Hurstway Care Home

Updated 17 November 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

The inspection was completed by an inspector and a nurse specialist.

Service and service type

Hurstway Care 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. Hurstway Care Home 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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 was not a registered manager in post. A manager had been recruited but had not yet commenced the registration process.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 06 July 2022 and ended on 28 July 2022. We visited the service on 06 July 2022, 20 July 2022 and 21 July 2022.

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. 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 seven people using the service and five of their relatives. We spoke with 13 staff, including the manager, quality assurance manager, nominated individual, carers, senior carers, nurses and housekeeping staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We sought information from external professionals working with the staff team. We reviewed a range of documents including eight care plans and other records of care monitoring. We looked at multiple medication administration records. We reviewed policies and procedures and quality assurance checks and documentation. We reviewed three staff files. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 17 November 2022

About the service

Hurstway Care Home is a nursing home providing personal and nursing care to up to 42 people. The service provides support to older adults including those living with dementia. At the time of our inspection there were 29 people using the service. Hurstway Care Home is a purpose built home consisting of two separate floors. People have their own bedrooms and en-suite bathrooms. They have shared use of lounges, dining areas and a garden.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

Some hazards and health and safety issues around the home had not been identified or addressed. Monitoring of some people’s risks around weight loss and skin integrity was not robust. Some gaps in medicines administration records were found and stock counts were not always accurate. Staffing levels were appropriate to people’s needs.

Care plans lacked detailed guidance for staff around supporting people with some medical conditions. Some relatives told us they had not been involved in developing or reviewing people’s care plans. We saw some improvement in the personalisation of people’s rooms, but the home décor was tired and in need of redecoration and repair. People told us they enjoyed the food.

Systems and processes in place to monitor and identify risk were not always effective. In some cases risks had been identified but not addressed in a timely way. Relatives told us communication with staff was not always effective. Staff were positive about the new management team and the changes being introduced.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support 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 10 February 2022) and there was a breach of regulation. 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 regulations. This service has been rated requires improvement for the last three consecutive inspections and prior to that was rated inadequate.

Why we inspected

We undertook a targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about the management of skin health and the risk of pressure wounds. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern with the management of skin health and the risk of pressure wounds, so we widened the scope of the inspection to become a focused inspection which included the key questions of Safe, Effective and Well-Led.

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 full report. The provider took action to address the concerns identified during the inspection.

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.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to governance and management of safety and risk in the home 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 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.