Archived: The Hornchurch Care Home

Updated 28 September 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection took place on 26 July and 14 August 2016 and was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the home and to provide a rating under the Care Act 2014.

Before our inspection, we reviewed the information we held about the home. This included the last inspection report for March 2014. We spoke to the local contracts and commissioning team that had placements at the home. We also reviewed notifications, safeguarding alerts and monitoring information from the local authority.

We also reviewed the provider information return (PIR). The PIR is a form that asks the provider to give some key information about the home, what the home does well and improvements they plan to make. The PIR also provides data about the organisation and service.

The inspection team consisted of one adult social care inspector, a brain injury and dementia nursing specialist 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.

During our inspection we observed how the staff interacted with people and how they were supported. We viewed people’s bedrooms with their permission. We spoke with 17 people who were using the service and four relatives. We spoke with four care staff, a registered nurse, the registered manager, the deputy care manager, a regional support manager, a clinical lead and a training officer.

We looked at six care files, staff duty rosters, six staff files, a range of audits, minutes for various meetings, medicine records, accidents and incidents records, training information, safeguarding information, health and safety folder and policies and procedures for the home.

Updated 28 September 2016

We inspected Hornchurch Care Home on 26 July 2016 and 17 August 2016. This was an unannounced inspection.

Hornchurch Care Home is registered to provide accommodation, nursing and personal care for up to 55 older people, some of whom maybe living with dementia. At the time of the inspection, 45 people were living at the home. The home has three units, each for people with particular needs, such as people that required nursing and dementia care. There were approximately 15 to 20 people living on each unit.

We previously inspected Hornchurch Care Home in March 2014, when they met the Regulations we inspected.

The home had a registered manager in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the home. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the home is run. The registered manager was on leave on our first day of inspecting the home but we were able to speak with them when we visited the home again on 17 August.

Care staff understood their responsibilities to protect the people in their care. They were knowledgeable about how to protect people from abuse and from other risks to their health and welfare. Medicines were managed and handled safely for people. Arrangements were in place to keep people safe in the event of an emergency. The home followed their recruitment procedures to ensure staff were safe to provide care to people.

We were not assured that there was an adequate number of suitable and qualified care staff on duty to respond quickly to the needs of people living on some of the units, particular on days when the home was short of staff. Care staff told us that they did not have the support they needed to keep people safe. Some people complained that they had to wait for long periods before receiving personal care.

The environment within the home was safe and clear of any health and safety hazards. Infection control procedures were in place and equipment was used to safely move and transfer people. Staff undertook training and received supervision to support them to carry out their roles effectively. The registered manager and the staff team followed the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff training records showed they had attended training in MCA and DoLS. People were supported to maintain good health and had access to health care services when it was needed.

People received a nutritionally balanced diet to maintain their health and wellbeing. People’s fluid intake and output was monitored but not always measured or recorded accurately. People’s needs were assessed. Their care and support was planned and delivered in line with their individual care needs. The care plans set out how each person should be supported to ensure their needs were met. Care plans were person centred but they were not always updated or reviewed when people's needs changed.

We observed that staff had positive and caring interactions with people living in the home. Staff respected people’s privacy and supported them to express their views. Some people did not feel their dignity was respected because they were not provided with personal care when they required it. People participated in activities, with the support of staff but some people felt lonely and isolated and did not have many things to do to occupy themselves. People did not feel they had the ability to make complaints and asked relatives to do so on their behalf. The home responded to complaints appropriately.

The home had a clear management structure in place. The registered manager was appointed six months prior to our inspection and we saw that they had taken steps to improve the safety and standard of the home. We noted that most of the home had recently been redecorated. People and staff told us they found the registered manager approachable and supportive. The registered manager demonstrated an understanding of their role and responsibilities. There were systems to routinely monitor the safety and quality of the home provided.

We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the back of the report.