CQC report explained · a residential care home
What the CQC found at Hammonds
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risks, medicines, staffing recruitment and infection control were generally managed well, although auditing of liquid medicines needed improvement.
- Effective?
- Requires improvement
- People did not always have enough involvement in choosing food and planning meals. The buildings, gardens and laundry facilities did not fully support independence, and care plans were not always up to date.
- Caring?
- Requires improvement
- Most staff were kind and compassionate, but inspectors saw people being spoken over and treated without enough dignity. Some people lacked keys, skill-building plans and consistent support to develop independence.
- Responsive?
- Requires improvement
- Person-centred planning and communication tools had improved. However, one-to-one activities were still limited, and more work was needed to plan meaningful activities and develop independent living skills.
- Well-led?
- Requires improvement
- Management had made some improvements, but the provider had not properly reviewed the culture, staffing deployment, layout or quality of people's experiences. The provider was in breach of Regulation 17.
What inspectors found, January 2023
Rated Requires Improvement; inspectors found people were generally safe, but dignity, choice, activities and service oversight were not consistent.
This was an unannounced inspection on 13 and 16 May 2022. Inspectors spoke with people, relatives, staff and health professionals. They observed care and reviewed care plans, medicines records, staff files and management records.
The home was rated Good for Safe. People were protected from abuse and avoidable harm, risks were assessed, medicines were generally managed safely and infection control was effective.
The other four areas were rated Requires Improvement. Inspectors found that people did not always have enough choice, independence or individual activities. Some staff did not protect people's dignity, agency staff did not always know people well, and the provider's checks had not identified or fixed important problems.
The overall rating remains Requires Improvement. The home had been rated Requires Improvement at the previous inspection, and it has received this rating for three consecutive inspections. The provider was no longer in breach of person-centred care rules, but remained in breach of dignity and respect and was also in breach of good governance.
People felt safe
People and relatives said they felt safe. Staff had safeguarding training and understood how to report concerns.
“People told us they felt safe. Relatives confirmed they felt their loved ones were safe.” from the report
Risk and medicines management
The home had risk assessments for complex health needs and used trained staff to administer medicines. Staff also followed principles intended to avoid unnecessary over-medication.
“People were supported by staff who followed systems and processes to administer, record and store medicines safely.” from the report
Health support
People had health plans and passports, and staff worked with health professionals. Communication tools were used to help people understand appointments and health needs.
“People received good quality health care, support and treatment because trained staff and specialists could meet their needs.” from the report
Some improvements in choice
The home had introduced person-centred planning tools and some people were gaining more opportunities to make choices and develop everyday skills.
“People had improved opportunities to take risks and develop independent living skills.” from the report
Dignity and privacy
seriousInspectors saw staff talking over people and discussing personal needs in shared areas. Some people did not have the opportunity to lock their own rooms, and personal care was not always finished respectfully.
“Not enough improvement had been made at this inspection and the provider was still in breach of regulation 10” from the report
Limited independence and activities
needs fixingPeople did not consistently have individual activities, skill-building plans or enough support to take part in everyday tasks. Staffing levels and the service layout reduced these opportunities.
“Staff were trying to be more focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life, some work had begun with some people but we were told there were not enough staff to provide this support consistently for everyone.” from the report
Buildings and shared spaces
needs fixingSome shared bathrooms, kitchens, gardens and laundry facilities limited people's independence. Parts of the garden were inaccessible or unkempt, and the home remained institutional in layout.
“The shared garden and courtyard areas were unkempt and not all areas were accessible to people.” from the report
Weak quality oversight
seriousThe provider had not fully assessed or monitored the quality of people's experiences, staffing needs or the effect of the layout. This was a breach of Regulation 17.
“The provider failed to assess, monitor and improve the quality and safety of the services provided including the quality of the experience of people in receiving those services” from the report
Inconsistent communication
needs fixingSome health professionals and relatives reported poor or inconsistent communication. Agency staff did not always know people well, which affected consistency of support.
“There have been occasions where meetings have been organised with Hammonds [online and face to face] and no members of staff attended or had to be chased to attend” from the report
- 01What specific steps and timescales are in place to fix the continuing dignity and respect breach?
