Archived: Hatton Grange

Hatton Grange is a residential care home providing personal care to 69 people aged 65 and over at the time of the inspection. Care is provided over six separate units across three separate floors. Three units provided residential care and three specialised in providing care to people living with dementia. The service can support up to 70 people.

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

We observed there were sufficient staff to meet people’s care and support needs and staff knew people’s needs well. However, people and relatives did not always feel there was enough staff. The registered manager acknowledged that recruitment was an ongoing challenge and appropriate action was being taken to recruit staff. The risks to people were assessed and minimised and people were protected from the risk of abuse. People were supported to take their medicines as required and there were systems to ensure concerns were quickly identified and addressed. There were suitable systems for ensuring the home was clean and equipment was safe for use.

Staff worked very closely with other healthcare professionals to ensure that people had the right type of support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. There were mental capacity assessments in place and the right people were involved in best interested decisions for individuals who lacked capacity. The policies and systems in the home supported this practice.

People were positive about staff and told us they were kind and caring. Staff supported people to maintain their independence and encouraged people to remain mobile. Staff had a good understanding of people’s care needs, preferences and how to meet these. Staff spoke affectionately about the people they were supporting.

Care plans were detailed and provided guidance for staff to support people with their care and support needs. These records were maintained and updated as required. People felt able to raise any concerns and make complaints and these were addressed by the registered manager. Staff provided a range of activities and we observed that people engaged well with these activities.

People and their families were happy and felt the home was being well run. The registered manager completed a range of regular checks on the quality and safety of the service and was committed to driving improvement within the home. There were close working relationships with other organisations and opportunities for people, families, staff and other agencies to contribute to improving the quality of 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 requires improvement (published 20 October 2018).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

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.

At the time of the inspection Hatton Grange was accommodating 67 people in one building across 3 floors divided into six units. The service could support up to 30 people in their three specialist dementia units and 40 people within the residential care units.

The service had a registered manager in place. 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.

Hatton Grange has been registered to deliver care under the provider, Anchor Carehomes limited since 24 April 2017 and this was the first inspection of this home under this provider. The service had been previously inspected in September 2016 under the provider registration of Anchor Carehomes (Hyde) limited. At that time the service was rated as requires improvement in the safe and well led domains and good in the effective, caring and responsive. The service was rated as requires improvement overall. We identified one breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This related to the governance of the service as we had identified concerns relating to how the provider monitored risks relating to the health and safety of people using the service. We also made a recommendation about staffing levels.

At this inspection we looked to see if the required improvements had been made. We found that maintenance tasks were carried out quickly, but concerns about safe staffing levels remained. This was identified as a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We identified a further breach in relation to the management and administration of medicines. You can see what action we told the provider to take at the back of the full version of the report.

At the time of the inspection we found there were not enough staff to meet people’s needs in a timely manner. We saw times when people were left for periods of time in the communal areas and heard many occasions where staff asked a person to wait a few minutes before they could attend to their care needs.

We found that medicines and medical equipment were not always stored securely when not in use, the registered manager took immediate action to remedy this. The service was in the process of changing how they supported people with administering their medicines and was changing from prefilled blister packs to boxed medication and electric medication administration records (eMARs). This had not yet been fully embedded, and errors were identified, the service had identified this prior to this inspection and appropriate action plans were in place.

The home was clean and tidy, however we found that there were rooms that should have been securely locked but were accessible to people. These were immediately resolved during inspection and action taken to reduce the risk of a repeat incident.

People were positive about the registered manager and the way the home was organised and managed. Staff told us they enjoyed working at the home and felt supported.

Recruitment procedures were in place which ensured staff were safely recruited. Staff received the training, support and supervision they needed to carry out their roles effectively.

Staff were aware of their responsibilities in safeguarding people from abuse and could demonstrate their understanding of the procedures to follow so that people were kept safe.

Individual and environmental risk assessments gave staff guidance on how to minimise and manage identified risks. Health and safety checks were carried out and equipment was maintained and serviced appropriately.

People had their nutritional needs met and had access to a range of health care professionals.

The requirements of the Mental Capacity Act 2005 were being met. 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 and their visitors spoke positively about the care and kindness shown by staff. They told us “Staff are very kind, very caring and helpful” and, “Nothing short of brilliant.” During the inspection we found that staff had a good understanding of people's likes and preferences. Staff offered assistance in a sensitive and unhurried manner.

Care records contained risk assessments and care plans that were person centred and detailed. There were a range of monitoring charts that were used depending on peoples’ support needs.

There was a range of activities on offer at the home and in the wider community. People were positive about activities and told us, “There is so much to do.”

People who used the service felt they were listened to and were involved in developing the service. There was a system for recording and dealing with any complaints and staff were clear about how to support people to do this.

Quality assurance systems were in place. Weekly, monthly and annual checks and audits were carried out by the registered manager and other managers of the service. These were used to assess, monitor and review the service.