CQC report explained · a residential care home
What the CQC found at Hartwood House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed, care plans gave staff guidance, staffing levels met people's needs, medicines were managed safely and infection control measures were effective. This rating improved from Requires Improvement at the previous inspection.
- Effective?
- Good
- This question was not inspected during this focused visit. The previous rating was used in the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. The previous rating was used in the overall rating.
- Responsive?
- Outstanding
- This question was not inspected during this focused visit. The previous rating was used in the overall rating.
- Well-led?
- Good
- Inspectors found effective governance, clear management oversight, staff involvement and a person-centred culture. The rating remained Good, although communication with some external professionals needed improvement.
What inspectors found, June 2022
Hartwood House is rated Good; inspectors found safer care and strong management, but communication with some outside professionals needed improvement.
This was an unannounced focused inspection on 24 May 2022. Inspectors looked only at Safe and Well-led because concerns had been raised about risk management, skin care, falls and communication. They spoke with people, relatives and staff, observed care, and checked care, medicines, staff and management records.
The home was rated Good for Safe. Inspectors found suitable risk assessments, enough skilled staff, safe medicines systems, safe recruitment and effective infection control. The Safe rating improved from Requires Improvement at the previous inspection.
The home was rated Good for Well-led, the same as before. Inspectors found effective checks and action plans, an approachable management team, and staff who understood people's needs. However, the management team said communication with some external professionals needed to improve.
The overall rating remained Good. The other three question ratings were carried forward from the previous comprehensive inspection because they were not inspected this time.
Improved safety
The home had improved its approach to safety since the last inspection. Inspectors found clear risk plans and staff who understood how to reduce risks.
“At this inspection this key question has improved to good.” from the report
Safe medicines
Medicines were stored securely, records were accurate and staff had training and regular checks of their competence.
“People could be confident that medicines were managed safely and administered by competent staff who had access to appropriate guidance and information.” from the report
Enough staff
Inspectors found enough suitably skilled staff to meet people's needs. Staff responded promptly to call bells and were not rushed when providing care.
“There were enough skilled staff deployed to support people and meet their needs.” from the report
Strong oversight
Management checks identified themes and led to corrective action. Records showed clear responsibility for actions and completion dates.
“Governance arrangements were embedded and effective.” from the report
Person-centred culture
Inspectors found that staff understood people's needs and supported activities and personal choices. Relatives were invited to share their views.
“The day to day culture of the home was person centred and delivered by staff who cared about people's wellbeing.” from the report
Communication with professionals
needs fixingThe management team said communication with external professionals needed to improve after the nursing element of the service was deregistered. A meeting with health professionals was planned after the inspection.
“They advised us communication between themselves and external professionals required improvement to ensure stronger collaborative working.” from the report
Family call-backs
minorOne relative said that staff did not always call back when the right person was not immediately available. Ask how the home makes sure family messages are followed up.
“If I don't get the right person, they're not very good at calling me back” from the report
- 01How do you now work with GPs, district nurses and other external health professionals?
- 02What happens when a family member leaves a message and the right person is not available?
- 03How are risks such as falls, skin damage and pressure sores reviewed and updated?
- 04How do you check that medicines are administered correctly and that staff remain competent?
- 05How do you decide whether staffing levels need to change when people's needs change?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 30 June 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, April 2018
Rated Good overall; Hartwood House provided kind, highly responsive care, but safety, medicines and staffing needed improvement.
This was an unannounced inspection over two days. Inspectors spoke with people, relatives, staff and health professionals. They observed care and reviewed care plans, medicines records, staff files, rotas, incidents and quality checks.
The home was rated Good overall. Effective, Caring and Well-led were rated Good. Responsive was rated Outstanding because staff knew people very well, supported their interests and helped them stay connected with family and the community.
Safe was rated Requires Improvement. Inspectors found errors and gaps in some medicines records, incomplete food and fluid charts, conflicting information about one person's bed rails, and staff concerns about staffing levels and deployment. The home had plans or had taken action on several of these issues.
Highly personalised care
Staff knew the small details that mattered to people and adapted care to their routines, preferences and interests.
“Staff had an excellent knowledge and understanding of the people they were supporting and this helped to ensure people received care and support which was responsive to their needs.” from the report
Activities and community links
People were offered varied activities, trips and one-to-one support. Staff helped people maintain links with local places and activities.
“Staff went the extra mile to provide care that was meaningful to people and provided them with opportunities to access their community and take part in events that were of interest to them.” from the report
Kind and respectful staff
Inspectors saw warm, patient interactions. People were supported with dignity, including during personal care, meals and drinks.
“People were cared for by kind and compassionate staff.” from the report
Good health support
The home worked with GPs and other professionals, including speech and language therapists, physiotherapists and occupational therapists.
“Staff worked closely with health and social care professionals to ensure people received effective care in line with their needs.” from the report
Quality monitoring
The provider used audits, feedback and action plans to monitor care and identify improvements.
“There were effective systems in place to monitor and improve quality and safety within the service.” from the report
Medicines records
seriousSome topical medicines records were incomplete. There were also medicines disposal records missing, unsigned administrations and other recording errors.
“We found four recording errors where people's medicines had been administered but not signed for.” from the report
Risks and nutrition records
seriousInspectors found a conflicting assessment about bed rails for one person. They also found incomplete food and fluid charts for a person who had lost weight, making it unclear whether enough nutrition was provided.
“A number of their daily charts had not been completed fully.” from the report
Staffing pressures
needs fixingSome staff said there were not enough staff at busy times, particularly in the evenings, and that people could sometimes wait for help. The provider did not use a specific tool to set staffing numbers and deployment.
“We can be short staffed and not feel supported, we cannot always give the care we want especially when more full, there is an impact on the residents as we can't be everywhere” from the report
Care plan updates
needs fixingSome care plans did not reflect current needs promptly. Important changes were sometimes recorded separately in monthly evaluations instead.
“The system did not always ensure care plans were always up to date and reflected people's current needs.” from the report
Training and supervision
needs fixingSome staff training had expired or was not completed promptly. Supervision was not always provided at the frequency set by the provider.
“The manual handling training for 14 of the 30 care and nursing staff had expired.” from the report
- 01What checks now make sure every medicine administration, topical cream and disposal is recorded correctly?
- 02How do you monitor food and fluid charts for people who are losing weight, and what action is taken when records are incomplete?
- 03How do you decide how many staff are needed on each unit and shift, especially in the evenings?
- 04Have all staff completed current manual handling and other role-specific training?
- 05How are care plans updated quickly when a person's health, nutrition or risks change?
This was an unannounced comprehensive inspection of the whole service, following concerns about how some people's care was being provided; the previous inspection was in February 2016. This explanation was written from the published report of 11 April 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.
Every inspection of Hartwood House
4 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- June 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- April 2018Goodstayed GoodSafe: Requires improvementWell-led: Good
- March 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015Inspected but not ratedSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvement
- April 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- May 2013
Registered with the Care Quality Commission on 16 May 2013.
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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