Hamilton's Residential Home

Updated 9 June 2022

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

This inspection was carried out by one inspector.

Service and service type

Hamilton’s Residential Home 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. Hamilton’s Residential Home is a care home without nursing care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with CQC to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there not a registered manager in post. The previous registered manager deregistered in January 2022. There was a new manager in post who had submitted an application to be registered with the CQC.

Notice of inspection

This inspection was unannounced.

What we did before 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 four people about their experience of the care provided. We spoke with six staff members including the provider, manager, senior carer and carers.

We reviewed a range of records. This included four people's care records and multiple medication records. We looked at two 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.

After the inspection We continued to seek clarification from the provider to validate evidence found. We looked at training data. We spoke with four relatives about their experience of the care provided.

Updated 9 June 2022

About the service

Hamilton’s Residential Home is a residential care home providing personal care to up to 17 older people, some of who were living with dementia. At the time of our inspection there were 15 people using the service.

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

People and their relatives told us they were happy living at Hamilton’s Residential Home. However, we found guidance was not in place for staff, to inform them how best to support people with their medical needs. In some cases, care plans were in place, but not followed putting people at risk of not receiving the care they needed. When accidents and incidents occurred, they were documented, but there was no analysis to look for patterns and trends.

Environmental risks such as rips in the flooring which could cause a trip hazard had not been identified by the provider. Medicines were not consistently managed safely; stock counts had not been completed on all medicines to ensure people had received their medicines as prescribed.

The provider and manager completed a series of checks and audits; however, these had not been effective in identifying and addressing issues highlighted in this inspection. Once issues were known the provider was responsive and implemented improvement and changes, for example putting catheter care plans in place, and fixing rips in the flooring.

People and staff told us there were sufficient numbers of staff to meet their needs. People told us they did not have to wait for care, and staff had time to chat with them. Staff understood their responsibilities around safeguarding and had received training. The service was clean.

People told us there was a positive culture within the service. Healthcare professionals and relatives were involved in supporting people to provide joined up care. 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

The last rating for this service was good (published 14 March 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service. The inspection was prompted in part due to concerns received about staffing and infection control. A decision was made for us to inspect and examine those risks. You can see what action we have asked the provider to take at the end of this full report. Following the inspection

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 changed from Good to Requires Improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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

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

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.