Hailsham House

Updated 15 February 2023

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 Health and Social Care Act 2008.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager. However, a manager had been recruited and was due to commence employment on the 30 January 2023 and due to register with the CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. The provider completed a Provider Information Return (PIR) in August 2022. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We reviewed documentation, inspected the safety of the premises and carried out observations in communal areas. We spoke with 15 people who used the service about their experiences of the care and support they received and ten visitors. We spoke with 12 members of staff including the regional manager, deputy manager, the Head of Quality & Governance, 3 registered nurses, maintenance people and care staff.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. This was undertaken in two of the three units.

We looked at a range of records. This included the care and medicine records for seven people and 4 staff files in relation to recruitment. Policies and procedures, environmental safety and information relating to the governance of the service were also reviewed. We also spoke with two relatives over the telephone.

Updated 15 February 2023

About the service

Hailsham House provides nursing care and accommodation for up to 90 people who live with a dementia type illness, for example, Korsokoffs disease or/and a mental health illness, such as Schizophrenia. The home also provides care and support for people with Huntingtons chorea and Creutzfeldt-Jakob disease The home is divided in to three units, (Holly, Willow and Orchard) each with their own lounge and dining areas. There were 62 people living in the service at the time of inspection.

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

The governance of the service had not supported the service to consistently improve and sustain improvement. Audit systems and processes whilst in place had failed to identify risks to people's safety and other aspects of the service that required improvement. Whilst improvements had been made in some areas since their last inspection, there were also repeated shortfalls in respect of pressure relieving equipment, management of covert medicines and aspects of health-related risk assessments. Additional concerns were identified during this inspection in relation to the risk assessment process for the call bell system and non-functioning lifts. There was a lack of clear and accurate records regarding some people's care and support. For example, diabetes and fluid support.

Risk management was an area identified as needing improvement to ensure peoples’ health and well-being was protected and promoted. We identified shortfalls in respect of the management of specific health problems. Staff practices regarding covert medicines needed to be further developed to ensure that staff follow the organisational policy for safe administration and recording of these medicines.

People received care and support from staff who had been appropriately recruited and trained to recognise signs of abuse or risk and understood what to do to safely support people. People were supported to take positive risks, to ensure they had as much choice and control of their lives as possible.

There were COVID-19 policies in place for visiting that was in line with government guidance. Families told us that they were welcomed into the home and followed the guidance currently in place.

Referrals were made appropriately to outside agencies when required. For example, GPs, community nurses and speech and language therapists (SALT). Notifications had been completed to inform CQC and other outside organisations when events occurred.

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 29 August 2019)

Why we inspected

This inspection was prompted due to information received of risk and concern in relation to staffing levels, communication and safeguarding concerns which had impacted on care delivery. We also used this opportunity to look at the breaches of Regulation 12 and 17 from the last inspection published in August 2019.

As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

The concerns raised were looked at during this inspection and have been reflected in the report. The provider took immediate action to mitigate risk to people.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led questions of this full report.

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

Enforcement

We have identified continued breaches in relation to safe care and treatment, staffing and good 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 continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.