CQC report explained · a residential care home
What the CQC found at Hatfield House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and staff understood safeguarding. Risk assessments were in place, but some lacked detail and did not clearly explain how risks had been judged or reduced. Some medicines processes also needed improvement.
- Effective?
- Good
- People's needs were assessed and care plans were reviewed. Staff received induction and training, but refresher training and formal supervision records were not always up to date.
- Caring?
- Good
- People and relatives described staff as kind and caring. Inspectors saw respectful interactions, and staff supported privacy, dignity, choice and independence.
- Responsive?
- Good
- Care was personalised and reflected people's preferences and communication needs. People's goals were recorded, but it was not always clear how staff helped them achieve those goals.
- Well-led?
- Requires improvement
- The manager and provider had quality checks, but these did not always identify or address important improvements. Required notifications had not always been sent to CQC promptly.
What inspectors found, July 2019
Hatfield House was rated Good overall, but inspectors found management and quality checks still needed improvement.
Inspectors visited on 05 June 2019. They spoke with four people, two relatives, the manager and three staff. They reviewed care plans, staff records, medicines records and quality checks.
People were described as safe, well cared for and treated with kindness and respect. Staff knew people's needs, offered choices, supported healthcare and provided personalised care. The five care areas were rated Good.
The home was rated Requires Improvement for being well-led. Risk assessments lacked detail, some medicines checks and staff training records needed improvement, and some mental capacity decisions were not clearly recorded. The provider had also not always sent required notifications to CQC on time.
The overall rating improved from Requires Improvement at the previous inspection, published on 16 June 2018. However, the well-led rating remained Requires Improvement, so CQC said it would continue monitoring the home.
People felt safe
People said they felt safe, and staff understood safeguarding procedures and how to report concerns.
“People told us they felt safe. Staff understood how to keep people safe and how to report any concerns they may have.” from the report
Kind and respectful care
People and relatives spoke positively about staff. Inspectors observed reassurance, respect for privacy and support for personal choice.
“People and relatives told us staff were caring, kind and respected their privacy and dignity.” from the report
Personalised support
Care plans reflected people's preferences, routines and communication needs. People were supported to make everyday choices and remain independent.
“People received personalised care. A relative told us, "[Person] chose the home themselves. It was all led by [person]. They now have the life they want to live.” from the report
Healthcare support
Staff made appropriate referrals and acted on advice from health professionals. Each person had a Health Passport for use in emergencies.
“Appropriate and timely referrals had been made to professionals involved in people's care and action had been taken to act on advice given.” from the report
Risk records lacked detail
needs fixingRisk assessments were present, but did not always explain how the risk level had been decided or give staff enough detail about reducing risks.
“However, it was not always clear how the level of risk had been identified and instructions for staff on how to mitigate risks lacked detail.” from the report
Medicines checks needed strengthening
needs fixingOne medicines record was not completed as expected. Staff medicine competence had also not been reassessed regularly, although the manager said a plan was being put in place.
“We identified one person's record had not been completed as per the provider's expectations.” from the report
Quality monitoring was not consistent
needs fixingAudits did not always identify important gaps, including missing mental capacity and medicines competency assessments. Improvement plans were not always in place to make sure action happened promptly.
“However, these audits did not always identify actions needed to continuously drive improvement.” from the report
Required notifications were late or missing
seriousThe provider and manager had not met their legal duty to notify CQC about people with Deprivation of Liberty Safeguards in place.
“The registered manager and provider had not met their legal obligation to notify us about people with a Deprivation of Liberty Safeguards (DoLS) in place.” from the report
Some decisions were not clearly recorded
needs fixingStaff understood the Mental Capacity Act, but the home did not have a clear internal process showing how it decided that a person lacked capacity.
“However, there was no clear internal process to demonstrate how the service had come to a decision a person lacked capacity.” from the report
- 01How have you completed and reviewed the new detailed risk assessments for each person?
- 02How often are staff now reassessed as competent to administer medicines, and how are medicines records checked?
- 03Have all outstanding refresher training, supervision and appraisal records now been completed?
