Hamilton House

Updated 8 March 2023

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.

Inspection team

The inspection was completed by 1 inspector 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.

Service and service type

Hamilton House 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 House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the 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 3 people who used the service and 1 relative about their experience of the service. We also observed staff engagement with people and spoke with additional people informally during the inspection days.

We spoke with the registered manager, deputy manager, and 5 support workers. We reviewed a range of records. This included four people's care records and numerous medication records. We looked at 3 staff files in relation to recruitment. Plus, a variety of records relating to the management of the service, including the staff rota, training and supervision matrix, audits and checks on quality and safety and meeting records.

After the inspection we spoke with a healthcare professional about their experience about the service.

Updated 8 March 2023

About the service

Hamilton House provides accommodation and personal care for up to 19 adults with mental health needs, including alcohol and substance misuse. There were 17 people using the service at the time of the inspection. The property spans over two converted houses, with all areas being accessible to people using the service.

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

People were protected from abuse and avoidable harm. People said they felt safe living at Hamilton House and knew how to raise any safeguarding concerns.

There were sufficient staff available to effectively meet people’s needs and they had been recruited safely. People said staff were always available when they needed them.

Risks associated with people’s care and support needs had been assessed and planned for. Staff had a positive and supportive approach with how known risks were managed. Health and safety checks of the environment and premises were regularly completed.

People were well supported with their prescribed medicines. Medicines were managed and stored safely.

The home was clean and hygienic. Improvements had been made to the environment, including redecoration and new flooring and this was ongoing. People had a choice of communal rooms and a safe and secure external rear garden with a smoking shelter and seating.

Before people moved to Hamilton House, they had an assessment of their care and support needs completed and were invited to visit the home. The provider had policies and procedures that reflected current legislation and best practice guidance.

People were supported by staff who were trained and supported. People were positive about the care and support they received and were confident staff understood their individual needs.

People received choices of meals and had continuous access to hot and cold drinks. People said they were happy with the meal choices and they received sufficient to eat and drink.

Health care needs were known and understood and monitored by staff. People said how staff supported them to attend health appointments if this was required. Positive feedback was received from a health care professional in how staff supported people with their health and welfare needs.

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.

New and improved systems and processes that assessed, monitored and reviewed safety and quality had been implemented. The provider had a service improvement plan to support further development and improvements.

People, relatives and staff received opportunities to share their experience of the service. People were positive about living at Hamilton House. Staff said they felt the management team were supportive.

There was a positive staff culture. Staff were kind, caring and compassionate. Staff understood and practiced the provider’s values. People were supported to achieve positive outcomes. This included developing their independence to enable them to live a more independent life in the community.

The staff worked well with external health and social care professionals. Positive feedback was received about how well staff supported and advocated for people and how care and support was person centred.

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 Requires Improvement (published 25 May 2022) and there were breaches 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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced focussed inspection of this service on 8 and 9 March 2022. Two breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the support for staff.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. We also checked whether the Warning Notice we previously served in relation to Regulation 17 Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

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.

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 Requires Improvement to Good, this is based on the findings at this inspection.

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

Follow up

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