CQC report explained · a nursing home
What the CQC found at Hazel Bank Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2024
Rated Requires Improvement; inspectors found kind, effective care and clear progress, but recruitment checks, medicines records and quality monitoring still need strengthening.
This was an unannounced follow-up inspection on 4 and 5 January 2024. Inspectors, a medicines inspector and an Expert by Experience looked around the home, observed care, spoke with people, relatives, staff and professionals, and checked care, medicines, recruitment and management records.
The home had improved since its last inspection, which was rated Inadequate. Inspectors found enough experienced staff, kind relationships, improved care plans, good support with food and health needs, and better monitoring of quality and safety.
Some important improvements were still needed. Recruitment checks were not always complete, records for some topical medicines were inconsistent, and some capacity assessments and best-interest decisions were not robust. The overall rating is now Requires Improvement. The home is no longer in Special Measures and was not in breach of regulations at this inspection.
Kind relationships
People appeared relaxed with staff. Inspectors saw warm, trusting relationships and said staff respected privacy, dignity and independence.
“People were well supported. Their privacy, dignity, and independence were respected and promoted.” from the report
Enough experienced staff
The home had enough staff to keep people safe. People were supported by a consistent and experienced team.
“The provider ensured there were enough staff to support people safely. People were supported by a consistent and experienced team.” from the report
Good support with needs
People were supported with nutrition, health care and activities. The home worked closely with health and social care professionals.
“There were close links with other health and social care professionals which included a weekly ward round by the GP.” from the report
Clear improvement
The provider had acted on the previous inspection findings. Inspectors found improvements in staffing deployment, nutrition and hydration monitoring, care planning and quality checks.
“The provider had taken positive action to address the issues from the last inspection.” from the report
Recruitment checks
needs fixingThe provider had not always followed its recruitment policy. Some records were incomplete and one staff member had not had all checks completed.
“They had not always followed their own recruitment policy and we found examples where records were incomplete and one instance where full checks had not been carried out for a staff member.” from the report
Topical medicine records
minorMedicines were generally managed safely, but records for some non-medicated creams and other topical preparations were inconsistent. The provider was asked to review its monitoring.
“However, there were some recording inconsistencies for non-medicated topical preparations.” from the report
Mental Capacity Act decisions
needs fixingSome people used bed or chair sensors without the required capacity assessments and best-interest decisions. The provider was asked to improve staff guidance and training.
“We saw examples where people were using bed and chair sensors without the appropriate capacity assessments and best interest decisions being in place.” from the report
Quality checks
needs fixingAudit systems had improved but were not fully established. They had not identified some problems in care records and staff recruitment.
“We found some areas where the systems required improvement to ensure they were fully embedded and identified all areas robustly.” from the report
- 01How have you checked that all current staff recruitment files now contain the required checks?
- 02How do you record and monitor the application of topical medicines and creams?
- 03How do you make sure bed and chair sensors are covered by proper capacity assessments and best-interest decisions?
- 04How are your audits now identifying gaps or contradictions in care records?
- 05What further improvements remain on the service improvement plan, and when will they be checked?
This was a follow-up inspection of action from the previous inspection; the report says ratings for key questions not inspected carried over from the last inspection. This explanation was written from the published report of 25 January 2024 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 2023
Rated Inadequate and placed in special measures; inspectors found serious safety, care and leadership shortfalls, although some staff interactions were warm.
Inspectors visited without notice on three days in April 2023. They spoke with people, relatives, staff and a health professional. They observed care and reviewed care records, medicines records, recruitment files, training records, audits and policies.
They found serious problems with risk management, medicines, care records and learning from accidents. People were also not always treated with dignity or given choices. Leadership and checks on quality had not identified or fixed problems raised at earlier inspections.
The overall rating was Inadequate. Safe and well-led were rated Inadequate, while effective and caring were rated Requires Improvement. The home was placed in special measures, meaning CQC said it would keep the service under review and normally reinspect within six months.
Staff training
Staff had received training for their roles, including refreshed moving and handling training. Medication staff had also been trained and assessed as competent.
“Staff had received training to administer medication and had their competency assessed in line with good practice guidance.” from the report
Safe recruitment
The home had improved its recruitment checks and introduced a tracker to monitor them.
“The required employment checks had been completed to ensure staff were suitable to work with people.” from the report
Health professional links
The home worked with health and social care professionals. Records showed healthcare involvement, and a visiting professional spoke positively about communication.
“They [staff] are on the ball. They are always welcoming and accommodating.” from the report
Infection control
Inspectors were assured that infection risks were being managed, including the use of protective equipment and the handling of possible outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Some caring relationships
Inspectors saw examples of warm interactions, and people and relatives generally spoke positively about staff.
“Most staff demonstrated caring values and a commitment to support people in a person-centred way.” from the report
Risks were not managed
seriousRecords did not consistently show that people received required checks or repositioning. Accidents and falls were not always followed up, leaving people at risk of further harm.
“People were exposed to the risk of harm. There was a failure to assess, monitor and mitigate risks in relation to people's health, safety, and well-being.” from the report
Medicines records and guidance
seriousThere was missing guidance and incomplete recording for creams, patches, laxatives and fluid thickener. Inspectors could not be sure that some medicines had been given safely or as prescribed.
“This meant we were not assured people had received their creams as prescribed.” from the report
Dignity and choices
seriousPeople were sometimes ignored when asking for support, were not always given choices and were not consistently supported with privacy, clothing or personal dignity.
“People were not consistently treated with compassion and kindness.” from the report
Care records and admissions
seriousNew people did not always have complete assessments or care plans that staff could access. One person's daily care records were missing for seven days.
“People's needs were not robustly assessed and person-centered care plans were not in place.” from the report
Weak leadership and checks
seriousThe provider's audits and governance systems had not found or fixed serious problems. The report also noted frequent management changes and unreliable records.
“Systems to assess, monitor and improve the service were not sufficiently robust.” from the report
Staffing and dining support
needs fixingStaff were often rushed, particularly in the afternoon. Inspectors also found that some people eating in communal lounges did not receive the dedicated support they needed.
“Staff did not always have time to be flexible to meet people's needs and we observed they were often rushed.” from the report
- 01What evidence can you show that risks such as falls, skin damage, poor nutrition and dehydration are now assessed and reviewed?
- 02How are creams, patches, laxatives and fluid thickener now prescribed, administered and recorded?
- 03How do staff make sure new admissions have complete care plans that are available to all staff from the first day?
- 04What has changed about afternoon staffing, and how do you check that staff have enough time to respond to people?
- 05How are people and their relatives involved in care decisions, including decisions about bed rails and medicines given covertly?
This began as a targeted inspection following Warning Notices about Regulations 12 and 17, then became a focused inspection of Safe, Effective, Caring and Well-led; Responsive was not assessed. This explanation was written from the published report of 3 June 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.
Every inspection of Hazel Bank Care Home
6 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.
- January 2024Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2023Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementWell-led: Inadequate
- February 2023Requires improvementstayed Requires improvementSafe: Requires improvementCaring: Requires improvementWell-led: Requires improvement
- August 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not rated
- December 2017Goodstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 January 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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