CQC report explained · a residential care home
What the CQC found at Hazeldell Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and staff knew how to reduce them. Medicines were received, stored, given and disposed of safely, and people received them at the prescribed times.
- Effective?
- Good
- People's eating and drinking needs were recorded, with referrals to dieticians when needed. Staff had training and supervision, worked with healthcare professionals and supported people to make decisions.
- Caring?
- Good
- People and relatives said staff were kind, caring and respectful. Staff offered choices, knew people's preferences and protected their privacy and dignity.
- Responsive?
- Good
- Care plans described people's needs and how staff should respond. The home offered activities, supported relationships and had a complaints process, although care plans were still being developed further to make them fully person-centred.
- Well-led?
- Good
- The new manager had implemented the previous action plan and introduced daily senior staff meetings. Inspectors found stronger quality checks, an open culture and better partnership working.
What inspectors found, February 2020
Hazeldell Residential Home rated Good; inspectors found safe, kind and well-organised care after improvements since the last inspection.
This was an unannounced inspection on 29 and 30 January 2020. The inspector spoke with people living in the home, relatives, staff and healthcare professionals. They observed care and checked care plans, medicines records, recruitment files, complaints records and other documents.
The home had acted on the four breaches found at the previous inspection. Inspectors found safer medicines management, better risk assessments, improved nutritional records and more personalised care plans. There were enough staff, and staff had suitable training and support.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The overall rating improved from Requires Improvement. The home was no longer in breach of regulations.
Safer medicines
The home had corrected the previous problems with medicines. Inspectors found that people received medicines as prescribed and staff were trained and knowledgeable.
“People received their medicines at the times they were prescribed.” from the report
Enough staff
There were consistently enough staff to meet people's assessed needs. Recruitment checks were also in place.
“From reviewing rotas and speaking with people and staff, there were consistently enough staff to meet people's assessed needs.” from the report
Kind and respectful care
People described staff as caring. Inspectors saw staff offering choices and respecting privacy, dignity and preferred names.
“Staff fully respected and promoted people's privacy and dignity.” from the report
Improved management
The new manager had fully implemented the action plan from the previous inspection. The home also had a quality assurance system to identify and address shortfalls.
“The service action plan written as a result of the last inspection had been fully implemented.” from the report
Care plans still being developed
minorCare plans had improved, but staff were still adding information to make them fully person-centred. Ask how this work is being completed and checked.
“Staff were working with people at their reviews to increase information about them to further develop the plans into being fully person-centred.” from the report
- 01How do you check that medicines continue to be given at the right times and that any errors are followed up?
- 02How often are risk assessments and care plans reviewed, and how are changes in people's needs recorded?
- 03Which parts of my relative's care plan still need to be made fully person-centred?
- 04How do you decide how many staff should be on duty for the people living here?
- 05What activities and outings are currently available, including support for individual interests?
This was an inspection of all five CQC questions and looked at both the premises and care provided; the home does not provide nursing care. This explanation was written from the published report of 28 February 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, August 2019
Rated Requires Improvement, with an Inadequate Safe rating; inspectors found serious medicines and risk-management failures despite kind staff.
This was an unannounced, planned inspection on 03 and 05 July 2019. One inspector spoke with people, a relative, staff and healthcare professionals, and reviewed care records, medicines records, staff files and management records.
The home was not consistently safe. Some prescribed medicines were not given, risks such as choking and pressure ulcers were not properly assessed, and care records did not always tell staff how to reduce risks. Nutritional support and referrals were also not always properly recorded.
People generally said staff were kind, respectful and quick to respond. The home was clean, there were enough staff during the inspection, recruitment checks were safe, and staff received training and support.
The overall rating fell from Good at the previous inspection to Requires Improvement. All five areas were rated Requires Improvement except Safe, which was rated Inadequate. The provider was required to send an action plan, and CQC said it would continue monitoring the home.
Kind staff
People and relatives spoke positively about staff. Inspectors saw staff offer emotional support and spend time with people who were unwell or distressed.
“There was a caring culture in the service which was evident in the actions of the care staff.” from the report
Staffing and recruitment
People said there were enough staff and that they responded quickly. Recruitment checks were in place to help ensure staff were safe to work with vulnerable people.
“People told us there were enough staff to meet their needs in a timely way, and this confirmed our observations.” from the report
Training and induction
Staff received a wide range of training, competency checks and a comprehensive induction. They also had opportunities to gain qualifications and take on more responsibility.
“The service provided staff with a wide range of training.” from the report
Clean environment
The home was clean and tidy. Staff had suitable protective equipment and changed it between tasks to reduce infection risks.
“The service was clean and tidy. People told us their home was kept clean.” from the report
Learning from falls
The home investigated a high number of falls and took action to support people. Inspectors saw a significant reduction in recorded falls afterwards.
“We saw that this had led to a significant reduction in the number of falls recorded in subsequent months.” from the report
Medicines were not always safe
seriousSome medicines were recorded as given but remained in blister packs. Refused medicines were not managed safely, and guidance was missing for some medicines taken when needed.
“Some medicines had been signed for as administered but remained in the blister pack.” from the report
Important risks were not planned for
seriousCare records did not consistently explain how staff should reduce risks such as choking, pressure ulcers or possible harm to other residents. Conflicting dietary information could also have led to unsuitable meals.
“There were significant shortfalls in the identification of and planning for risks to people.” from the report
Weight loss was not always managed
seriousSome people had significant weight loss without clear care plans or evidence of appropriate dietician referrals. Advice that had been received was not always added to care records.
“The support people required with eating and drinking was not always clearly documented in their care records.” from the report
Care was not always personalised
seriousPeople's views, preferences, life histories and independence needs were not consistently reflected in their care plans. End-of-life plans also lacked sufficient detail.
“Care plans required further development to ensure consistent personalisation and avoid generic statements.” from the report
Management did not act quickly enough
seriousAudits had identified many problems, but serious shortfalls remained. Action plans had not led to prompt and robust improvements, especially for medicines and risk assessments.
“Despite this, robust improvements had not been made and significant shortfalls in medicines administration remained at our visit.” from the report
- 01What action has been completed to ensure every medicine is given, recorded and reviewed safely?
- 02How are choking, pressure-ulcer and other individual risks assessed and explained to all staff, including agency staff?
- 03How are people who have lost weight supported, and when are dietician or other healthcare referrals made?
- 04How are capacity assessments and best-interests decisions recorded for people who may not be able to make particular decisions?
- 05Has the new manager started, and how is the provider checking that the previous inspection action plan is being completed?
This was an unannounced, planned inspection covering all five CQC questions; the report says the previous rating was Good, published on 23 March 2017. This explanation was written from the published report of 1 August 2019 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 Hazeldell Residential Home
3 rated inspections over 3 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2019Requires improvementdown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2015
Registered with the Care Quality Commission on 10 February 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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