Hamble Heights

Updated 31 October 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors carried out the inspection with the support of a registered nurse and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Hamble Heights is a ‘care home’. People in care homes receive accommodation and nursing and personal care as a single package under one contractual agreement dependent on their registration with us. Hamble Heights 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 in post. A new manager had been in post for 4 months and had submitted an application to register. We are currently assessing this application.

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. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people and 3 relatives who used the service about their experience of the care provided. We spoke with 12 members of staff including the manager, deputy manager, clinical lead, operations manager, maintenance manager, head of quality, clinical manager, registered nurses, care practitioner and the chef.

We reviewed a range of records. These included 6 people’s care records and multiple medication records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from 15 relatives. We also received feedback from 2 health and care professionals.

Updated 31 October 2023

About the service

Hamble Heights is a nursing home providing personal and nursing care to up to 60 people. The service provides support to older people some of whom may be living with dementia. At the time of our inspection there were 46 people using the service. Hamble Heights provides care for people over 4 floors, each floor providing specialist care to people living with different needs, for example, one floor delivers specialist dementia care and another residential care.

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

People using the service were not always kept safe. We could not be assured risks associated with people’s needs were always assessed appropriately or managed. A lack of robust record keeping meant we could not be assured people were getting enough daily fluids and being repositioned in line with their care plan.

We could not be assured risks associated with people’s needs were always assessed appropriately or managed. Care plans sometimes lacked information to keep people safe.

Environmental risks were not always managed effectively; Staff did not have regular fire evacuations to keep people safe. Peoples risk assessments were sometimes missing key information to keep them safe and to support staff.

Medicines administration records (MAR) confirmed people had received their medicines as prescribed. However, we found some concerns with medicines that wasn’t always safe. The service has since put in some measures to improve medicines. Health professionals felt people were not always kept safe as improvements were required to meet people’s clinical needs, especially around pressure area care.

Governance systems were not always effective in promoting a person-centred culture. A new manager was in place and was working to ensure new systems were in place and effective and was getting to know people at the service. There were systems in place to monitor the quality and safety of the service provided, however these were not always effective in identifying areas for improvement or where safety had been compromised.

Relevant recruitment checks were not always completed. For one staff member there were gaps in their employment history which meant the service could not check the staff members employment history to make sure they were of good character and had the necessary skills. Staff received support and one to one sessions or supervision to discuss areas of development. They completed training but some further clinical training was required. Systems were in place to protect people from abuse. Sufficient staff were deployed to meet people's needs.

People were supported with their nutritional needs. People received varied meals including a choice of fresh food and drinks. Staff knew people well and treated people with kindness and compassion

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.

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 January 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last 3 consecutive inspections. We will describe what we will do about the repeat requires improvement in the follow up section below.

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 the provider remained in breach of some regulations.

Why we inspected

The inspection was prompted in part due to concerns received about poor pressure care, lack of fluids and staffing. 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.

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 based on the findings of this inspection.

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

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and governance at this inspection.

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

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.