Hamilton House

Hamilton House is a care home that can accommodate up to 36 people who require residential care. The home can provide care to people who might be living with dementia. Hamilton House is an older style property and is set out over three floors. At the time of the inspection 31 people were living at the home.

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

Medicines were managed safely, and people received their medicines as prescribed. The provider had made improvements to safe recruitment and risk management practices.

Staff regularly assessed the risks associated with people's care and well-being and took appropriate action to ensure the risks were managed and that people were safe.

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.

The service was well-led by a registered manager who was committed to improving people's quality of life. We received positive feedback about the management of the service.

The provider and registered manager had developed effective quality assurance processes which were used to improve people's care. The service had a clear management and staffing structure in place and staff worked well as a team. Staff worked well with external social and health care professionals.

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 2019).

At our last inspection we recommended the provider reviewed processes for recording risks associated with individual's emotional needs and learning from untoward events.

At our last inspection we recommended the provider introduced robust processes to protect people from the risks associated with being cared for by staff who are not suitable for the role.

The provider had acted on these recommendations and made improvements.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Follow up

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

Hamilton House is a residential care home and was providing personal care to 33 predominantly older people at the time of the inspection. The service can support up to 36 people. Hamilton House is an older style property and is set out over three floors.

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

People and their relatives were positive about the care and support at Hamilton House. They told us staff were friendly, approachable and skilled. One relative commented; “We got a good feeling as soon as we walked in.”

Hamilton House had been purchased by Darbyshire Care Limited and newly registered with the Care Quality Commission in September 2019. The provider had identified where improvements needed to be made in the service and developed an improvement plan. Some changes had already been introduced, others were planned for the future. Not all the changes to systems and working practices had been fully established and we will check on this at our next inspection.

There were enough staff employed to meet people’s needs. New staff had pre-employment checks before starting work. When requests for references were not successful there were no processes to help minimise any risk. We have made a recommendation about this in the report.

A system of induction and training helped ensure staff were able to support people according to their needs. A programme of more specific training was planned to develop staff skills and knowledge. Staff supervision sessions had lapsed, and this had been addressed at a recent staff meeting.

An electronic care planning system had recently been introduced and staff told us this was an improvement. Care records outlined people’s needs over a range of areas. These were supplemented by risk assessments; however, these did not always include guidance for staff on how to mitigate risk. We have made a recommendation about this in the report.

Senior staff had responsibility for managing and administering medicines. They had completed the relevant training but observations of practice to allow management to assess their competencies in this area were not being carried out. There were plans to address this in the future. An external healthcare professional had worked with the service to develop skills in medicine management.

Hamilton House was originally two houses and was spread over three floors. The layout was not easy to navigate and there was a lack of signage or use of colours to aid people living with dementia, to find their way around independently. We have made a recommendation about this in the report. Some furnishings had been replaced and additional signage was purchased immediately following the inspection.

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

This service was registered with us on 02/09/2019 and this is the first inspection. The last rating for this service was requires improvement (published 4 June 2019) and there were multiple breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. We imposed a condition requiring the provider to send us monthly action plans to evidence any improvements made. Since this rating was awarded the registered provider of the service has changed. The new provider continued to complete the action plan following the change to the registration. We have used the previous rating, and enforcement action taken, to inform our planning and decisions about the rating at this inspection.

Why we inspected

This inspection was carried out to follow up on action we told the previous provider to take following our last inspection.

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.