CQC report explained · a residential care home
What the CQC found at Hart Care Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm, with enough staff deployed to meet people's needs. Inspectors found improvements in medicines management, but recommended better practice for skin patches and more complete risk records.
- Effective?
- Good
- People received support with food, drink, healthcare and personal choices. Inspectors recommended that mental capacity and best-interests decisions were properly recorded.
- Caring?
- Good
- This question was not covered by this focused inspection. People told inspectors that staff were kind, caring and respectful.
- Responsive?
- Good
- This question was not covered by this focused inspection. The report says people and relatives were involved in care planning and could give feedback.
- Well-led?
- Good
- A new management team had improved leadership, monitoring and staff morale. Some care, risk and mental capacity records still needed to better reflect decisions and actions.
What inspectors found, November 2022
Hart Care Nursing & Residential Home was rated Good; inspectors found safer systems and kind care, but some records and medicines practice still need improvement.
This was an unannounced focused inspection on 25 and 27 October and 1 November 2022. Inspectors spoke with people living at the home, relatives, staff and health professionals. They also checked medicines, care records, recruitment, training, accidents, audits and infection control.
The home was rated Good for Safe, Effective and Well-led. Inspectors found that medicines were generally managed safely, staffing levels were sufficient, risks were assessed and infection control arrangements were in place. People said they felt safe and were treated with kindness.
The home had improved since its previous inspection, when it was rated Requires Improvement. A new management team had strengthened oversight and the home was no longer in breach of regulations. Inspectors still recommended improvements to some medicines practice, care and risk records, and mental capacity records.
Improved leadership
A new management team had strengthened oversight, audits and quality monitoring. The home was no longer in breach of regulations.
“The quality of the service people received was monitored and audited to help ensure it was consistently good.” from the report
People felt safe and respected
People told inspectors they were happy and felt safe. They described staff as kind and caring.
“People told us they were happy living at the service, they felt safe, and staff treated them with respect and kindness.” from the report
Safer medicines systems
Medicines were ordered, stored, given, recorded and disposed of safely. Staff training and competency checks were in place.
“Improvements had been made in how the service managed people's medicines. Medicines were ordered, stored, administered, recorded, and disposed of safely.” from the report
Infection control
Inspectors were assured that infection prevention arrangements, including the use of protective equipment, were effective.
“We were assured that the provider was using PPE effectively and safely.” from the report
Support with food and healthcare
People had food and drink choices, support with nutrition risks and access to health professionals. Mealtimes were relaxed and social.
“We observed mealtimes during the inspection. We found mealtimes were relaxed and very much a social occasion with good attentive support from staff.” from the report
Skin patch medicines
needs fixingFor one person, the application site for a medicine patch was not moved as often as the manufacturer recommended. Inspectors recommended following best practice.
“However, for one person we saw the site of application was not moved as often as recommended by the manufacturers.” from the report
Weight loss records
needs fixingWhen people lost weight, care plans and risk assessments did not always show what staff had done to reduce the risk of further weight loss.
“This meant that staff may not have sufficient information to ensure that they were doing everything possible to reduce the risk of further weight loss.” from the report
Waiting for staff
minorAlthough inspectors found staffing levels were sufficient, some people said they had to wait for help and that staff sometimes seemed rushed.
“Some people reported that they had to wait a long time for staff to help them and others reported that staff always seemed to be rushed.” from the report
- 01How do you make sure medicine patches are moved according to the manufacturer's instructions?
- 02What action do you take when someone loses weight, and where is this recorded in their care plan and risk assessment?
- 03How do you record mental capacity assessments and best-interests decisions, and can families see these records where appropriate?
- 04How often are staff medicines competencies checked?
- 05How do you monitor waiting times when people use their call bells?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not assessed in this report. This explanation was written from the published report of 18 November 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, August 2021
Rated Requires Improvement; inspectors found clear progress after an Inadequate rating, but medicines and quality checks were still not reliable enough.
This was an unannounced focused inspection on 30 June and 13 July 2021. Inspectors spoke with people, relatives, staff and professionals. They observed care and checked medicines, care records, staff files and management records.
The home had improved since the previous inspection, when it was rated Inadequate and placed in special measures. Staffing, safeguarding, risk management, infection control and leadership had improved. People generally said they felt safe, and the new management team was viewed positively.
Some important problems remained. Records and guidance for medicines given when needed were not always clear. Care plans for conditions such as diabetes needed more detail. Quality checks had not found all these problems. The home was no longer Inadequate or in special measures, but improvements still needed to become consistent.
Improved staffing
Inspectors found enough staff to meet people's needs and keep them safe. Staff said staffing levels and training had improved.
“At this inspection we observed there were sufficient numbers of staff to meet people's needs and to keep them safe.” from the report
Safeguarding
The home had introduced stronger safeguarding procedures and trained staff to recognise and respond to abuse or poor practice.
“Since the last inspection the provider had developed robust safeguarding policies and procedures.” from the report
Positive leadership
People, relatives and staff spoke positively about the new management team. Inspectors found more stable and consistent leadership.
“The provider had appointed a new manager and deputy manager who provided stable, consistent leadership and support.” from the report
Risk management
The home had improved how it assessed and managed risks such as falls, pressure damage, nutrition and moving and handling.
“Risk assessments were reviewed monthly or more frequently if the person's needs changed.” from the report
Learning from incidents
Accident and incident reporting had improved. Management reviewed incidents and looked for possible causes and improvements.
“Records showed that the management team reviewed all accidents and incidents on a regular basis and analysed any potential causes to identify any areas for improvement.” from the report
Medicines given when needed
seriousRecords did not always explain why medicines given when needed were administered or whether other support had been tried. This meant inspectors could not be sure they were always given as intended.
“The absence of this documentation meant it was not possible to be sure the medicines were always given in the way that benefitted the person's health and well-being or as intended by the prescriber.” from the report
Quality checks missed problems
needs fixingAudits had not identified concerns about medicines given when needed and medicine storage temperatures. The provider was asked to improve its systems.
“The quality auditing system had failed to identify concerns we found in relation to temperature monitoring and PRN medicines.” from the report
Health condition records
needs fixingSome care records did not contain enough detail about diabetes and related risks. Staff knew how to support one person, but the written information needed to be clearer and more consistent.
“It was noted that the care records were not in all cases sufficient in detail to ensure staff had the information they needed in relation to this condition and associated risks.” from the report
Infection-control details
needs fixingInspectors were only somewhat assured that protective equipment was stored and used safely. Signage and handwashing checks also needed improvement.
“PPE was not in all cases stored in a way that prevented risks of cross infection.” from the report
- 01How do you decide when to give medicines prescribed for use when needed, and how do you record the reason and any other support offered?
- 02What changes have you made to medicine temperature checks and audits since this inspection?
- 03How do you make sure care plans contain clear, individual information about diabetes and other long-term health conditions?
- 04What checks now confirm that protective equipment is stored correctly and that staff follow handwashing procedures?
- 05What nursing or personal care needs can the home safely support now that nursing care was stopped during the improvement period?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive areas were not covered and their ratings are not given in this report. This explanation was written from the published report of 20 August 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 Hart Care Residential Home
6 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2021Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- October 2020Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- January 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- July 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- June 2011
Registered with the Care Quality Commission on 13 June 2011.
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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