CQC report explained · a nursing home
What the CQC found at Hayward Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2022
Requires Improvement; inspectors found missed medicines, staffing pressures and weak quality checks.
This was an unannounced inspection on 6 and 7 July 2022. Three inspectors spoke with people and staff, reviewed care and medicines records, checked recruitment and safety records, and observed care for people living with dementia.
The main concerns were medicines not always being given as prescribed, too few staff at times, and weak systems for checking and improving the service. In June 2022, there were eight medicine incidents. One person missed 14 doses because their medicine was not in stock.
There were also positive findings. The home was clean, infection control arrangements were suitable, risks were assessed, and people said they felt safe and liked the staff. However, the overall rating fell from Good at the previous inspection to Requires Improvement.
People felt safe
People told inspectors they felt safe and liked the staff.
“People told us they felt safe and they liked the staff.” from the report
Clean and prepared
The home was clean and inspectors were assured that infection prevention measures and PPE arrangements were suitable.
“The home was clean throughout. Staff were wearing appropriate personal protective equipment (PPE).” from the report
Risk planning
Risk assessments covered issues such as mobility, skin breakdown and catheter care. Staff understood the actions needed to keep people safe.
“Risk assessments and management plans had been reviewed and updated as people's needs changed.” from the report
Healthcare links
Staff worked with health and social care professionals and made referrals when people needed further support.
“Staff worked with a range of healthcare professionals to make sure people's health needs were met.” from the report
Medicines were missed
seriousPeople did not always receive medicines as prescribed. There were eight medicine incidents in June 2022, and one person missed 14 doses because their medicine was unavailable.
“During June 2022 there were eight incidents in which people were either not supported to take their medicine at all, or they received a lower dose of medicine than they had been prescribed.” from the report
Staffing pressures
seriousPeople and staff said there were not always enough staff. Inspectors saw delays and found that staff did not always have time for meaningful interaction with people living with dementia.
“There are not enough of them. You have to be patient and wait for them to come to you.” from the report
Gaps in nurse cover
seriousThe home did not have a registered nurse in the building for a period on three occasions since October 2021.
“There had been three occasions since October 2021 when the home did not have a registered nurse in the building for a period.” from the report
Weak quality checks
needs fixingThe provider knew about medicine errors but they had increased despite its improvement plan. It had not formally surveyed people using the service for two years.
“The provider did not have effective systems to assess the quality of the service and make improvements.” from the report
- 01How many medicine errors have there been since the inspection, and what has been done to prevent missed or reduced doses?
- 02How do you now check that staffing levels are enough for people's care and social needs, especially for people living with dementia?
- 03What arrangements are in place if the home is at risk of having no registered nurse on site?
- 04What results did the staff survey and any later survey of residents produce?
- 05Can we see the action plan responding to the CQC breaches and evidence of the improvements made?
This was a focused inspection prompted by concerns about medicines and covering Safe and Well-led; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 1 September 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, September 2020
Hayward Care Centre is rated Good; inspectors found kind, well-led care, but medicines and some infection-control practices needed improvement.
This was a focused inspection on 13 August 2020. It followed whistle-blower concerns about care during the Covid-19 pandemic, medicines, infection control and leadership. Inspectors spoke with staff, reviewed 11 care records and medicines records, observed care, and contacted health and social care professionals.
The home was rated Requires Improvement for Safe. Medicines were not always managed safely. Records about medicines being returned to the pharmacy were incomplete, some medicines could be accessed without a clear record, and national guidance was not always followed when completing medicine records. Some staff also did not consistently follow hand-washing guidance, and some hydration records were incomplete.
The home was rated Good for Well-led. Inspectors saw warm and person-centred care, enough staff to meet people's needs, and a management team that knew people well. The home acted promptly after inspectors raised concerns, although its audits had not identified every problem.
The overall rating stayed Good. This was because only Safe and Well-led were inspected, while ratings for the other questions came from the previous comprehensive inspection. The previous overall rating, published in May 2019, was also Good.
Kind and personal care
Inspectors saw staff being warm and person-centred. Staff knew people's interests and routines well.
“We saw people being supported by staff who were warm, friendly and person-centred in their approach.” from the report
Enough staff
The inspection found enough staff available to meet people's needs. Recruitment checks were also carried out before staff started work.
“Based on our observations, we found there to be enough staff available to meet people's needs.” from the report
Support during Covid-19
People were helped to keep in contact with relatives through phone calls, video calls and garden visits. Social distancing measures were used in shared areas.
“Also, phone calls and video calls with relatives were facilitated during difficult and emotional times.” from the report
Medicines systems
seriousMedicines waiting to go back to the pharmacy were not always securely stored or properly recorded. This meant medicines could be accessed without a clear record of what had happened.
“Records of medicines to be returned to the pharmacy were not well maintained.” from the report
Medicine records
seriousSome handwritten changes to medicine records were signed by only one staff member instead of two, contrary to national best-practice guidance.
“National best practice guidance was not always being followed in the medicine administration records (MAR) when staff added hand-written details about people's prescriptions.” from the report
Hydration records
needs fixingRecords for some people at risk of dehydration did not consistently show that they had received enough to drink. Inspectors did see people being offered drinks and having fresh drinks available.
“Records for people at risk of dehydration were not consistently maintained to show they had enough to drink.” from the report
Audits missed problems
needs fixingThe home's checks did not identify all the medicines, infection-control and care-record issues found by inspectors. Action was taken promptly after the inspection feedback.
“However, not all were identifying the issues we found during the inspection.” from the report
- 01Have the medicines systems been overhauled, and what checks now confirm that medicines returned to the pharmacy are secure and fully recorded?
- 02How do you make sure medicine administration records are completed correctly, including when prescriptions are handwritten?
- 03What monitoring is now in place to make sure staff wash their hands consistently when supporting different people?
- 04How do you check that people at risk of dehydration are drinking enough and that their records are complete?
- 05Have all the actions promised after this inspection been completed, and can families see how the results are checked?
This was a focused inspection of Safe and Well-led only; the other ratings came from the previous comprehensive inspection. This explanation was written from the published report of 23 September 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.
Every inspection of Hayward Care Centre
6 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- September 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2020Goodstayed GoodSafe: Requires improvementWell-led: Good
- May 2019Goodup from Requires improvementSafe: Requires improvementWell-led: Good
- June 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- August 2015Requires improvementSafe: Requires improvementEffective: InadequateCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2015
Registered with the Care Quality Commission on 16 January 2015.
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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