- 04How do you record mental capacity decisions and show that they are made lawfully and in the person's best interests?
- 05How do you record and review the practical support each person receives to achieve their goals and end of life wishes?
This was a planned inspection covering all five CQC questions, including the premises and care, but the provider could not complete its Provider Information Return because of technical problems. This explanation was written from the published report of 6 July 2019 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, June 2018
Rated Requires Improvement; inspectors found kind and responsive care, but weaknesses in safety checks, medicines and management oversight.
The inspection was comprehensive, unannounced and took place on 21 May 2018. One inspector spoke with all four people living at the home, two relatives, four care staff and the registered manager. They also reviewed two care plans, daily records, medicine records and management checks.
The home was rated Good for Effective, Caring and Responsive. Staff knew people well, supported their choices and treated them respectfully. There were enough staff, people were supported with food and healthcare, and relatives said they were happy with the care.
Safe and Well-led were rated Requires Improvement. Risk assessments were missing, medicines records and processes were not consistently safe, and some safety and repair issues had been left unresolved. Audits identified problems, but action was not always taken promptly.
The overall rating changed from Good at the previous inspection to Requires Improvement. This means the home was not consistently meeting the expected standard in some important areas, although three of the five areas remained Good.
Kind and respectful staff
People were comfortable with staff, who knew them well and supported their privacy, dignity and choices.
“People were comfortable in the presence of staff. We saw that all four people moved about the home, without restrictions, and interacted with staff.” from the report
Enough staff and useful training
Staff said they had enough time to support people and received induction, refresher training and supervision.
“There were enough staff on shift to support people and meet their individual needs.” from the report
Personalised support
Staff adapted support to people's needs and preferences, including activities, dental care, food choices and health appointments.
“People's needs were assessed and plans of care developed so staff had the information they needed to meet those needs in an individual and consistent way.” from the report
Missing risk assessments
seriousRisks were often known verbally but not properly assessed or recorded. This included falls and the safe use of an electronic cigarette charger.
“We found this person had no falls risk assessment despite there being previous falls when they had lost their balance.” from the report
Medicine safety
seriousOne medicine was recorded incorrectly and another was missing from a medicine record. Creams, as-needed medicines and medicine signatures were not managed consistently.
“This posed a risk of this person not being given all of their correct medicine.” from the report
Poor follow-through on audits
needs fixingAudits identified problems, but actions were not always completed or checked by the registered manager and provider. Some actions had remained open for long periods.
“Where actions were identified as needed for improvements to be made, these had not always been completed and remained outstanding for over six months.” from the report
Unresolved premises and infection issues
needs fixingA shared towel remained in a communal toilet and shower room despite an earlier warning. Repairs and privacy improvements, including flooring, radiators, a handrail and a blind, were also delayed.
“However, we saw the communal ground floor toilet / shower room had a communal use hand towel for people to use as an alternative to the paper towels available.” from the report
Accidents were not analysed
needs fixingAccidents were recorded, but there was no overall analysis and actions to reduce the chance of repeat accidents were not always taken promptly.
“However, there was no overall accident analysis.” from the report
- 01Have complete, up-to-date risk assessments now been written for falls, uneven ground and the use of the electronic cigarette charger?
- 02How are medicine records checked now, including medicine signatures, opened creams, as-needed medicine instructions and medicine stock?
- 03Have the gas safety check, accessible emergency evacuation plans, handrail, flooring, radiators and shower-room privacy blind all been dealt with?
- 04How are accidents now analysed, and how do you make sure actions are completed to prevent them happening again?
- 05How does the registered manager and provider now check that audit actions are completed promptly rather than remaining outstanding?
This was a comprehensive, unannounced inspection of all five key questions; inspectors reviewed two people's care plans and records and also spoke with all four people living at the home. This explanation was written from the published report of 16 June 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 Hatfield House
3 rated inspections over 3 years: the service has held its Good rating throughout.
- July 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 3 February 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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At least 100 live-in carers within about an hour of Warwickshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £950 to £1,260 a week. 77 can care for a couple. 11 years' experience on average.
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