CQC report explained · a residential care home
What the CQC found at Hartfield House Rest Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks, accidents, safeguarding, medicines, staffing, recruitment and infection control were managed safely. The home was clean and tidy, although work was still under way on issues identified in the fire risk assessment.
- Effective?
- Good
- Staff had relevant training and support, including training for diabetes care. People received suitable food and drinks, health needs were monitored and healthcare professionals were contacted when needed.
- Caring?
- Good
- Staff were kind, patient and respectful. People were supported to make choices, remain independent and have their privacy and dignity respected.
- Responsive?
- Good
- Care was based on people's individual needs, interests and choices. Activities, trips, hobbies and opportunities to spend time alone were available, and complaints were addressed.
- Well-led?
- Good
- The manager and directors were visible and supportive. Audits, feedback and action plans were used to identify and track improvements, although some best-interest and lasting-power-of-attorney records were not easy to find.
What inspectors found, September 2018
Hartfield House Rest Home was rated Good; inspectors found kind, person-centred care and improvements in managing health risks and records.
Inspectors visited on 7 and 9 August 2018. The first visit was unannounced. They reviewed care plans, risk assessments, medicines, staff records, complaints, accidents, audits and the building. They spoke with people living there, visitors, staff and health professionals, and observed care and mealtimes.
The home received a Good rating in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough suitably recruited staff, safe medicines systems, good training and appropriate support for people's health needs.
People were described as receiving kind, respectful and personalised care. Staff knew people well, supported their choices and helped them stay active through activities and hobbies. The home was clean and had systems for managing risks, complaints and improvements.
The previous inspection in May 2017 found that complex health risks and record keeping needed improvement. Inspectors found that these areas had improved, although some mental capacity records, best-interest information and care-plan involvement still needed attention.
Improved health-risk management
The home had improved its management of complex health needs since the previous inspection. Diabetes care had clear protocols, trained staff and recorded blood sugar checks.
“At this inspection we found improvements had been made and people's health needs were managed safely.” from the report
Kind and respectful care
Staff knew people well and treated them with patience, affection and respect. Inspectors saw that privacy, dignity, independence and personal choices were supported.
“People were supported by staff who were kind and caring.” from the report
Activities and personal interests
People had activities, trips and opportunities to continue hobbies such as painting, knitting and spending time in the garden. Staff respected people who preferred not to join group activities.
“There was an activity program, which included trips out, and people told us they had enough to do.” from the report
Safe medicines and staffing
Medicines were ordered, stored, given and disposed of safely. Inspectors found enough staff to meet people's needs and saw people being supported without being rushed.
“People received their medicines as prescribed because safe systems were in place.” from the report
Improved record keeping
Records were more complete than at the previous inspection. Daily notes, mattress checks and cream charts better reflected the care people received.
“At this inspection we found improvements had been made and records were well completed.” from the report
Mental capacity records
needs fixingMental capacity assessments were not always specific to the decision being made. The manager was reviewing them during the inspection.
“Mental capacity assessments were in place however, these were not decision specific.” from the report
Written care-plan involvement
minorSome people said they had not been involved in developing their written care plans, although staff said they discussed care informally and inspectors saw people involved in daily decisions.
“Some people told us they had not been involved in developing their own care plans.” from the report
Fire risk actions
needs fixingThe manager and provider were working on issues identified in the fire risk assessment. Ask what the issues were and whether the planned work has been completed.
“They told us they were currently working to address issues identified within the fire risk assessment.” from the report
Best-interest information
minorBest-interest discussions took place, but records of those discussions and information about lasting power of attorney were not always easy to find.
“Best interest decisions were discussed with people however, records of these discussions and information about lasting power of attorney were not always easy to find.” from the report
- 01What issues were identified in the fire risk assessment, and have all the actions now been completed?
- 02How will you make sure mental capacity assessments are specific to each decision?
- 03How will my relative and our family be involved in creating and reviewing the written care plan?
- 04How are best-interest decisions and lasting power of attorney information recorded and kept easy to find?
- 05What training and competency checks will staff caring for someone with diabetes or other complex health needs receive?
This was a comprehensive inspection covering all five key questions and included records, observations and discussions with people, visitors, staff and healthcare professionals. This explanation was written from the published report of 1 September 2018 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, July 2017
Hartfield House Rest Home was rated Requires Improvement; inspectors found kind, personalised care but gaps in complex health care and records.
This was an unannounced inspection on 9 and 11 May 2017. Inspectors spoke with nine people living at the home, three visitors and six staff. They observed care and checked care plans, medicines, staffing, complaints, accidents, training and quality checks. They also contacted three healthcare professionals.
People were generally treated with kindness and respect. Staff knew people well, supported their choices and provided personalised care. There were enough staff, recruitment checks were completed, and staff had training and supervision. People received suitable food and had access to healthcare.
The home was not consistently safe for people with complex health needs. Diabetes checks were not always completed, and guidance for some 'as required' medicines was missing. Daily records and some other checks were not always complete. The home had no registered manager at the time, although a new manager had started the registration process and improvement work was under way.
The overall rating was Requires Improvement. Effective, caring and responsive were rated Good. Safe and well-led were rated Requires Improvement.
Kind and respectful care
People were treated with kindness and respect. Staff listened, worked at people's own pace and protected their privacy and dignity.
“People were treated with kindness and respect by the staff.” from the report
Personalised support
Staff knew people's likes, dislikes, routines and communication needs. Care plans contained detailed information and people were involved in developing them.
“People received care that was person-centred and responsive to their needs because staff knew and understood them well.” from the report
Staffing and training
Inspectors found enough staff to meet people's needs. Recruitment checks, training, supervision and induction were in place.
“There were enough staff to meet the needs of people who lived at the home.” from the report
Choice and nutrition
People could choose what and where to eat, and alternatives were offered. Mealtimes were relaxed and sociable.
“The dining experience was a relaxed and sociable occasion.” from the report
Diabetes monitoring
seriousBlood sugar checks and follow-up tests were not always completed. This meant staff could not show whether further medical help was needed.
“These had not always been completed so staff were unable to demonstrate if the person required further medical intervention.” from the report
Incomplete care records
needs fixingDaily notes did not always show what people had done, their mood or their wellbeing. Some pressure mattress checks and cream charts were also incomplete.
“People's care plans were detailed but their daily notes did not fully reflect what people done each day.” from the report
Missing medicine guidance
needs fixingGuidance was not available for every 'as required' medicine. Staff understood people's medicines, but written instructions were needed for consistent decisions.
“Although staff had a good understanding of when and why people needed PRN medicines protocols were not in place for every PRN prescribed.” from the report
Activities needed development
minorThe manager had identified that activities were not always meaningful or suited to each person. People also wanted more opportunities to go out.
“The manager had identified that activities were not always meaningful or developed to suit each individual.” from the report
- 01What changes have been made to diabetes checks and follow-up testing since the inspection?
- 02What written guidance is now available for each person's 'as required' medicine?
- 03How do you check that daily notes, pressure mattress checks and cream charts are complete?
- 04What activities and outings are now available for people who want more individual or group opportunities?
- 05Has the manager completed the CQC registration process?
This was an unannounced comprehensive inspection covering all five key questions and was the first inspection since the new provider took over. This explanation was written from the published report of 5 July 2017 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 Hartfield House Rest Home
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- September 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2016
Registered with the Care Quality Commission on 15 August 2016.
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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Most charge £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
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