The Hornchurch Care Home

The Hornchurch Care Home supports older people, some of whom have dementia care needs. It is registered to accommodate up to 55 people with nursing and personal care. At the time of the inspection, 54 people were living at the home. The home has three floors with adapted facilities and en-suite rooms.

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

Medicines were administered to people safely and as prescribed. However, we have made a recommendation for the provider to review the way they manage medicines and equipment to monitor people’s blood sugar levels.

People were safe and there were systems to protect them from the risk of abuse. Potential risks to people were assessed and monitored. Staff were recruited safely and appropriately. There were enough staff to meet people's care and support needs. Systems were in place to record and monitor accidents and incidents.

People were protected from the risks associated with the spread of infection. People were supported by staff who had received professional training and support. People's needs were assessed before they started to use the service. The staff worked with other health and social care professionals to ensure people were in good health.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service did support this practice.

People were encouraged to maintain a healthy balanced diet and were provided food and drink that met their preferences and needs. Staff knew people well and they provided care and support to them in a kind and compassionate way. People were treated with respect and their views were listened to and their requests acted upon.

People received personalised care and support in accordance with their individual needs. Care plans provided guidance on how to support people, and included their preferences and communication needs. People were positive about the care and support they received from staff and the management team. There was a positive culture in the home and equality, diversity and inclusion was promoted.

Activities for people in the home were engaging and meaningful. People were supported to pursue their interests. People and their relatives were positive about the management team and could approach them with any concerns.

The provider had systems in place to assess, monitor and improve the quality and safety of the services provided. Feedback was sought from people, relatives, staff and other professionals. The home worked with local services and was a part of the community.

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 the service was Good (report published 20 April 2020).

Why we inspected

This inspection was prompted in part due to concerns we received about the quality and safety of the service and the management of end of life care support. A decision was made for us to inspect and examine those risks.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The Hornchurch Care Home is a residential care home providing personal care and nursing to older people. The service can support up to 55 people and at the time of the inspection, 54 people were living in the home. The home is a three floor building. Each floor or unit has separate adapted facilities.

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

The home was safe. Procedures were in place to protect people from abuse. Medicines were managed safely and people received their medicines as prescribed. There were enough staff available in the home to provide support to people. Staff had their backgrounds checked before they started working in the home to ensure they were suitable.

Risks associated with people's needs were assessed and staff understood how to reduce these risks. Staff followed infection control procedures to maintain the hygiene and cleanliness of the home. Accidents and incidents that had taken place in the home were reviewed to learn lessons to prevent them re-occurring. Premises and equipment safety was maintained to ensure the home environment was safe.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported with maintaining their health and nutrition. The service worked in collaboration with health care professionals to ensure people’s health needs were met. People were encouraged to maintain their independence as much as they could.

Staff were kind and caring towards people. Staff understood the importance of promoting equality and diversity. People’s privacy was respected. Staff knew how to communicate with people who had difficulty speaking.

Activities took place in the home and people were encouraged to participate in them if they wished. Staff interacted and engaged with people throughout the day and people were not made to feel isolated.

Staff were provided with suitable training to ensure their skills and knowledge were up to date. Staff felt supported by the management team. They received supervision to monitor their performance.

People and their relatives were supported to make complaints about the home. There were quality assurance systems to monitor the safety of the home through audits and obtaining feedback from people and relatives.

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 26 September 2017). After our last inspection, the home was transferred to a new provider but they retained their rating.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Hornchurch Care Home is registered to provide nursing care for 55 older people some of whom may have dementia or palliative care needs. On the day of our inspection, 51 people were using the service.

At our last inspection on 17 August 2016, we found the provider at the time did not meet legal requirements to ensure the service was safe because there was not always enough staff on duty, people's care needs were not being met on time and records were not always up to date. The provider wrote to us to let us know what action they were taking to meet these requirements. However, since our previous inspection, the service transferred to a new provider. This was the first inspection under the new provider.

We saw that improvements had been made and the service was now safe. There were enough staff working in the service to meet people’s needs during the day and at night.

The service had a registered manager in post. 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.

People told us they felt safe living at Hornchurch Care Home. The service has three units, with people living on a unit that was best equipped to meet their needs.

The premises were safe, clean and regularly maintained. The registered manager had arranged for refurbishments to be carried out externally and internally, including a new outdoor garden patio and a therapeutic indoor sensory garden.

Risks to people were identified and managed to ensure they remained safe.

Staff received training on how to keep people safe and were able to describe the actions they would take if they had any concerns about people’s safety. The provider also had a whistleblowing policy which staff were aware of and they knew how to report on concerns they had.

The provider had safe recruitment procedures in place and carried out checks on new employees.

Staff were supported with regular training, meetings and supervision. Staff work performance was reviewed on a yearly basis and they were encouraged to develop their skills.

The provider had systems in place to support people who lacked capacity to make decisions for themselves. Staff received training in the Mental Capacity Act 2005 and were knowledgeable of the processes involved in assessing people’s capacity.

Staff ensured people had access to appropriate healthcare when needed and their nutritional needs were met.

Staff were aware of people’s preferences, likes and dislikes. People were treated with dignity and their choices were respected.

People received personalised care and support, to ensure their individual needs were met. They were encouraged to participate in activities and remain as independent as possible.

People and relatives were able to make complaints and have them investigated. Disciplinary action was taken by the registered manager when required to ensure staff conducted themselves appropriately.

Staff felt supported by the management team. The registered manager had systems in place to monitor the quality of the service provided to people. They were supported by regional managers and they worked well together to ensure improvements were made.