CQC report explained · a nursing home
What the CQC found at Hartismere Place
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- Inspectors found established safeguarding systems, appropriate risk assessments, safe recruitment, well-managed medicines and suitable infection control arrangements.
- Effective?
- Good
- Staff had relevant training and supervision. People had access to healthcare, support with food and drink, and care that followed assessments of their needs and choices.
- Caring?
- Good
- People were treated warmly and respectfully. Staff understood individual preferences, involved people and relatives in care planning, and supported independence.
- Responsive?
- Outstanding
- Care was exceptionally personalised. Staff used people's life histories, interests and changing needs to improve confidence, independence, wellbeing and involvement in activities.
- Well-led?
- Outstanding
- The management team created an open, inclusive culture and used audits, feedback, training and partnership working to identify and make improvements.
What inspectors found, February 2020
Hartismere Place was rated Outstanding; inspectors found safe, kind and effective care, with especially strong personalised support and leadership.
This was an unannounced inspection on 19 November 2019. The inspection team observed care, spoke with people living in the home, relatives, staff and healthcare professionals, and reviewed care, medicines, training and management records.
The home was rated Good for Safe, Effective and Caring. Inspectors found that people were protected from abuse, risks were assessed, medicines were managed safely, staff were trained, healthcare was available and people were treated with kindness, dignity and respect.
Responsive and Well-led were rated Outstanding. Staff knew people very well and used their histories, interests and changing needs to provide highly personalised care. The management team used audits, feedback and staff development to improve the service.
The overall rating improved from Good at the previous inspection, published in May 2019. The report says the home would continue to be monitored and could be inspected sooner if concerning information was received.
Personalised care
Staff knew people's backgrounds, interests and preferences well. They adapted support when people's physical or mental health changed.
“The care provided was exceptionally personalised staff knew people well.” from the report
Meaningful activities
People could take part in activities linked to their interests and daily lives. The home also supported community involvement and outings.
“There were a wide range of activities provided to ensure people did not become socially isolated and promoted their physical and social well-being.” from the report
Strong leadership
Inspectors found an open and inclusive culture. Managers supported staff, listened to feedback and acted on audits and suggestions.
“There was an open and transparent culture at the service and if things went wrong people were informed and actions were taken to make things right.” from the report
Safe medicines and staffing
Medicines systems were organised and staff had their competence checked. Staffing levels were based on people's care and support needs.
“The number of staff on duty for each shift were based upon the collective care and support needs of each person in residence.” from the report
Respect and independence
People were involved in decisions about their care and supported to keep their skills and independence where possible.
“People were supported to be as independent as they were able and had the opportunity to retain their skills and abilities.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you currently calculate the number of staff needed on each shift, and how often is this reviewed?
- 02The report says agency staff use had recently reduced after new recruitment. How much agency cover is being used now?
- 03How will you find out about my relative's life history, interests and preferences, and turn these into regular activities?
- 04How does the monthly Resident of the Day review involve relatives who cannot attend in person?
- 05What support can you provide if my relative later needs end of life care?
This was an unannounced comprehensive inspection covering all five key questions, including the premises and care provided; the previous overall rating was Good. This explanation was written from the published report of 14 February 2020 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, May 2017
Rated Good; inspectors found kind, safe and improving care, but staffing and some care records needed attention.
Inspectors made an unannounced visit on 21 March 2017. They spoke with people living at the home, relatives, staff and health professionals. They also observed care and reviewed care records, risk assessments, medicines records, recruitment files and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from abuse, risks were managed, medicines were handled safely and staff supported people's health, choices, privacy and dignity.
There were some areas to improve. Staffing was a concern on the Beech unit, some end of life wishes and life history information were not recorded consistently, and lunch was served slowly for some people. The management team acted during or after the inspection, including increasing staffing on Beech.
Safe medicines
Medicines were stored securely and records showed that doses had been given without gaps in the records. Audits were used to identify and address problems.
“Medicines were stored securely, with appropriate facilities available for controlled drugs and temperature sensitive medicines.” from the report
Kind and respectful care
People experienced a warm and relaxed atmosphere. Staff respected privacy and dignity and supported people to make choices and remain independent.
“People's privacy and dignity was respected. One staff member said, "I knock on doors, if supporting people with personal care, I cover people with a towel".” from the report
Activities and involvement
People could join a range of activities, including music, exercise and games. Staff also arranged individual activities for people who preferred to stay in their rooms.
“People were supported to take part in activities within the service.” from the report
Management improvements
Inspectors found that the covering manager and clinical lead had made significant progress after earlier concerns about staff skills and activities. The home had an action plan and quality checks.
“At this inspection we found that the covering manager had made significant progress to address the areas of concern.” from the report
Staffing on Beech
needs fixingPeople and staff reported that there were sometimes too few staff on Beech, especially in the mornings. Inspectors found staff were not always visible there, although they saw timely responses overall and staffing was increased after the inspection.
“However, we noted on Beech unit that staff were not always visible, and people also told us there were not enough staff.” from the report
End of life wishes
needs fixingPeople's end of life preferences were not always recorded. This could make it harder for staff to follow someone's wishes if their health worsened suddenly.
“People's individual wishes and preferences in regard to their end of life care were not always being recorded.” from the report
Life history information
minorInformation about people's lives was not consistent across the home. The management team knew this needed improvement and had started work on it.
“Information relating to people's life history was not consistent across the service.” from the report
Slow lunch service
minorOn Beech, lunch was served slowly and people eating in their rooms waited longer. The manager said prompt action would be taken.
“However, on Beech unit we found that lunch was served very slowly, with people eating at different intervals.” from the report
Management cover
minorThere was no registered manager in post during the inspection. A covering manager was in place while a permanent manager was recruited, and a new registered manager was appointed after the inspection.
“There was not a registered manager in post.” from the report
- 01What are the current staffing levels on the Beech unit, particularly in the mornings, and how do you check that people are helped without long waits?
- 02How do you now record and review each person's end of life wishes and preferences?
- 03How do you make sure staff have accurate, up-to-date information about each person's life history?
- 04How do you ensure lunch reaches people who eat in their rooms at the expected time?
- 05What improvements made by the covering manager and clinical lead have been maintained since the new registered manager took over?
This was an unannounced inspection of the overall service, covering all five CQC questions and including observations, interviews and reviews of care, medicines, staffing and quality records. This explanation was written from the published report of 26 May 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 Hartismere Place
2 rated inspections over 3 years: the service has improved, from Good to Outstanding.
- February 2020Outstandingcurrent ratingup from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Outstanding
- May 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015
Registered with the Care Quality Commission on 8 October 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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