CQC report explained · a nursing home
What the CQC found at Haughgate House Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found safe medicines practice and prompt responses to call bells, but some risk assessment reviews were overdue and some areas were not thoroughly clean.
- Effective?
- Good
- Staff had training, induction and supervision, and people's health needs were supported with help from health professionals. Some care plans were not reviewed on time and some fluid charts were incomplete.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff supported independence and involved people in decisions about their care and daily lives.
- Responsive?
- Good
- Care was personalised and people could take part in activities, community groups and visits. Complaints systems were in place and people and relatives knew how to raise concerns.
- Well-led?
- Good
- The home had quality checks, sought feedback and worked with outside professionals. However, the home's own audits had not identified some of the cleaning and recording problems found by inspectors, and there was no registered manager at the time.
What inspectors found, February 2023
Rated Good; inspectors found kind, person-centred care and improvements since the previous inspection, but some records and cleaning needed attention.
This was an unannounced follow-up inspection on 8 February 2023. Inspectors spoke with 6 people, 7 relatives and staff. They reviewed 10 care records and documents about medicines, recruitment and health and safety.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People generally spoke positively about the care. Staff were described as kind, knew people well and supported personal choices, activities and contact with relatives.
The home had improved from Requires Improvement at the previous inspection in December 2021. Inspectors found it was no longer in breach of the regulations identified previously. They still found some overdue risk and care plan reviews, incomplete fluid records and areas that were not thoroughly clean.
Kind and respectful care
People and relatives described staff as kind, helpful and respectful. Staff knew the people they supported and encouraged independence.
“People were supported by kind and caring staff who knew them well.” from the report
Activities and relationships
People were supported to maintain family relationships, attend community groups and take part in activities inside and outside the home.
“People were supported to access local community groups.” from the report
Improvement since the last inspection
The provider had acted on the previous inspection findings. Inspectors found the home was no longer in breach of the regulations previously identified.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Staffing views were mixed
needs fixingPeople and relatives did not all agree that there were enough staff, although most staff thought staffing was sufficient. Inspectors saw staff in the home and call bells were answered promptly, while recruitment was continuing.
“We received mixed views as to whether there were enough staff to meet people's needs.” from the report
Some risk reviews were overdue
needs fixingIndividual risks were assessed, but some reviews had not been completed on time. Ask how the home now checks that reviews are kept up to date.
“However, some reviews of risk assessments were overdue.” from the report
Records were not always complete
needs fixingSome care plans had not been reviewed according to the home's policy. Some records of people's fluid intake were also incomplete.
“Some fluid charts were not fully completed. We discussed this with the manager who identified it as a recording issue which they would address.” from the report
Cleaning needed improvement
needs fixingInspectors were only somewhat assured about the cleanliness of the premises because some areas were not thoroughly clean.
“Some areas of the service were not thoroughly clean.” from the report
No registered manager at the inspection
minorThe manager had applied to register with the CQC, but the application was still being assessed when inspectors visited.
“The service did not have a registered manager.” from the report
- 01What has changed to make sure staffing levels meet people's needs, especially at busy times?
- 02How do you now make sure risk assessments and care plans are reviewed on time?
- 03What action was taken after inspectors found some areas were not thoroughly clean?
- 04How do you check that fluid charts are completed fully and accurately?
- 05What is the current position of the manager's application to register with the CQC?
This was an unannounced follow-up inspection prompted by the previous inspection, covering all five key questions and infection prevention and control. This explanation was written from the published report of 22 February 2023 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, December 2021
Haughgate House Nursing Home was rated Requires Improvement; inspectors found risks involving staffing, infection control, medicines and management checks.
This was an unannounced inspection on 17 and 18 November 2021. Inspectors spoke with people living in the home, relatives and staff. They reviewed care records, medicine records, staff files and management information.
The home had too few permanent care staff and nurses, with heavy use of agency staff. Inspectors found unsafe risks from hot radiators, bed rails, missing risk plans and incomplete medicine records. Cleaning and infection control were not reliable, including in rooms where people had died.
The home’s checks did not identify these problems. Inspectors found breaches of regulations covering safe care and treatment, good governance and staffing. The overall rating fell from Good at the previous inspection to Requires Improvement.
People felt safe
People told inspectors they felt safe and were treated well by staff.
“People told us they felt safe and that staff treated them well.” from the report
Kind staff
People told inspectors that staff were kind.
“People told us staff were kind.” from the report
COVID-19 arrangements
Inspectors were assured that visitor screening, testing, personal protective equipment and visits were in place.
“We were assured that the provider was using PPE effectively and safely.” from the report
Safer recruitment checks
The required checks had been completed for the staff files inspectors reviewed.
“Required recruitment safety checks had been carried out to ensure that staff employed were suitable to carry out the work they were employed to perform” from the report
Staffing shortages
seriousThere was a high use of agency staff and occasions when there were not enough staff to meet people’s assessed needs. The staffing dependency tool was not regularly updated.
“We noted from a review of management reports, rotas and talking with staff there was a high number of agency staff employed to fill gaps in staffing shortages” from the report
Risks in the building and care plans
seriousPeople were at risk from hot radiators and the use of bed rails had not always been reviewed. Some people also lacked clear risk information, including people with epilepsy.
“We found people were at risk of burns and scalding from hot surface radiators in people's rooms.” from the report
Infection control
seriousCleaning schedules were not accurate. Some rooms had not been deep cleaned after deaths, including a room containing clinical waste and medicines after a person who had COVID-19 died.
“We found rooms of people who had died unlocked and had not been deep cleaned with beds unchanged.” from the report
Medicine records
seriousSome creams and lotions did not have medicine administration records, and other records had gaps in staff signatures. Internal and external medicines were also stored together.
“This meant we were not assured people had received their medicines as prescribed.” from the report
Weak management checks
seriousAudits did not identify several safety and infection risks. Investigations did not always record lessons to prevent future harm.
“The provider's quality assurance systems were not robust.” from the report
Changes in leadership
needs fixingThere had been several changes of registered manager in the previous year. The registered manager was due to leave and new management arrangements were planned.
“There had been changes of registered manager in the last 12 months with a third change imminent which had destabilised the service and resulted in inconsistency in approach.” from the report
- 01How many permanent nurses and care staff are currently employed, and how often are agency staff being used?
- 02What changes have been made to check staffing levels against people’s changing needs?
- 03How are hot radiators, bed rails and other risks now identified and reviewed for each person?
- 04How do you check that creams, lotions and other medicines are recorded as given and stored safely?
- 05What evidence can you show that cleaning, infection control and management audits have improved since this inspection?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were not covered by this report. This explanation was written from the published report of 22 December 2021 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 Haughgate House Nursing Home
3 rated inspections over 4 years: the service has held its Good rating throughout.
- February 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Haughgate House Nursing Home →
- December 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Haughgate House Nursing Home →
- April 2019GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2018
Registered with the Care Quality Commission on 15 February 2018.
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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23 live-in carers within about an hour of Suffolk
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Most charge £1,020 to £1,260 a week. 17 can care for a couple. 7 years' experience on average.
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