CQC report explained · a nursing home
What the CQC found at Havelock Court Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People were protected from abuse and medicines were managed safely. However, some risk assessments lacked enough detail, and people reported waits of up to 15 minutes for call bells.
- Effective?
- Requires improvement
- People had suitable food, access to healthcare and staff training. However, some staff did not receive regular supervision, communal areas were affected by refurbishment, and one floor had a strong odour and unclean areas.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were involved in decisions about their care and encouraged to remain as independent as possible.
- Responsive?
- Requires improvement
- Communication needs and complaints were handled well, but activities were not sufficient for everyone's social needs. Care plans did not always describe people's routines, preferences or end-of-life wishes clearly enough.
- Well-led?
- Requires improvement
- People and staff spoke positively about the manager and felt able to raise concerns. However, monitoring did not identify or address several problems consistently, including gaps in records, staffing time, supervision and activities.
What inspectors found, November 2022
Rated Requires Improvement; inspectors found kind care and safe medicines, but concerns about staffing response times, activities, records and oversight.
Inspectors made an unannounced visit on 13 September 2022. They spoke with people, staff and healthcare professionals, and checked care plans, recruitment files, medicines, incidents, fire safety and management records.
The home was rated Good for caring. People were treated with kindness, dignity and respect, and staff supported people's choices and independence. Medicines were managed safely, people were protected from abuse, and healthcare support was available.
The other four areas were rated Requires Improvement. Inspectors found long waits for some call bells, too few staff time for meaningful activities, gaps in risk and care records, incomplete best-interest decisions, missed staff supervisions and problems with cleanliness and odour in one area.
The overall rating means there was limited assurance that care was consistently safe and effective. The provider breached Regulation 17 on good governance. The home had to provide an action plan, and the CQC said it would monitor progress with the local authority.
Kind and respectful staff
People said staff looked after them well. Inspectors observed friendly and respectful interactions, with attention to dignity, choice and independence.
“During the inspection we observed staff interacting with people in a friendly and respectful manner.” from the report
Medicines managed safely
The medicines round followed good practice. Records were complete, stock balances matched, and people were supported to self-administer where safe.
“Medicine Administration Records (MAR) were completed accurately with no gaps or omissions.” from the report
Protection from abuse
Staff knew how to recognise, report and escalate safeguarding concerns. Records showed incidents were shared with the local authority when required.
“People continued to be protected against the risk of abuse, as staff understood how to recognise the signs of potential abuse and knew how to escalate and report any concerns” from the report
Access to healthcare
People could request GP visits and were supported to access healthcare professionals. Healthcare staff said guidance was acted on.
“People continued to have access to healthcare services to monitor and maintain their health and wellbeing.” from the report
Risk information was not detailed enough
needs fixingSome risk assessments did not explain clearly enough how staff should respond to individual needs, including signs of distress or feeling overwhelmed.
“Records showed that potential risks to people were not always suitably assessed and managed as well as they could be.” from the report
Delayed call bell responses
seriousPeople said they sometimes waited a long time for staff to respond. Inspectors found recorded responses of up to 15 minutes.
“We reviewed the call bell analysis and found there were instances whereby staff had taken up to 15 minutes to respond to the call bell.” from the report
Too little activity and interaction
needs fixingSome people had little or no interaction with staff and did not have enough activities to meet their interests and social needs.
“People did not always receive sufficient activities to meet their social needs and preferences.” from the report
Inconsistent care records
needs fixingCare records did not consistently describe people's daily routines, preferences, best-interest decisions or end-of-life wishes. This meant staff might not have all the information needed.
“Management had not consistently ensured records were always contemporaneous and clearly reflected people's needs to ensure staff had all the information they needed to care for people.” from the report
Weak quality oversight
seriousThe provider's monitoring did not identify or correct several issues before the inspection. This was a breach of the good governance regulation.
“The failure to ensure the service was well-led is a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014 Good Governance.” from the report
Cleanliness and refurbishment disruption
needs fixingOne floor had a significant unpleasant smell and areas of uncleanliness. Refurbishment also limited communal areas for sitting, activities and dining at the time of the visit.