- 02How will you make sure each person can have privacy and use an accessible way to lock their room if they want to?
- 03How many permanent staff posts are now filled, and how will you reduce reliance on agency staff?
- 04How will you provide regular one-to-one activities and skill-building support for my relative?
- 05What is the current plan and timetable for improving the gardens, shared spaces, kitchens and laundry facilities?
This was an unannounced inspection covering all five CQC key questions, carried out to assess how the home applied the Right support, right care, right culture principles. This explanation was written from the published report of 5 January 2023 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, September 2019
Rated Requires Improvement; inspectors found safe and effective care, but concerns about dignity, communication, activities and management remained.
This was a planned, unannounced inspection on 20 August 2019. Inspectors observed care, spoke with people, relatives, an advocate and staff, and checked care plans, medicines, staff records and management information.
The home was rated Good for Safe and Effective. Medicines, risk assessments, safeguarding, staffing, staff training, food, healthcare and consent arrangements had improved or worked well.
The home was rated Requires Improvement for Caring, Responsive and Well-led. People were not always treated with dignity, supported to communicate, helped to develop independence or offered activities based on their own interests. Care plans did not show people's involvement clearly enough.
The overall rating stayed Requires Improvement. The home had improved enough to address the previous breach, but inspectors found two new breaches concerning person-centred care and dignity and respect. The home had received this rating at the last two inspections.
Safe medicines
The home had reliable systems for ordering, giving, storing and disposing of medicines. Staff administering medicines were trained and their competence was checked annually.
“There were reliable arrangements for ordering, administering, storing and disposing of medicines.” from the report
Risk and safeguarding
People had detailed risk assessments and emergency evacuation plans. Staff understood how to recognise and report abuse, and incidents were reviewed for learning.
“All staff had a good understanding of safeguarding procedures including the roles of outside agencies.” from the report
Health and nutrition
People were supported with food, drink, weight monitoring and healthcare appointments. Health passports were available for hospital visits.
“People were supported to access healthcare services in their local community and had been registered and treated by a team of healthcare professions.” from the report
Staff teamwork
Many staff had worked at the home for a long time. Staff said they felt supported and worked together effectively.
“All staff consistently knew people well and felt they worked well as a team.” from the report
Dignity and respect
seriousPeople were not always treated with dignity or supported compassionately. Inspectors saw a person's breakfast removed without the reason being explained, and people were not supported to change clothes after food was spilled.
“The provider failed to ensure people were treated with dignity and respect.” from the report
Communication support
needs fixingCare plans gave too little guidance for people with limited speech. Staff were not trained to use one person's Makaton, and there were not enough communication aids.
“There was a lack of evidence that the provider had done all that was reasonably possible to ensure people were supported in this area.” from the report
Individual activities and independence
needs fixingPeople had limited opportunities to build independence, take part in meaningful activities or follow their own interests. Some people stayed in their rooms without effective monitoring of social isolation.
“People had limited opportunity to take risks and develop independent living skills.” from the report
Involvement in care planning
needs fixingThe five care plans checked did not record people's involvement in planning or reviewing their care. Reviews did not show people's views.
“None of the five care plans sampled recorded people's involvement.” from the report
Inconsistent management
needs fixingAudits identified important shortfalls, but the home was not yet consistently providing an inclusive, person-centred experience. Staffing changes and agency reliance had affected outcomes.
“At the time of the inspection, the provider was not offering a person centred, inclusive experience for people where good outcomes could always be achieved.” from the report
- 01What has changed to make sure each person is involved in planning and reviewing their care?
- 02How will staff support people who use Makaton or other non-verbal communication methods?
- 03How are you helping each person develop independence, including mobility, cooking, shopping and other daily living skills?
- 04How do you make sure activities reflect each person's interests rather than mainly being group activities?
- 05What action has been taken to improve dignity and respectful responses when people are upset or make different choices?
This was a full inspection covering all five CQC questions, with care and the premises both examined; the visit was unannounced and followed the previous Requires Improvement rating. This explanation was written from the published report of 12 September 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 Hammonds
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- January 2023Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2019Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 19 November 2010.
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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