CQC report explained · a residential care home
What the CQC found at Hall Green Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that people were protected from avoidable harm. Staffing, medicines, safeguarding, equipment checks and incident learning were managed safely.
- Effective?
- Good
- This key question was not inspected during this focused visit, so the report gives no new rating for it.
- Caring?
- Good
- This key question was not inspected during this focused visit, so the report gives no new rating for it.
- Responsive?
- Good
- This key question was not inspected during this focused visit, so the report gives no new rating for it.
- Well-led?
- Good
- Inspectors found effective governance, visible and approachable management, and staff who understood their responsibilities. People, relatives and staff were involved in improving the service.
What inspectors found, May 2022
Rated Good; inspectors found safe, well-managed care, with minor issues about mask use and relatives' meetings.
This was an unannounced focused inspection. Two inspectors visited on 7 and 13 April 2022, and the inspection activity ended on 14 April. They spoke with people living at the home, staff and relatives. They also checked care, medicines, recruitment and management records.
The home was rated Good for Safe and Well-led. Inspectors found enough suitably trained staff, safe medicines practice, suitable safeguarding arrangements and effective checks on the quality of care. People and relatives said people felt safe, and staff were described as supportive.
There were some minor issues. A few staff were not wearing masks correctly during the first visit, but this was corrected by the second visit. Relatives' meetings had not recently taken place because of COVID-19 concerns, although plans were in place to restart them.
The overall rating improved from Requires Improvement at the previous inspection in October 2019 to Good. This visit only examined Safe and Well-led, so the other areas were not reassessed in this report.
Safe staffing
There were enough staff, and their numbers and skills matched the needs of the people living at the home. Recruitment checks and induction also supported safety.
“The numbers and skills of staff matched the needs of people using the service.” from the report
Medicines
Medicines were prescribed, given, recorded and stored safely. Staff received training and checks on medicines practice.
“People were supported by staff who followed systems and processes to prescribe, administer, record and store medicines safely.” from the report
Strong management
Managers had oversight of care and used governance checks to monitor quality, risks and staff responsibilities.
“Governance processes were effective and helped to hold staff to account, keep people safe, protect people's rights and provide good quality care and support.” from the report
Learning from incidents
The home reported and investigated incidents and shared lessons so that care could be made safer.
“Managers investigated incidents and shared lessons learned.” from the report
Mask use
minorDuring the first visit, a few staff had masks below their noses. Managers reminded staff about the guidance, and masks were being worn correctly at the second visit.
“During the first site visit we saw a few staff whose masks had slipped beneath their noses.” from the report
Relatives' meetings
minorThere had been no recent relatives' meetings because of concern about COVID-19 transmission in larger groups. The home said it planned to restart them.
“There had not been any recent meetings for relatives due to concern about COVID-19 transmission risk for larger groups.” from the report
- 01How do you make sure all staff wear masks correctly and follow infection-control guidance?
- 02When did relatives' meetings restart, and how can families give feedback now?
- 03How do you obtain enough information quickly when someone is newly admitted to the Enhanced Assessment Beds area?
- 04How are people and relatives involved in decisions about floor sensors and other restrictions?
- 05What improvements have been made since the previous Requires Improvement inspection, and how are they being checked?
This was a focused inspection of Safe and Well-led only; the other key questions were not inspected and the overall rating used the previous ratings for those areas. This explanation was written from the published report of 12 May 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2019
Rated Requires Improvement; inspectors found improvements in medicines and staff support, but safety and management systems still needed time to become consistent.
This was an unannounced, focused inspection on 18 September 2019. One inspector looked at medication and care records for five people, spoke with four people and four staff, and reviewed the home's monitoring systems.
The home was rated Good for Effective. People had detailed assessments, were supported to access health professionals, and received food, drink and care suited to their needs. The home was also working within the Mental Capacity Act and had completed the required authorisations.
Safe and Well-led were both rated Requires Improvement. Medicines were managed more safely than at the previous inspection, and the home was no longer in breach of regulations. However, the CQC said the improvements needed to become consistent over time.
The overall rating remained Requires Improvement. Caring and Responsive were not assessed during this focused inspection, so their previous ratings were carried forward into the overall rating.
Improved medicines support
Medicines were stored safely and given at the right time. Staff explained medicines to people, and records and audits showed no errors since the previous inspection.
“We saw that the administration of medicines was working well, and concerns raised at the last inspection had been addressed.” from the report
Enough trained staff
The home used a dependency tool to decide staffing levels. Staff had recruitment checks, training and the skills needed to support people.
“People were supported by staff who were trained, recruited safely and had the skills to meet people's needs.” from the report
Respectful care
People were involved in decisions about their care and their preferences were respected, including preferences about staff support.
“People were supported by staff who were caring. People were involved in decisions around their care and were treated with respect and dignity.” from the report
Better staff and management support
Senior care staff had received extra training for management duties. Staff said they felt more confident and supported.
“Staff told us that the changes that had been made had improved the service and they felt more confident and supported in their role.” from the report
Systems not fully consistent
needs fixingThe newer medicines systems were working better but were still at an early stage. The CQC wanted them to be fully embedded so practice stayed consistent.
“Although improvements had been made, the systems in place need to be fully embedded to ensure consistency.” from the report
Management needed more time to improve
needs fixingThe CQC found that leadership and the culture created by managers did not always support high-quality person-centred care. The rating could not be raised until good practice was consistent over time.
“This meant the service management and leadership was inconsistent, leaders and the culture they created did not always support the delivery of high -quality person centred care.” from the report
Garden work was unfinished
minorImprovements to the enclosed garden were still being planned. A small safe area was available while the work had not been completed.
“At this inspection the registered manager was in the process of getting quotes for the renovation of the outside area.” from the report
- 01How have you kept the new medicine systems consistent since the inspection?
- 02How do you check that medicine records remain accurate and that PRN and covert medicines are given as planned?
- 03What further changes have been made to management and quality monitoring since the CQC inspection?
- 04Has the enclosed garden renovation been completed, and what areas can residents use now?
- 05What were the previous ratings for Caring and Responsive, and when will these areas next be assessed?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 25 October 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Hall Green Care Home
5 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- May 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- September 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- May 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- June 2013
Registered with the Care Quality Commission on 13 June 2013.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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