Hamilton House Care Home

Updated 14 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.

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 carried out by 2 inspectors over 2 days and an Expert by Experience on day 2 of the inspection. A second Expert by Experience made telephone calls to relatives after the inspection. 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 with 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 relatives, 8 people, and had informal chats with a further 10 people. about their experience of the care provided. 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.

We spoke with the registered manager, regional operations manager, deputy manager, care home assistant practitioner (CHAP), 3 carers, 2 activity co-ordinators, head housekeeper, chef and kitchen assistant.

We walked around the service and looked at the environment. We reviewed a range of records relating to people's care which included, multiple medicine records and 8 care plans. We reviewed 4 staff recruitment files and a further 6 staff files to review supervision and training records. A variety of records relating to the management of the service, including fire, health and safety, accident/incident reporting, safeguarding, audits, policies and procedures were reviewed, and others were requested.

Following the visit to the service we sought feedback from relatives, community professionals and continued to seek clarification from the registered manager. We received written feedback from 7 staff and spoke with 12 relatives.

Updated 14 March 2023

About the service

Hamilton House Care Home is a nursing home providing personal and nursing care for up to 46 people. At the time of the inspection there were 23 people using the service. The service was over 3 floors all accessed by a lift. Some bedrooms were en-suite and for those that were not, there were communal bathrooms and toilets available.

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

People and their relatives were happy with the care provided. They felt people got safe care and told us the registered manager had brought positive changes to the service.

Risks to people were identified and mitigated. Accidents and incidents were managed, and action taken to prevent reoccurrence. Systems were in place to manage infection control risks.

Safe medicine practice was promoted, and people’s health and nutritional needs were identified and met.

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.

Staff were suitably recruited, inducted, trained and supported in their roles. Sufficient staff were provided with less reliance on agency staff, which promoted continuity of care for people.

The service was clean and free from odours. Areas of the service had been refurbished with further improvements planned.

Staff were kind, caring and had a good knowledge of people. Staff were responsive to people’s needs.

Person centred care was provided, with people and their relatives involved in their care. Communication needs were identified, and end of life wishes sought. Access to activities had improved for people with further improvements planned. Systems were in place to manage concerns.

The service was suitably audited and well managed which resulted in improvements across the service. Records were suitably maintained, and organised. Systems were in place to get feedback from people and their relatives. Communication and teamwork had improved which resulted in positive outcomes for people.

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 inadequate (published 27 April 2022) and there were breaches of regulations. 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.

At our last inspection we recommended that the provider follow best practice in relation to safeguarding people, meeting people's hydration and nutrition needs and to promote people's privacy, dignity, choices and ensure they are treated with respect.

At this inspection we found the provider had acted on the recommendations and improvements had been made.

This service has been in Special Measures since 27 April 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 28 February, 1 and 15 March 2022. 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 safe care and treatment, staffing, need for consent, person centred care, good governance, premises and equipment and notifications to us.

We undertook this inspection to check they had followed their action plan and to confirm they now met legal 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.

The overall rating for the service has changed from inadequate to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hamilton House Care Home 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.