“We observed that the first floor had a significant malodour with areas of uncleanliness.” from the report
- 01What has changed to reduce call bell response times, and what are the recent response records?
- 02How many staff are now available to provide activities and meaningful interaction, and what activities are offered to each person?
- 03Have all risk assessments, personalised care plans, best-interest decisions and end-of-life wishes been completed and checked?
- 04Have all staff received the required supervisions, and how is completion being monitored?
- 05What action was taken about the odour and unclean areas, and what was the outcome of the refurbishment?
This was an unannounced inspection covering all five key questions, the premises and care provided, including infection prevention and control; it also considered support for people with a learning disability or autism. This explanation was written from the published report of 16 November 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 2021
Inspected but not rated; inspectors were assured about most infection controls, but had some reservations about managing outbreaks.
The inspection took place on 31 March 2021 during a COVID-19 outbreak. It was a targeted inspection of infection prevention and control, and was announced in advance.
Inspectors found strong arrangements for visitors, testing, isolation, protective equipment, cleaning and social contact with relatives. Staff received infection control training and used protective equipment correctly.
The home was relying heavily on temporary agency staff because many permanent staff were self-isolating. Inspectors were only somewhat assured that outbreaks could be prevented or managed effectively, and the provider was directed towards further resources.
The service was inspected but not rated. This report does not provide an overall quality rating or ratings for care, effectiveness, responsiveness or leadership.
Protective equipment
Staff used protective equipment correctly and had up-to-date infection control and COVID-19 training. The home had enough protective equipment for demand at the time.
“Staff used PPE safely and in accordance with current IPC guidance.” from the report
Cleaning
The home had detailed cleaning schedules, including regular cleaning of frequently touched surfaces. An additional cleaner was being used during the outbreak.
“There were detailed records kept of staffs new cleaning schedules, which included a rolling program of cleaning high touch surfaces, such as light switches, grab rails and door handles.” from the report
Keeping families connected
Although non-essential visits were restricted, people were supported to keep in touch with relatives and friends by telephone and video calls.
“Alternative arrangements were in place to help people living in the care home maintain relationships with relatives and friends.” from the report
Isolation and testing
Managers and staff understood isolation arrangements. Residents and staff were tested regularly, including daily testing for staff during the outbreak.
“Managers and staff understood the principles of isolation and implemented them appropriately.” from the report
Outbreak management
needs fixingInspectors were only somewhat assured that infection outbreaks could be prevented or managed effectively. The provider was directed towards resources to develop its approach, including staff understanding of vaccination.
“We were somewhat assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Reliance on temporary staff
minorThe home was heavily reliant on temporary agency staff because many permanent staff had tested positive and were self-isolating. Agency staff received an induction and were kept on the same units or floors to reduce infection risks.
“The service was now heavily reliant on temporary agency because a large percentage of the permanent staff team had recently tested positive for COVID-19 and were required to self-isolate.” from the report
- 01What has changed in your outbreak prevention and management arrangements since this inspection?
- 02How do you now make sure all staff understand the importance of vaccination and their role in keeping people safe?
- 03How many permanent and temporary agency staff are currently working in the home?
- 04What arrangements are in place to maintain safe staffing if permanent staff are absent?
- 05How are relatives currently supported to visit or keep in touch with residents?
This was a targeted inspection of infection prevention and control during a COVID-19 outbreak; it did not rate the overall service or assess the other four questions. This explanation was written from the published report of 22 April 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 Havelock Court Care Home
6 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- November 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2021Inspected but not ratedSafe: Inspected but not rated
- April 2020Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2019Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2016Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- July 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- October 2010
Registered with the Care Quality Commission on 1 October 2010.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Lambeth
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 £980 to £1,250 a week. 76 can care for a couple. 11 years' experience on average.
“She cared for my mum with Alzheimer's with endless patience and kindness, always arriving with a smile and a positive attitude”
“She is just one of those people that looks around, sees what needs to be done and does it.”
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.