CQC report explained · a nursing home
What the CQC found at Hartcliffe Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Safe was not assessed during this focused inspection. The report says the rating from the last inspection was used when calculating the overall rating.
- Effective?
- Good
- Inspectors found that people's food, drink and repositioning records had improved and were complete. Staff understood people's dietary needs, arranged healthcare support and had the training and supervision needed for their roles.
- Caring?
- Good
- Caring was not assessed during this focused inspection. The report says the rating from the last inspection was used when calculating the overall rating.
- Responsive?
- Good
- Responsive was not assessed during this focused inspection. The report says the rating from the last inspection was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found that managers had introduced daily checks after recent record-keeping shortfalls. The home also used audits, staff feedback and meetings with people and relatives to monitor and improve the service.
What inspectors found, September 2022
Hartcliffe Nursing Home is rated Good; inspectors found effective, person-centred care, with recent record-keeping shortfalls addressed.
This was an unannounced, focused inspection on 25 August 2022. Inspectors checked whether earlier improvements had been made, especially to records about food, drinks and repositioning. They spoke with the manager, deputy, staff and people living at the home, observed care and reviewed records.
The home had improved since the 2018 inspection. Food and drink records were complete and recorded what people were offered, what they consumed and when they refused. Staff understood people's dietary needs, made healthcare referrals when needed and supported people to make choices.
A monitoring activity on 10 August 2022 had found some recent shortfalls, including records being completed at hourly times rather than the actual time. Daily checks and staff retraining were put in place, and inspectors found the records fully completed during this inspection.
The inspection covered only Effective and Well-led, both rated Good. The overall Good rating also used ratings from the previous inspection for the other areas, which were not inspected this time.
Improved records
Records about food, drinks and repositioning were complete during the inspection. Managers had introduced daily audits and staff retraining after recent shortfalls.
“Due to the daily monitoring we found the records to be fully completed.” from the report
Support with food and drink
Staff knew who needed special diets, thickened drinks or support with eating. They offered alternatives and allowed people time to choose.
“Staff took time to explain options on the menu to people in the dining room and allowed them time to decide for themselves.” from the report
Trained and supported staff
Staff completed induction and training before working alone. They received ongoing training, supervision and appraisal support.
“Staff received ongoing training to help them to deliver good care and to maintain their skills and knowledge.” from the report
Person-centred management
Inspectors found an open management style and examples of care being adapted to people's interests and relationships.
“The provider, management team and staff were committed to supporting a person-centred approach for people living in the home.” from the report
Recent record-keeping shortfalls
needs fixingA monitoring activity shortly before this inspection found problems with food, fluid and repositioning records. The home had taken action, but families may want to check that the improvement has been maintained.
“Some shortfalls were identified in relation to people's food and fluid charts, nutrition and the timings recorded on positional charts.” from the report
- 01How are food, fluid and repositioning records checked now, and how often are the checks reviewed?
- 02What retraining have staff received on completing these records, and how is their understanding tested?
- 03How will you identify quickly if someone is not eating or drinking enough?
- 04How are people's special diets, thickened drinks and allergies recorded and shared with staff?
- 05How do people and relatives give feedback, and what changes have been made as a result?
This was a focused inspection of Effective and Well-led only; the other ratings were carried over from the previous inspection and were not assessed this time. This explanation was written from the published report of 21 September 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 2021
Rated Good; inspectors found safe, caring support and strong management, with some issues around staffing pressures and communication during the coronavirus outbreak.
This was an unannounced, focused inspection on 24 February 2021. Inspectors looked only at whether the home was safe and well-led. They spoke with staff, relatives, professionals and people living at the home, and checked records, policies and audits.
The home was rated Good for Safe and Well-led. Inspectors found enough staff to meet people's needs, safe recruitment, suitable medicine checks and systems to protect people from abuse and infection. They also found that managers monitored quality and followed up areas needing improvement.
The inspection followed concerns about staffing and care. Inspectors found no evidence that people were at risk of harm from these concerns. The overall rating stayed Good, but the ratings for Effective, Caring and Responsive were carried over from the previous comprehensive inspection because they were not checked this time.
Protection from harm
Staff understood safeguarding and knew how to report concerns. Inspectors found systems to identify risks and take action to protect people.
“Systems and processes were in place to protect people from the risk of harm or abuse.” from the report
Infection control
Inspectors were assured that the home had arrangements for preventing and managing infections, including safe admissions, testing, protective equipment and hygiene.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Person-centred care
Staff were described as committed to knowing people well, respecting them and supporting their quality of life.
“Staff were passionate and committed to caring for people in a person centred and professional way.” from the report
Management oversight
Managers used audits and action plans to monitor the service and address shortfalls. Staff said they were supported and could raise concerns.
“Audits were carried out, and where shortfalls were identified, an action plan and follow up checks were in place.” from the report
Staffing during the outbreak
needs fixingStaffing was difficult when people were off sick or isolating during the coronavirus outbreak. Agency staff were sometimes needed, although permanent staff covered some gaps.
“When staff were off sick or isolating at home during the recent coronavirus outbreak at the service, it was recognised that it had been difficult to cover all shifts.” from the report
Communal chair spacing
minorInspectors suggested changing the spacing of chairs in communal areas to support social distancing.
“We made a suggestion about the spacing of chairs in communal areas to support this.” from the report
- 01How will staffing levels be maintained when the home is full or staff are off sick or isolating?
- 02What changes have been made to the spacing of chairs in communal areas?
- 03How will you keep relatives informed about changes in a person's health or wellbeing?
- 04How are medicines storage audits carried out, and what happens if a problem is found?
- 05How are action plans from audits checked to make sure improvements have been completed?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried over from the previous comprehensive inspection. This explanation was written from the published report of 27 March 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 Hartcliffe Nursing Home
5 rated inspections over 8 years: the service has held its Good rating throughout.
- September 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2021Goodstayed GoodWell-led: Good
- July 2018Goodup from Requires improvementSafe: GoodEffective: Requires improvementWell-led: Good
- May 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- February 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 22 December 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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