CQC report explained · a nursing home
What the CQC found at Hampton Grange Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2019
Rated Requires Improvement; inspectors found people were generally safe, but governance and leadership still needed improvement.
This was an unannounced, focused inspection on 30 August 2019. Inspectors looked only at Safe and Well-led after concerns about moving and handling, staffing, risks and medicines. They spoke with people, relatives, staff and community professionals, and checked care, medicines, recruitment, incident and safety records.
The Safe rating improved from Requires Improvement to Good. People said they felt safe, risks were assessed, premises were checked, staff recruitment checks were completed and the home was clean. However, inspectors found unexplained gaps in records for topical medicines. They also reviewed a safeguarding incident record that did not explain the manager's review or why it had not initially been reported to the safeguarding team and CQC.
The Well-led rating remained Requires Improvement, so the overall rating also remained Requires Improvement. Quality checks had not found the recording problems. Staff described unclear leadership on some shifts, and inspectors saw confusion and delays during a lunchtime meal. Ratings for the other key questions were not assessed during this visit and were carried over from earlier inspections.
Risks were assessed
Inspectors found that risks linked to people's health, safety, nutrition, hydration, pressure care and mobility were assessed and kept under review.
“The risks to people's health, safety and welfare were assessed, recorded and kept under review.” from the report
Clean environment
The home was clean and hygienic. Staff had protective equipment and inspectors saw it being used appropriately.
“We found the home to be clean and hygienic throughout.” from the report
Staff knew how to report abuse
Staff understood how to recognise and report possible abuse and said they would raise concerns immediately.
“Staff understood how to recognise and report potential abuse involving the people who lived at the home.” from the report
Medicine records had gaps
needs fixingInspectors found unexplained gaps in records showing when topical medicines had been applied. This means the home's checks did not always show clearly what care had been given.
“people's topical medication application records contained unexplained gaps in recording.” from the report
Incident review was incomplete
seriousA record of a potential safeguarding incident did not explain the manager's review or why it had not initially been reported to the safeguarding team and CQC. The manager contacted the safeguarding team after the inspection.
“This report contained no details of the registered manager's review, or their rationale for not reporting this incident to the local safeguarding team and CQC.” from the report
Quality checks were not effective
seriousThe provider's audits had not identified or corrected the incomplete medicine and incident records. This was a continued breach of Regulation 17.
“The provider's quality assurance systems and processes were still not as effective as they needed to be.” from the report
Unclear leadership on shifts
needs fixingFour staff reported a lack of clear leadership and direction. Inspectors also saw confusion about meals and some people waited significantly longer than others.
“Four of the staff we spoke with raised concerns about a lack of clear leadership and direction on shift” from the report
- 01What changes have been made to ensure topical medicine records are complete every time?
- 02How are safeguarding incidents now reviewed, recorded and reported to the local safeguarding team and CQC?
- 03Who provides clear leadership and direction on each shift, and has the recruitment of team leaders been completed?
- 04What evidence can you show that your quality checks now identify and correct problems promptly?
- 05What are the current ratings and improvements for Effective, Caring and Responsive, which were not inspected during this visit?
This was a focused inspection of Safe and Well-led only; the other key questions were not inspected and their previous ratings were used in 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.
What inspectors found, April 2019
Rated Requires Improvement; inspectors found kind and effective care, but staffing, personalised care and management needed urgent improvement.
This was an unannounced planned inspection on 20 February 2019. Two inspectors observed care, spoke with people, relatives, staff and managers, and checked care files, medicines, staffing records, complaints, recruitment and quality audits.
The home was rated Good for Effective and Caring. Inspectors found that people generally received kind care, were treated with dignity, had their health and nutrition needs assessed, and received safe medicines support from trained staff.
The home was rated Requires Improvement for Safe, Responsive and Well-led. Concerns included heavy reliance on agency staff, possible delays in care, inconsistent personalised support, weak quality checks and no registered manager in post. The overall rating stayed Requires Improvement, as it had been at the previous inspection and for the last three inspections.
Kind and respectful care
Inspectors found that staff treated people with kindness, respect and dignity. Staff supported people's privacy and encouraged everyday choices.
“Staff delivered people's care and support in a kind and compassionate manner.” from the report
Medicines managed safely
Nurses and trained staff administered medicines safely. Records were up to date and improvements had been made with topical medicines.
“Up-to-date and accurate records were maintained in relation to the administration of people's medicines.” from the report
Staff training
New and agency staff received induction, and staff had ongoing training and supervision to support their work.
“Staff received a range of training to give them the knowledge and skills needed to work safely and effectively.” from the report
Food and activities
People could choose what to eat and drink, received support with dietary needs and had opportunities for regular activities.
“Staff promoted a positive, unrushed mealtime experience.” from the report
Agency staffing and deployment
seriousThe home relied heavily on agency staff, and inspectors were not assured that the mix of skills and experience was right. Relatives and staff reported shortages, delays and poor monitoring of one communal area.
“We were not assured staff always had the right mix of skills, knowledge and experience to meet people's needs.” from the report
Inconsistent personalised care
seriousChanges in staffing meant some people experienced delays and care that was less familiar or personalised. Inspectors found this was a continued breach of Regulation 9.
“The provider had failed to ensure people received consistent personalised care and support that met their needs.” from the report
Weak management oversight
seriousQuality checks had not identified or resolved the staffing and personalised care problems. Regulation 17 remained breached, and there was no registered manager in post at the inspection.
“The provider's governance and quality assurance systems and processes were not as effective as they needed to be.” from the report
Gaps in repositioning records
needs fixingRecords of support with repositioning had improved but still contained unexplained gaps. This means the home could not always clearly show that this support had been recorded.
“Records of people's support with repositioning had improved, but still contained some unexplained gaps in recording.” from the report
- 01How many permanent care staff are now working on each shift, and how often are agency staff used?
- 02How do you make sure agency staff understand each person's care needs, preferences and communication needs?
- 03What has been done to prevent delays in helping people with toileting and other personal care?
- 04How do you monitor the ground-floor communal lounge so that people are consistently observed and supported?
- 05What progress has been made with the monthly reports and with appointing a registered manager?
This was an unannounced comprehensive inspection covering all five key questions, including both the premises and the care provided. This explanation was written from the published report of 18 April 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 Hampton Grange Nursing Home
5 rated inspections over 3 years: the service has held its Requires improvement rating throughout.
- October 2019Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- February 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- May 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2017Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2015
Registered with the Care Quality Commission on 17 December 2015.
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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11 live-in carers within about an hour of Herefordshire, County of
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £960 to £1,410 a week. 10 can care for a couple. 8 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.