Haythorne Place

Updated 27 March 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

On the first day of inspection the inspection team consisted of four inspectors. Three inspectors visited the service, whilst one inspector carried out telephone interviews to staff remotely. Two Experts by Experience carried out telephone interviews to people and their relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service

On the second day of inspection the inspection team consisted of one inspector to look at medicines at the service.

Service and service type

Haythorne Place is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Prior to the inspection we reviewed information and evidence we already held about the home, which had been collected via our ongoing monitoring of care services. This included notifications sent to us by the home. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. We also sought feedback from partner agencies who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with 10 people who used the service, and 13 relatives about their experience of the care provided. We spoke with 18 members of staff including the registered manager, regional operations manager, deputy manager, unit managers, nurses, senior care staff, care staff and domestic staff.

We observed staff providing care, to help us understand the experience of people who used the service. We also viewed a range of records. This included people’s care records, staff personnel files and multiple medication records. We also looked at other records relating to the management of the home and care provided to people living there.

After the inspection

We met with the provider to share information of concern. We also continued to seek clarification from the provider and registered manager to validate evidence found. We looked at evidence of action taken to address our concerns.

Updated 27 March 2021

About the service

Haythorne Place is a nursing and residential service, providing personal and nursing care for up to 120 people, some of whom were living with mental health conditions or dementia. The service comprised of six houses and one management building.

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

People told us they felt safe living at the service and the standard of care they received was quite good. However, aspects of the service were not safe. Staffing arrangements negatively impacted the quality of support people received, and in some cases, placed people at risk. Although processes had been established to protect people from risks relating to the spread of infection, these processes were not consistently followed by staff. People received their medicines as prescribed.

The systems of governance were comprehensive, but they had not been effective at meeting regulatory requirements or improving the quality of care people received. For example, this was the third consecutive inspection where feedback about staffing was poor. Despite our initial concerns, the new registered manager and provider were very proactive in engaging with CQC after the inspection. The provider took immediate action to address infection prevention control concerns after our visit and confirmed they will take onboard our comments about staffing. The registered manager understood aspects of the service must improve.

Throughout the inspection we saw caring interactions between staff and people who used the service. We have made a recommendation about how the provider embeds a person-centred culture at the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 8 October 2019).

Why we inspected

We received concerns in relation to staffing and the culture of the service. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to staffing, infection prevention and control and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.