The Care Quality Commission

Archived: Hamilton Lodge Nursing Home

36 Honor Oak Road, Forest Hill, London, SE23 3RZ (020) 8699 6080

Provided and run by:
Premiere Care (Southern) Limited

All Inspections

4 June 2013

During an inspection looking at part of the service

We found that some people had been harmed and other people and staff were at risk of harm because processes for safeguarding people's safety and welfare were not adequate. A manual hoist had been used when the battery operated hoists were not available for use and this had resulted in injuries to people using the service. The provider had not taken reasonable steps to prevent the harm caused by the hoist and had not responded appropriately by informing the local authority when the incidents occurred.

We found that people's needs had been assessed and there were recently dated care plans, accompanied by daily reports which recorded the care given during the day. However, risk assessments were not always updated to reflect current risks and needs.

We observed staff treating people with respect. Activities taking place were based on people's preferences and abilities.

Staff were accessing training, but staff training needs were not fully understood. Staff were having one-to-one meetings with their line manager.

There had been improvements to the management of medicines. There were improved systems in place to protect people using the service from the risk of financial abuse.

22 February 2013

During an inspection looking at part of the service

We used a number of different methods to help us understand the experiences of people using the service because some people were not able to tell us their experiences.

People told us they liked the staff. Care staff were starting the morning shift early and this meant people were able to get up at the time they wanted. One of them said 'I used to wait and wait and now I get up early'.

Staff demonstrated an understanding of people's needs and preferences and treated them with respect. However, the provider could not be sure the delivery of care was in line with people's current needs. Some people's health was at risk because monitoring information was not acted on.

There were appropriate systems in place for the storage of medicines, but some stock was out of date. We found some discrepancies in the administration and recording of medicines.

Staff felt well supported by the interim manager, but the frequent change in manager was disruptive. The provider could not be sure that all staff had received appropriate training. Nurses were not receiving supervision and support from a suitably qualified manager.

There were some improvements to the systems for monitoring the quality of the service. However, the checks on quality and safety were not always effective.

9 April 2013

During an inspection in response to concerns

We undertook a responsive inspection because of concerns raised by the Local Authority about the provider's management of the personal accounts of people using the service.

We looked at records of accounts and spoke to members of staff. We did not talk to people using the service on this occasion.

We found the provider did not have suitable arrangements in place to safeguard people using the service against financial abuse. The records of people's personal accounts were incomplete and inaccurate.

8 November 2012

During an inspection looking at part of the service

We used a number of different methods to help us understand the experiences of people using the service because some people were not able to tell us their experiences.

The people we spoke with said they were happy with the care they received. People said staff were kind and one person said 'I can't fault them, they're lovely'. We observed people receiving prompt attention from staff when they asked for something. A visitor to the home told us her relative received the care she needed to keep well.

Although people told us they were satisfied with their care, there was other evidence that people were not always protected against the risks of receiving inappropriate or unsafe care.

27 June 2012

During a routine inspection

There were 26 people living at Hamilton Lodge Nursing Home at the time of our visit. We spoke with six people and a relative who was visiting the home.

Some people told us that the staff 'work very hard' and pointed out particular members of staff that they knew well and who were helpful and kind to them. Another person said 'I like it here'.

One person told us that they do not like to be assisted by temporary members of staff because they did not know their needs and preferences. This person said that they are particularly unhappy when temporary staff assisted them at night time.

The visitor to the home said that there were more activities than before and her relative was spending more time with other people instead of sitting in their bedroom. One person said that they were assisted to go out recently, something which they had not done for a long time.

7 March 2012

During an inspection looking at part of the service

The people we spoke with said that their personal care needs were being met. However, people and their relatives said that there were few if any activities available in which to participate. We also observed that people received care in an environment where their personal records were not always fit for purpose.

23 November 2011

During an inspection looking at part of the service

People and their relatives said that they were well cared for by staff at the home. However, on the day of our visit, one person said that they were still waiting to receive personal care, though it was nearly mid-day. Another person said that they felt that at times there were not enough staff on duty.

12 January 2011

During an inspection in response to concerns

People we spoke to said they felt that they were able to make choices and found the home a pleasant place to live.

Relatives of people who live at Hamilton Lodge said that they were not always kept up to date with their relative's care and the changes in the home's management.

There had not been any relatives meetings 'for some time'.

People and relatives said that staff were kind and caring.

'Sometimes have to wait quite a long time' for a nurse or care assistant to provide personal care.

One person's relative said that 'there was a lack of activities' and 'they used to be good a providing activities for people'.

A person's relative stated that she had complained to staff that her relative's hands were not being kept clean and that this continued to be a problem.

There were 'not enough staff on duty'. 'Staff were sometimes not available when they were needed, particularly when'[the person]' wanted to go to the toilet'.

People were happy with the quality of food. One person stated that 'she enjoyed her lunch' and another said that their dietary needs had been taken into account. All of the people we spoke to said that they were provided with adequate refreshments throughout the day.