CQC report explained · a residential care home
What the CQC found at Hatley Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were safeguarded from harm, risks were generally identified and managed, and there were enough safely recruited staff. Medicines were managed safely, but four administration records had not been signed and some risks were not recorded.
- Effective?
- Good
- This key question was not inspected during this focused inspection. The previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused inspection. The previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused inspection. The previous rating was used when calculating the overall rating.
- Well-led?
- Good
- The provider had audits and other systems to monitor quality and drive improvement. Some records were incomplete, but the manager and provider had identified the issues and had plans to address them.
What inspectors found, December 2020
Rated Good overall; inspectors found safer care and good leadership, but some medicines and other records were incomplete.
This was a focused inspection on 10, 17 and 18 November 2020. Inspectors looked at Safe and Well-led because of concerns about management, staffing, medicines, risk management, infection control and safeguarding.
The home was rated Good for Safe and Well-led. Inspectors found people were protected from harm, there were enough suitably checked staff, risks were generally managed, and infection control arrangements were mostly good. Medicines were managed safely, but four administration records had not been signed.
The home had effective systems for reporting concerns and learning from incidents. However, some records about medicines, consent and risks were incomplete. The manager had been in post since September 2020 and was working to improve the staff culture.
Safeguarding
Staff had safeguarding training and knew how to report concerns. Inspectors found people were safe and relatives said their family members were safe.
“Staff had received training in safeguarding adults and reporting potential abuse. We found staff had ensured people were safe.” from the report
Staffing
Inspectors found enough staff had been recruited safely. Staff had the skills needed and attended to people promptly and without rushing.
“Staff on duty had the necessary skills and knowledge and we saw they attended to people promptly and in an unhurried manner” from the report
Learning from incidents
The home reported incidents and near misses, then changed risk assessments and checked staff competence to reduce the chance of problems happening again.
“To help avoid further risk of harm and any potential recurrences, lessons were learned, such as amending risk assessments” from the report
Involvement in care
People were involved in decisions about their care, food and activities. Staff gave people time to express their choices.
“People were involved with decisions about their care and support and their choices and preferences were respected.” from the report
Family communication
Relatives said staff kept them informed during lockdown and used technology to help people stay in contact with their families.
“Relatives told us they felt staff had informed them of what was happening at the service, particularly during COVID-19 lockdown.” from the report
Medicine signatures
needs fixingFour occasions were found where staff had not signed the medicine administration records after giving medicines. The manager said they would address this through staff supervision.
“However, we found four occasions where staff had not signed for medicines they had administered.” from the report
Incomplete risk records
needs fixingRisks were generally managed, but not all had been recorded. This included individual risk assessments relating to COVID-19.
“For example, individual risk assessments for risk associated with COVID-19, were not present.” from the report
Incomplete care records
needs fixingSome records about medicines, consent to care and risk assessments were not completed correctly. The provider and manager said they would address this immediately.
“Not all records had been completed correctly including medicines administration, consent to care and risk assessments.” from the report
New management arrangements
minorThere was no manager registered with CQC. The current manager had only been in post since September 2020 and was being supported by an operations manager.
“The service did not have a registered manager. The new manager had been in post since September 2020” from the report
- 01How do you now check that every medicine given is signed for on the medicines administration record?
- 02Have individual COVID-19 and other risk assessments now been completed and reviewed?
- 03How are consent decisions and best interest decisions recorded and checked?
- 04What support and oversight is the current manager receiving while applying to become the registered manager?
- 05How are you continuing to improve staff team culture and wellbeing?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and previous ratings were used for the overall rating. This explanation was written from the published report of 9 December 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 2018
Rated Good overall, but Safe Requires Improvement because medicines records and guidance were not always complete.
This was an unannounced, comprehensive inspection on 5 April 2018. Inspectors spoke with people living in the home, relatives and staff. They also reviewed care records, medicines records, health and safety checks and quality monitoring, and observed care.
The home had improved since the previous inspection in August 2017 and its overall rating rose from Requires Improvement to Good. Inspectors found enough staff, suitable recruitment checks, detailed care plans, kind staff and good access to healthcare, food and activities.
The main weakness was medicines safety. Medicines were mostly managed safely, but some records did not accurately show what people had received. Some guidance for 'when needed' medicines was missing, and some medicines kept in rooms were out of date, not prescribed or stored incorrectly.
Kind and respectful staff
People and relatives said staff were kind, caring and respectful. Staff knew people well and supported their choices, privacy and dignity.
“All the people and their relatives spoken with said that staff worked hard and were kind, caring and respectful to them.” from the report
Enough staff
Inspectors found staffing levels were sufficient and people received help promptly. Staff said they had enough time to provide care and talk with people.
“There was enough staff to keep people safe.” from the report
Detailed care plans
Care plans contained practical information about people's needs, risks and preferences. Records showed staff followed the plans and updated them after changes such as hospital stays.
“The care plans were detailed and included all of the information that staff required to meet people's individual needs.” from the report
Activities and daily life
People had daily activities, one-to-one support and opportunities to follow hobbies and interests. Inspectors saw people taking part in a quiz and responding positively.
“There was a wide range of activities for people to be involved in.” from the report
Quality checks
The home used regular audits, meetings and feedback from people, relatives and staff to identify and address improvements.
“There was an effective quality assurance system in place to ensure that, where needed, improvements were made in the home.” from the report
Inaccurate medicines records
seriousSome records did not show all medicines given, including medicines administered by visiting health professionals. Records for creams and ointments did not always match what was being used or where it was applied.
“Records were not always an accurate reflection of medicines people had received.” from the report
Missing medicines guidance
needs fixingA few protocols explaining when to give 'as required' medicines, including some painkillers and a laxative, were missing.
“In a few cases these were missing for pain killers and a laxative.” from the report
Medicines stored incorrectly
seriousSome medicines in people's rooms were out of date, no longer prescribed or stored in a refrigerator with food. One allergy-related decision was also not documented in the person's records.
“We did find some people's medicines in their rooms that were out of date, not currently prescribed or stored inappropriately in the refrigerator with food.” from the report
Activities noticeboard not up to date
minorDaily activities were being organised, but the weekly noticeboard did not list them at the time of the inspection.
“Although a schedule of daily activities for the week was not available at the time of the visit” from the report
A collection request was not recorded
needs fixingOne relative said a request for someone to be ready for an outing had not been recorded, so the person was not ready when collected.
“When the relative raised their concern with staff they were told that they request had not been recorded.” from the report
- 01How do you make sure medicines given by visiting health professionals are recorded on the medicines administration record?
- 02What checks are now in place to ensure 'as required' medicines have clear protocols?
- 03How do you check medicines kept in people's rooms are in date, prescribed and stored safely?
- 04How are requests about outings and other arrangements recorded and passed to staff?
- 05How will people and relatives be told about the current daily activities?
This was an unannounced inspection of the overall service and all five CQC questions, including care, accommodation, medicines, staffing and management. This explanation was written from the published report of 16 May 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 Hatley Court
5 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- December 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2018Goodup from Requires improvementSafe: Requires improvementWell-led: Good
- October 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- November 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2016
Registered with the Care Quality Commission on 22 January 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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17 live-in carers within about an hour of Cambridgeshire
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 £1,020 to £1,200 a week. 14 can care for a couple. 12 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.