Haughgate House Nursing Home

Haughate House Nursing Home is a residential care home providing personal and nursing care for up to 42 people. The service provides support to older people. At the time of our inspection there were 27 people using the service. Haughgate House Nursing Home provides care in one adapted building.

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

People were happy living at Haughate House Nursing Home and spoke positively about the care they received and the running of the service.

We received mixed views from people and relatives whether there were enough staff to meet people’s needs. Most staff told us there were enough staff. During our inspection we observed that staff were visible in the service. The manager and the service development and regulation director told us they were actively recruiting new staff.

People were protected from avoidable harm because there was effective staff training and safeguarding policies in place. 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; the policies and systems in the service supported this practice.

Staff received appropriate training and support to enable them to carry out their role safely. They received regular supervision to help develop their skills and support them in their role.

People's needs were met in a personalised way. Staff knew the people they supported well and had a good understanding of their needs. People were supported to take part in a range of activities which took place inside and outside the service.

Effective and robust quality assurance systems had been developed and implemented to continually assess, monitor and improve the quality of care people received.

Throughout the inspection the management team showed a commitment to provide people with person centered, safe and effective care. They were open, transparent and responsive to our requests throughout the inspection.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 20 December 2021).

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 inspection was prompted by a review of the information we held about this service and to follow up on action we told the provider to take at the last 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 requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Haughgate House Nursing Home on our website at www.cqc.org.uk.

Follow up

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

Haughgate House Nursing Home is a care home providing personal and nursing care for up to 42 older people in one adapted building. At the time of our inspection there were 29 people living in the service

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

The service had experienced a high turnover of staff and challenges recruiting both care staff and nurses. As a result, there was a high level use of agency staff which people told us impacted on the quality of care they received. A number of incentives had been introduced to improve the ability to recruit and retain staff.

The provider’s governance systems in monitoring the quality and safety of the service were ineffective and did not identify the shortfalls we found at this inspection. Where we found people at risk from scalding hot radiators, this had not been identified in management audits.

Infection control processes were not robust. People were not sufficiently protected from the risks associated with the spread of infection, including from COVID-19 due to ineffective cleaning regimes. There were systems to support people to have visitors and a programme to test staff and people using the service.

The lack of management oversight meant some previously evidenced standards and regulatory compliance had not been maintained. We were not assured incidents were analysed effectively, and lessons were learned and applied to reduce the risks to people and ensure their safety.

People told us staff were kind.

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 15 April 2019).

Why we inspected

Prior to our inspection we received concerns about shortages of staff including a lack of permanently employed nurses and ineffective leadership. 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.

This report only covers our findings in relation to the Key Questions safe and well-led only.

We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Haughgate House on our website at www.cqc.org.uk.

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 discharge our regulatory enforcement functions required 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 risk management, infection control, health and safety and governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

¿ Haughgate House Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. This service provides provide nursing care. Haughgate House accommodates up to 31 older people in one adapted building. During our comprehensive unannounced inspection on 14 March 2019, there were 26 people using the service, some living with dementia.

The previous provider of Haughgate House Nursing Home was Haugh Care Limited. On 15 February 2018, Healthcare Homes Group took over as the new registered provider of Haughgate House Nursing Home.

People’s experience of using this service:

¿ Haughgate House Nursing Home provided a safe service to people.

¿ Systems were in place to help protect people from the risk of abuse and harm.

¿ There were enough trained and skilled staff to meet people’s needs. Recruitment processes were safe.

¿ Medicines were managed safely and were available when required.

¿ The environment was clean and staff followed good infection control practices.

¿ People were supported to access healthcare professionals when needed and had their nutritional and hydration needs met by staff who understood their dietary requirements.

¿ People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

¿ People were supported by compassionate and caring staff who knew them well.

¿ People were supported to be independent, their privacy was respected, and their dignity was maintained.

¿ People's end of life wishes were documented to ensure their wishes would be respected at the end stage of life and following their death.

¿ People were occupied with meaningful activity and had opportunities to maintain positive links with their community.

¿ There was a complaints procedure in place and people’s concerns were addressed

¿ There was an open culture in the service. People using the service, their representatives and staff were asked for their views about the service and these were valued and used in the ongoing improvement in the service.

¿ The service had systems to continuously monitor, assess and improve the service provided.

Rating at last inspection:

¿ This was the first inspection of the service.

Why we inspected:

¿ This was a planned inspection following registration in 15 February 2018.

Follow up:

¿ We will continue to monitor this service according to our inspection schedule.

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