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Archived: Hungerford Care Home Good

The provider of this service changed - see old profile

The provider of this service changed - see new profile

Reports


Inspection carried out on 29 & 30 September 2015

During a routine inspection

This inspection took place on 29 and 30 September 2015 and was unannounced. This was a comprehensive inspection which included follow-up of progress on the non-compliance identified in the report of the previous inspection on 17 October 2014.

At the previous comprehensive inspection we identified non-compliance against Regulations 9 (Care and welfare of service users), 10 (Assessing and monitoring the quality of service provision), 12 (Cleanliness and infection control), 17 (Respecting and involving service users) and 23 (Supporting workers) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

From April 2015, the 2010 Regulations were superseded by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found that the provider was meeting the requirements of the comparable current regulations. Regulations 9 (Person-centred care), 17 (Good governance), 12 (Safe care and treatment), 10 (Dignity and respect) and 18 (Staffing).

We found that the service had taken action to address the previous concerns although further improvements were needed. A number of new initiatives had yet to become established to ensure the changes are sustained.

Hungerford Care Home is a residential home with nursing that offers a service for up to 59 older people. Some people are living with varying types and degrees of dementia.

A new manager had been in post since May 2015 who became registered manager on 25 September 2015. 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.

The new registered manager had identified key areas where improvement was needed and had taken action to address these. A number of new systems and monitoring processes had been established to oversee the quality of the service. The premises were undergoing a complete redecoration programme including the provision of new furnishings. People had been involved in choosing the décor and furniture.

People were happy with the care they received and told us staff were kind and respectful. We saw staff were enthusiastic and engaged positively with people. People were offered choices and given time to make them.

The level and range of activities had been improved and more individual activities were provided.

People’s health and nutritional needs were met and the service consulted and worked effectively with external healthcare agencies. Advice and guidance from the local authority and the health authority care home support team had been taken and acted upon.

The service had recently been given a new brand name, “Brighterkind”. As part of this process, new initiatives on catering, activities and healthcare were being introduced to improve the care people received.

Inspection carried out on 17 July 2014

During a routine inspection

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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service. This was an unannounced inspection.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The Hungerford Care Home provides accommodation and nursing care for up to 59 older people who have nursing or dementia care needs. There were 52 people living at the home when we visited.

People gave us complimentary comments about the service they received. People felt happy and well looked after. However, our own observations and the records we looked at did not always match the positive descriptions people and relatives had given us.

People’s safety was being compromised in the home. Some equipment was not cleaned or well maintained, procedures to control the spread of infection were not robust, and there was insufficient support for people who became distressed or who were unable to make their needs known.

People’s health care needs were assessed. However, staff did not always provide support and care in an effective way. People were not always supported to eat and drink enough to meet their nutrition and hydration needs. In some cases, this either put people at risk or meant they were not having their individual care needs met.

Although people told us they felt their privacy and dignity was respected and made positive comments about staff, we saw that care was mainly based around completing tasks and did not take into account people’s preferences. Some people living at the home were not engaged in meaningful activities or did not have opportunities for social engagement. People who use the service were not always treated with consideration, and their privacy and dignity respected while receiving their care and support.

The provider had a system to assess staffing levels and make changes when people’s needs changed. The rota demonstrated the provider had the right numbers of staff on duty to support people. However, they could not be sure that at all times the staff had the appropriate knowledge and qualifications to meet people’s needs.

Staff training records included mandatory training considered by the provider as being appropriate training for the staff. However, not all staff were up to date with, or had received their mandatory training. We saw evidence that learning was not always put into practice when staff supported people.

Staff were following the principles of the Mental Capacity Act 2005 (MCA) when supporting people who lacked capacity to make decisions. The manager was knowledgeable about Deprivation of Liberty Safeguards (DoLS) and MCA. They had taken appropriate action with the local authority to ensure where restrictions were placed on people, these were reviewed and agreed. Where people’s liberty was restricted, this was carried out in the least restrictive way in order to help protect people’s rights and freedom.

The registered manager investigated and responded to people’s complaints, according to the provider’s complaints procedure. Most people and relatives told us they did not have any complaints. One person told us they had made one complaint and it was responded to appropriately. People and relatives told us they knew they could speak to staff or address the issues with the manager.

The manager had a system in place to assess and monitor the quality of care. However, we saw this system did not work effectively to identify all issues or concerns with the home and practices. Without an effective system the home was not able to make improvements where and when necessary so that people could receive support and care they needed.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 1 May 2013

During a routine inspection

We spoke, in depth, with eight people who used the service, two visitors, five relatives and four staff members. We spoke with others for short periods of time during the inspection.

We found that people�s consent was obtained wherever possible. They were given choices and helped to make as many decisions for themselves as possible. One person told us that staff ��always give me time to make my own decisions��.

We found that people�s health and care needs were well met. One person said �� I love it here, I am lucky to live in such a special place��. Another person said ��the care is so good I can�t believe anyone could have any complaints��. People who lived in the home, relatives and visitors described the service as an ��excellent home��.

People told us that the food was ��absolutely delicious�� and ��it is always very tasty��. A visitor told us that the food ��is absolutely excellent, like a five star hotel��.

We saw that the home was well maintained and comfortable. People told us that the garden was beautiful and gave them great pleasure and that the home was very comfortable.

People described staff as ��brilliant��. Relatives told us that ��staff had an excellent attitude and always put people first��. People who lived in the home, staff, relatives and visitors told us that there always appeared to be enough staff around to help people if needed.

The home kept accurate records and stored them appropriately.

Inspection carried out on 12 October 2012

During a routine inspection

We spoke with five people who lived in the home, five relatives of people who lived in the home, four staff and the registered manager.

We found that people were involved in their care planning and were treated with dignity and respect. People said ��staff always treat me as an individual.�� People were encouraged to make their own decisions and choices, where they were able. People told us that staff worked hard to make sure that people made all the choices they were able to. Care was planned to meet people�s individual daily care and health needs. People told us that they were ''very well looked after.'' They said that the home gave ��excellent care.�� The home made sure that people were protected from all forms of abuse. People told us that they felt ��very safe�� in the home. There were enough staff to meet people�s needs. People said that staff were ��excellent and did a wonderful job.�� The home asked people their views and dealt with complaints effectively. People told us that they were confident their views would be acted on.

Inspection carried out on 17 November 2011

During an inspection in response to concerns

People told us that they liked living at the home. They told us the food was "lovely", "nice" and "very good". People told us they felt safe at the home.