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Inspection Summary

Overall summary & rating


Updated 12 December 2018

This was an unannounced inspection that took place on 1 November 2018. We returned announced on the 8 November 2018 to complete our inspection.

At our previous inspection on 4 May 2017 we found that people’s risk assessments and the provider’s quality assurance system needed improvement. These were breaches of Regulation 12 Safe care and treatment and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Good governance.

Following this inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions ‘Is the service safe?’ and ‘Is the service well-led’ to at least ‘Good’. At this inspection we found the provider had followed their action plan and was now compliant in these areas.

Hamilton House provides accommodation and personal care for up to 19 adults with mental health needs. There were 15 people living in the home at the time of the inspection.

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

Hamilton House has a registered manager. This 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 felt safe at Hamilton House. Staff were trained in safeguarding and understood their responsibilities to protect people from harm. Records showed that If concerns arose about a person’s safety staff worked with the local authority and other agencies, where appropriate, to protect the person from harm.

The home had enough staff to support people to stay safe and meet their needs. Staff were available in the home during the day and at night times. If people needed extra support, for example to attend appointments or if they were unwell, extra staff were put on duty.

The provider had acted to reduce the risk of scalding and accidents at the home. Some individual risk assessments still needed to be put in place.

Medicines were well-managed and staff were aware of people’s healthcare needs and knew what to do in an emergency.

People received personalised care that was responsive to their needs. People who were moving towards independent living were supported to acquire the skills they needed to do this. Care plans were regularly reviewed and records showed people making progress towards their goals.

People said the staff was well-trained and knowledgeable. Staff told us they received thorough and varied training. We observed staff supporting people in a skilful and effective manner, providing personal care, company and reassurance where necessary.

People said they were happy with the food served. They said staff encouraged them to eat and drink enough, maintain a healthy diet, and cook for themselves. The home catered for a range of diets. Staff supported people to make healthy food choices where possible.

People could take part in individual and/or group activities if they wanted to. Some of the people using the service had created an attractive garden feature with fish and plants. Other group activities included charity fundraising, exercise on the park, and film nights. Individual activities included health promotion courses, accessing community facilities, and taking part in cultural events.

The premises were spacious and had a choice of lounges and other communal areas. The home was clean and free of clutter. People with reduced mobility had bedrooms on the ground floor to make access easier for them. There was an outside covered smoking area which was popular with people who liked to smoke.

The staff team was established and people and staff had the

Inspection areas


Requires improvement

Updated 12 December 2018

This service was mostly safe.

There were systems in place to protect people from the risk of harm and staff were knowledgeable about these.

Some people did not have all the risk assessments they needed in place.

There were enough staff on duty to keep people safe and staff were safely recruited.

People were supported to take their medicines safely and the provider was committed to reviewing and learning from accidents and incidents.



Updated 12 December 2018

The service was effective.

People's needs were assessed and met by staff who were skilled and had completed the training they needed to provide effective care.

People were supported to maintain their health and well-being, and, where required, with their meals and drinks.

Staff understood the principles of the Mental Capacity Act 2005, including gaining consent to care and people's right to decline their care.



Updated 12 December 2018

The service was caring.

The staff were caring and kind and understood the importance of building good relationships with the people they supported.

People were encouraged to express their views and be actively involved in making decisions about their care and support

Staff supported people to be independent and to make choices. People�s privacy and dignity was respected.



Updated 12 December 2018

This service was responsive.

People were supported to be involved in the planning of their care. They were provided with support and information to make decisions and choices about how their care was provided.

A complaints policy was in place and information readily available to raise concerns. People knew how to complain if they needed to.



Updated 12 December 2018

This service was well-led

There was clear leadership and management of the service which ensured staff received the support they needed to provide good care.

Feedback from people and staff used to drive improvements and develop the service. People�s diverse needs were recognised, respected and promoted.

Audits were completed regularly at the service to review the quality of care provided.