CQC report explained · a residential care home
What the CQC found at Hamilton's Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2022
Rated Requires Improvement; inspectors found kind care and enough staff, but safety, medicines and management checks were not reliable.
This was an unannounced inspection on 27 April 2022. The inspection was prompted partly by concerns about staffing and infection control. Inspectors spoke with people, relatives and staff, and reviewed care plans, medicines records, staff files and management records.
The home was not always safe. Staff did not always follow care plans for diabetes, constipation and other medical needs. Medicines records and stock checks were incomplete. Inspectors also found trip hazards from damaged flooring and no effective review of accidents to identify patterns.
People and relatives were generally positive about the care and said staff were kind, available and respectful. The home was clean, infection control arrangements were satisfactory, and staff understood safeguarding. The provider fixed some problems after the inspection, including damaged flooring and missing catheter care guidance.
The overall rating changed from Good to Requires Improvement. Safe and Well-led were both rated Requires Improvement. The other three key questions were not inspected, so their previous ratings were carried forward.
Kind and respectful care
People and relatives said staff were kind, respectful and caring. People said they felt safe and were happy living in the home.
“People and their relatives told us they were happy living at Hamilton's Residential Home.” from the report
Enough staff
People and staff told inspectors there were enough staff to meet people's needs. People said they did not have to wait for care and staff had time to talk.
“People told us there were sufficient numbers of staff to meet their needs and keep them safe.” from the report
Safeguarding awareness
Staff had safeguarding training and understood how and where to report concerns. The provider had worked with the local authority when concerns were raised.
“Staff had received training in safeguarding and knew how, and where to report concerns.” from the report
Infection control
Inspectors were assured about the home's infection prevention arrangements, including PPE, testing, cleaning and managing possible outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Changes after inspection
The provider responded to some findings after the visit. It supplied evidence that catheter guidance was added and damaged flooring was repaired.
“Following the inspection, the provider sent us evidence that the flooring had been repaired.” from the report
Medical care plans were incomplete or not followed
seriousStaff did not always follow guidance for diabetes care. There was also missing guidance for catheters and constipation, and staff records did not always show that needed action had been taken.
“Staff did not follow care plans to support people to manage diabetes care well.” from the report
Medicines records were not reliable
seriousSome as-needed medicines did not have clear instructions or records showing why they were given and whether they worked. Medicine stock counts and records were also incomplete.
“Medicines were not always managed safely.” from the report
Risks and accidents were not reviewed properly
seriousDamaged flooring created trip hazards. Accidents were recorded but not analysed for patterns, so the home could not identify whether repeated incidents needed different action.
“There was no oversight of accidents and incidents to use to identify patterns and trends.” from the report
Management checks missed problems
seriousAudits did not identify the flooring hazards, medicines problems, incomplete care plans or inaccurate weight records. This meant people could be placed at risk before problems were found.
“Governance and auditing systems had not been effective in identifying shortfalls highlighted during this inspection.” from the report
- 01How are you now checking that staff follow care plans for diabetes, constipation and catheter care?
- 02How do you record as-needed medicines, including why they were given and whether they worked?
- 03How often are medicine stock counts completed, and can you show that all medicines are reconciled?
- 04What system now checks for trip hazards and reviews accidents for repeated patterns?
- 05What action plan did you send to CQC, and what evidence can you show that the improvements have been sustained?
This was a focused inspection prompted by concerns about staffing and infection control; only Safe and Well-led were inspected, while the other ratings carried over from the previous inspection. This explanation was written from the published report of 9 June 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, March 2019
Rated Good; inspectors found safe, kind and responsive care, with some tired areas needing redecoration.
This was an unannounced inspection on 27 and 28 February 2019. The team spoke with people living at the home, relatives, staff and a health professional. They observed care and checked medicines, care records, staffing, complaints, accidents, safety checks and other records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People and relatives said they felt safe and that staff were kind. Inspectors found that medicines were given as prescribed, risks were managed, health needs were monitored and people were supported to access healthcare.
The home had improved since the previous inspection, when it was rated Requires Improvement. Window restrictors had been fitted, staffing had increased and earlier problems with medicines records and quality checks had been addressed. The report noted that some areas of the building were tired and would benefit from redecoration.
People felt safe
People and relatives said they felt safe. Inspectors found that risks were assessed and managed, and staff knew how to respond to safeguarding concerns.
“People were protected from risks and their health conditions were monitored to ensure that they remained well and signs of illness.” from the report
Kind and respectful care
Staff knew people well and treated them with dignity. They supported people to make choices and to do things for themselves where possible.
“This place is fabulous, it's like a home to me, they treat me like a family member and with respect. The staff are saints.” from the report
Activities and personal preferences
People were supported to enjoy activities such as music, puzzles and gardening. Care plans recorded people's preferences and communication needs.
“There was a lively atmosphere at the service and people were engaging in activities such as listening to and playing music and signing, others were completing puzzles and jigsaws.” from the report
Active quality checks
The manager and provider carried out regular checks and acted when they found problems. Feedback from people, relatives and staff was used to improve the service.
“There were regular audits of medicines, falls, care plans, risks assessment, health monitoring, health and safety and environmental concerns.” from the report
Some areas were tired
minorThe building was suitable for people's needs, but inspectors said some areas looked tired and would benefit from redecoration.
“Some areas were tired and would benefit from re-decoration.” from the report
- 01Which areas of the building were described as tired, and what redecoration has been completed or planned?
- 02How are medicines administration records checked now to make sure the earlier recording problems do not return?
- 03How are staffing levels decided, including one-to-one support and checks on people who cannot use the call bell?
- 04How are people's communication needs, preferences and activities kept up to date in their care plans?
- 05How will the home support my relative with end-of-life wishes when the time comes?
This unannounced scheduled inspection looked at all five CQC questions, including the care provided and the premises. This explanation was written from the published report of 14 March 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 Hamilton's Residential Home
8 rated inspections over 7 years: the service has improved, from Inadequate to Requires improvement.
- June 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- March 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2017Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- September 2016Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2015InadequateSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- May 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- November 2013
Registered with the Care Quality Commission on 7 November 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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Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
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