken with demonstrated their understanding of safeguarding procedures and felt able to raise any issues or concerns.

Some people living at Hamilton Rest Home were being deprived of their liberty. Appropriate legal authorisations were in place, as required.

Feedback was consistently positive, with people and their relatives expressing they felt safe and were confident in the support provided by staff. We were told, “I’ve been here about 10 months. Yes, I’m safe; it’s the people, residents and staff”, “I feel safe; it’s the carers, if something was the matter you’d tell the carers and it would get sorted” and “He’s safe here, he’s told me he feels safe.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Care plans provided sufficient information to guide staff in supporting people safely. Areas of potential risk to people’s health and well-being were assessed and planned for. Additional monitoring records and checks were completed, such as weight loss and falls. This meant changes in need could be quickly identified and responded to.

People’s relatives told us their family members were helped to stay healthy and safe. We were told, “He’s encouraged to use his frame”, “Yes, [person] is safe although she’s had some falls, so they have moved her downstairs and since then no falls” and “[Person] was dehydrated when he came and now, he is eating and drinking regularly now.”

Environmental risks were monitored with checks to the premises and equipment. A specific risk assessment has now been completed for the screen at the bottom of the stairs; this is to be kept under review.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Time was spent looking around the environment. The home was clean, tidy and homely. New chairs had been purchased for the lounge and profiling beds for those who needed them. Medication storage had been improved and a small consulting created, which could be used by the GP or visitors, if necessary. We were told further work was to be carried out including a new kitchen and proposed extension to create 3 ensuite ground floor bedrooms. As part of the ongoing improvements to the home the provider should also consider good practice guidance with regards to being dementia friendly, helping to orientate people when moving around the home. Following our visits we were informed the provider had completed a dementia-friendly environmental review giving further consideration to additional signage and other adaptations according to individual needs.

Bathroom and toilet facilities were available on each floor. Aids and adaptation had been provided throughout to promote people’s safety and independence. Where people had been identified at risk of falls, specialist equipment had been put in place to alert staff.

Bedrooms were personalised with belongings from home. Some rooms, however, did not have locks fitted. This was brought to the provider’s attention and immediate action was taken. People’s relatives told us, “The home looks OK and [person] is happy there” and “The home looks fine; it’s always been fine.”

Regular servicing of appliances, such as gas, electric and fire safety, were completed and up to date. Internal health and safety checks were also carried out, including fire drills. A fire risk assessment was in place. The provider was aware this would need to be updated when changes are made to the premises.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Relevant recruitment checks had been undertaken prior to new staff commencing employment.

The provider used a dependency tool to monitor staffing levels and review arrangements when people's needs changed or where occupancy increased. People and relatives spoken with felt a sufficient number of staff were available and responsive to their needs. We were told, “There seems to be enough staff, they look after me ok”, “Yes, there’s enough staff, they are always about and you don’t have to wait” and “The staff are brilliant and make him feel OK.”

Staff were positive about working at the home and told us they felt supported by management. They described good teamwork and spoke positively about opportunities for training and development. It was noted ancillary staff had not undertaken training to support their interactions with people. This included dementia awareness, dignity in care, and accident and incident reporting.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Designated staff were responsible for cleaning of the home each day. Rooms were clean and tidy and there were no malodours. People told us their rooms were regularly cleaned. Comments included, “They are always hoovering. They clean my bedroom and bathroom”, “My room’s nice and you can have your own stuff” and “They clean and take everything out, even the wardrobes to clean. My bin is emptied and washed every day.”

Supplies of personal protective equipment, such as aprons and gloves were readily available. Staff wore personal protective clothing when assisting people with aspects of care. Whilst the laundry area was small, staff were mindful of infection prevention procedures when managing soiled items.

An audit had been undertaken by the local authority health protection in January 2026. The home was awarded a ‘green’ rating with 97% compliance.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People received their prescribed medicines safely. Medication administration records were audited to check people had received their medicines as prescribed. Protocols were in place for ‘when required’ medicines to guide staff when this should be used, particularly for those people unable to advocate for themselves. The provider was implementing a new electronic medication records system. Senior staff felt this system would be more robust and enable them to better monitor and audit the system in place.

Staff completed relevant training and assessments of competency were carried out to ensure practice was safe. People told us staff ensured they had their medication when needed. People told us, “I only have 2 tablets and a milkshake” and “The tablets come from the doctor and they deal with them.”