CQC report explained · a nursing home
What the CQC found at Haresbrook Park Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, January 2023
Haresbrook Park Care Home was rated Requires Improvement; inspectors found concerns with medicines, cleanliness, environmental safety and quality checks.
This was an unannounced focused inspection. Inspectors visited on 14 and 16 November 2022, spoke with people, relatives, staff and a health professional, observed care, and reviewed care, medicine, recruitment and management records.
The home was not always safe. Inspectors found inaccurate controlled drugs records, five out-of-date medicine competency checks, dirty areas and damaged chairs, and loose radiator covers that could have caused burns. The management team acted immediately on the medicine checks, returned surplus controlled drugs and fixed the radiator covers.
The home was also not always well-led because its checks had not found these problems. Staff were safely recruited and trained, understood safeguarding, and people and relatives were generally positive about staff. The overall rating fell from Good at the previous inspection to Requires Improvement.
Safeguarding
Staff had safeguarding training and knew how to recognise, report and record concerns about abuse.
“People were supported by staff who had received training in safeguarding people and understood the signs of abuse and how to raise concerns if they needed to.” from the report
Safe recruitment
Recruitment records showed that staff had been checked before supporting people at the home.
“Recruitment records evidenced staff had been recruited safely to ensure they were of good character to support vulnerable people.” from the report
Learning from incidents
Accidents and incidents were reviewed for patterns, and learning was shared with staff to reduce risks.
“Accidents and incidents were recorded and analysed monthly by the registered manager to identify any trends and themes.” from the report
Positive staff culture
Staff and relatives spoke positively about the management team and described staff as kind, caring and supportive.
“Relatives described staff as, "friendly," "welcoming," "kind" and "caring".” from the report
Medicine records
seriousControlled drugs records were not always accurate or up to date. Medicine audits had not identified the problem, although surplus drugs were returned and competency checks were brought up to date during the inspection.
“Record keeping of controlled drugs was not always accurate or kept up to date.” from the report
Medicine competency checks
seriousFive staff competency checks for giving medicines were out of date. This meant the provider had not assured itself that all staff remained competent.
“However, we found 5 staff competency checks were out of date.” from the report
Environmental safety
seriousSome radiator covers had come away from the wall and posed a possible burns risk. The management team arranged immediate action after inspectors raised this.
“Some had become detached from the wall, which posed a possible burns risk to people.” from the report
Cleanliness
needs fixingInspectors found some dirty chairs, damaged chair fabric exposing foam, and dirty floors in a bathroom and toilet.
“We found some chairs were dirty and had the outer fabric damaged exposing the foam core and a bathroom and toilet were found to have dirty floors.” from the report
Quality oversight
needs fixingThe home's monitoring systems had not reliably identified the concerns found during inspection. Inspectors said quality assurance needed strengthening.
“The provider's quality assurance required strengthening to support people's safety and welfare.” from the report
- 01How are controlled drugs records checked now, and how will you identify and correct any errors quickly?
- 02How often are staff checked as competent to administer medicines, and are all checks currently in date?
- 03What routine checks make sure chairs, radiator covers, bathrooms and toilets remain safe and clean?
- 04How will the registered manager make sure the improvements are sustained now they plan to dedicate their time solely to this home?
This was a focused inspection of Safe and Well-led, with infection prevention and control also considered under Safe; the other ratings were carried forward from the previous inspection. This explanation was written from the published report of 14 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, November 2021
Haresbrook Park Care Home was rated Good; inspectors found clear improvements, with some records and infection-control actions still needing attention.
This was an unannounced focused inspection on 12 October 2021. Inspectors spoke with people living at the home, staff, relatives and a visiting health professional. They observed care and reviewed care, medicine, staffing, incident and quality records.
The home was rated Good for Safe, Effective and Well-led. Inspectors found improvements in risk management, medicines, staff training, infection control, incident monitoring and management oversight. People were supported by staff who knew their needs and respected their choices.
The previous rating was Requires Improvement, with several breaches of regulation. Inspectors found the home had improved and was no longer in breach. This inspection did not assess Caring or Responsive, so those ratings came from the previous comprehensive inspection.
Improved safety
Risk assessments, fire safety arrangements and medicine administration had improved since the previous inspection.
“At this inspection we found enough improvement had been made and the provider was no longer in breach of regulation 12.” from the report
Staffing and safeguarding
People said there were enough staff and that call bells were answered promptly. Staff knew how to report safeguarding concerns.
“People told us there were enough staff to respond to their needs, and call bells were answered promptly.” from the report
Respect for choices
Staff asked for consent, understood people's individual needs and supported people to make choices about their care.
“People felt staff respected their wishes and listened to them.” from the report
Food and health support
People had meal choices and support with eating and drinking. Staff monitored weights and helped people attend healthcare appointments.
“People told us they were given a choice of meals to eat during the day which they enjoyed.” from the report
Positive management
People, relatives and staff gave positive feedback about the new management team. Staff said communication and teamwork had improved.
“Staff told us the atmosphere in the home had positively changed since the new registered manager came in to post.” from the report
Respite care records
needs fixingCare plans for people receiving respite care were not always completed promptly. The manager knew about this and was working on the electronic recording system.
“However, we found that care plans for people who were receiving respite care were not always completed in a timely manner.” from the report
Covert medicine records
needs fixingRecords for three people who needed covert medicines were not readily available when checked. This was corrected by the end of the inspection.
“However, we found that records for three people who required covert medicines were not readily available.” from the report
Infection-control bin
minorThe bin for disposing of face masks was not foot operated. Inspectors raised this with the home during the inspection.
“We found the bin for disposal of face masks was not a foot operated bin we raised this at the time of our inspection.” from the report
Outstanding audit actions
needs fixingSome actions from external quality checks were still only partly completed or had not been completed.
“However, we found that there were still actions that were either partially or not met.” from the report
- 01How do you make sure care plans for people receiving respite care are completed promptly?
- 02How are covert medicines authorised, recorded and checked now?
- 03What was done about the mask-disposal bin after the inspection?
- 04Which actions from the external consultant's audits remained incomplete, and have they now been finished?
- 05What were the previous ratings for Caring and Responsive, which were not assessed in this inspection?
This was an unannounced focused inspection of Safe, Effective and Well-led; Caring and Responsive were not assessed and their previous ratings carried over. This explanation was written from the published report of 16 November 2021 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 Haresbrook Park Care Home
9 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- January 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2021Goodup from Requires improvementSafe: GoodWell-led: Good
- December 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- January 2020Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- November 2019Inadequatestayed InadequateSafe: InadequateWell-led: Inadequate
- October 2019Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- September 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- September 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2015
Registered with the Care Quality Commission on 1 April 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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