CQC report explained · a nursing home
What the CQC found at Hazelhurst Nursing Home
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- Inspectors found suitable staffing, recruitment checks, risk assessments, safety checks and medicines arrangements. Four medicine recording errors had occurred in the previous year, although records were checked each medicine round.
- Effective?
- Outstanding
- Assessments and care plans reflected people's needs and choices. Staff training was up to date, food and drink needs were supported, and the home worked effectively with health professionals.
- Caring?
- Good
- People and relatives described staff as kind, caring and friendly. Inspectors saw respectful interactions and found that people were involved in decisions about their care and daily lives.
- Responsive?
- Outstanding
- Care and activities were highly personalised. People were supported with communication, relationships, interests, cultural needs, complaints and end of life wishes.
- Well-led?
- Good
- The managers provided good leadership and staff worked towards a shared focus on people's care and wellbeing. Audits, meetings and an ongoing improvement plan were used to monitor and improve the home.
What inspectors found, February 2020
Rated Outstanding; inspectors found exceptionally effective and responsive care, with safe, kind and well-led support.
This was an unannounced inspection on 12 December 2019. One inspector spoke with people, relatives, staff and a healthcare professional. They observed care and checked care records, training, complaints, audits and quality reports.
The home was rated Outstanding overall. Effective and Responsive were Outstanding. Safe, Caring and Well-led were Good. Inspectors found enough staff, safe medicines systems, suitable training, kind care and strong attention to people's individual needs and wishes.
People had personalised care plans, regular activities and support to keep in touch with family and the community. The home also provided good end of life care and worked closely with health and social care professionals.
The previous overall rating was Good, published in July 2017. Effective and Responsive improved from Good to Outstanding. Safe, Caring and Well-led remained Good.
Personalised care
Care plans reflected people's needs, preferences and life histories. Staff knew people well and adapted support to what mattered to each person.
“The plans were very informative and provided a true reflection of the person's care and support needs.” from the report
Activities and relationships
The home offered a wide range of activities, including individual opportunities based on people's interests. Visitors could come at any time.
“There was a range of planned activities each day and people were continually asked what they would like to do.” from the report
Staff skills
Staff had completed induction and refresher training, including clinical, dementia and end of life training. They also received regular supervision.
“Training records were kept for each staff member and they evidenced that all staff training was up to date.” from the report
Kind and respectful care
People and relatives gave very positive feedback. Inspectors saw staff maintaining privacy, dignity and respectful relationships.
“Staff treated people well at all times and their dignity and privacy were maintained.” from the report
End of life support
The home worked with families, GPs and hospice nurses to support people's wishes and help them remain at the home where possible.
“Where end of life care wishes were difficult to achieve, the staff looked for solutions to ensure the person received the best care.” from the report
Medicine recording errors
minorThe provider reported four medicine recording errors in the previous 12 months. Inspectors said medicine records were checked each round so errors could be identified and addressed quickly.
“The provider told us in the last 12 months there had been four medicine recording errors.” from the report
Pending liberty safeguards
needs fixingEight people had Deprivation of Liberty Safeguards authorisations in place, while seven others were waiting for approval. The report says the home had systems to monitor when authorisations needed renewal.
“DoLS authorisations were in place for eight people and seven others were waiting for approval.” from the report
- 01What is the current position on the seven Deprivation of Liberty Safeguards applications that were waiting for approval?
- 02What caused the four medicine recording errors reported in the previous year, and what checks are now in place to prevent them?
- 03How do you decide staffing levels for each shift, and how often do you need agency staff?
- 04How would you tailor activities and communication for my relative's interests, abilities and communication needs?
- 05How would you support my relative's end of life wishes and keep our family involved?
This was an unannounced comprehensive inspection covering all five CQC questions, with the previous ratings for Effective and Responsive improving from Good to Outstanding. This explanation was written from the published report of 25 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, July 2017
Hazelhurst Nursing Home was rated Good; inspectors found safe, kind and person-centred care, with some staffing and management issues to watch.
The inspection was unannounced and took place on 25 May 2017. Two inspectors and an Expert by Experience observed care, spoke with people, relatives and staff, and checked care records, medicines, complaints and quality audits.
The home was rated Good overall. All five areas were also rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practice, good support with meals and health, and respectful care.
People were supported to keep their interests and independence. Inspectors saw links with the local community, activities tailored to people's lives, and a strong focus on dignity and end-of-life care.
There was no registered manager when inspectors visited, although this was a recent change and recruitment was under way. Staff said agency use meant care was not always consistent, and some staff needed more knowledge about legal safeguards and people's inherited care plans were being reviewed.
Safe care and medicines
Inspectors found enough staff to meet people's needs and saw that medicines were given safely and as prescribed.
“There were enough staff to meet people's needs safely.” from the report
Respect and dignity
The home made practical changes to protect privacy and dignity, including discreet signs, dignity boxes and more appealing dining equipment.
“There was an emphasis in the home on dignity and respect.” from the report
Good end-of-life care
People and relatives were consistently positive about the care. Inspectors were told about highly personal and respectful support at the end of a person's life.
“People and their relatives were consistently positive about the care people received.” from the report
Activities and independence
People were supported to continue hobbies, take part in activities and make choices about where and how they spent their time.
“The only thing which should change is the person's address; every day should be a good day for people, and every day should have value.” from the report
Food and health support
People had choices at mealtimes, including different meals, drinks and snacks. The home worked with health professionals and had seen improvements in some people's wounds and weight.
“People enjoyed a variety of different food and drinks, with mealtimes being a pleasurable and social experience.” from the report
Agency staffing
needs fixingStaff said vacancies meant the home regularly used agency staff. They felt this did not compromise safety, but said care was not always consistent.
“Staff told us that whilst they felt there were enough staff on duty at any one time, there was currently regular usage of agency staff due to vacancies at the home.” from the report
No registered manager
needs fixingThere was no registered manager when inspectors visited. A temporary management arrangement was in place while the provider recruited a replacement.
“There was no registered manager in post at the time of our inspection.” from the report
Staff knowledge of legal safeguards
needs fixingStaff understood the main legal principles about consent, but were not familiar with the process for authorising restrictions on people's liberty. The provider said more training and support would be given.
“Although staff we spoke with had an understanding of the Act and how this underpinned their daily practice, they were not familiar with the DoLS process” from the report
Care plans being updated
minorThe provider said inherited care plans did not fit the home's newer approach and needed to be revised to reflect people's preferences, life histories and needs.
“The provider and the manager told us a priority was to revisit people's care plans due to the fact these had been inherited when the new provider took over.” from the report
- 01Has a registered manager now been appointed, and who is responsible for the home's day-to-day management?
- 02How many agency staff are currently used, and what is being done to fill the vacant posts and provide consistent care?
- 03How have staff members' knowledge and training about legal safeguards and restrictions been updated?
- 04Have all inherited care plans been reviewed with people and their relatives, and how are personal preferences recorded now?
- 05How does the home check that its activities and support continue to match each person's interests and changing needs?
This was an unannounced comprehensive inspection covering the overall service and all five CQC questions, using observations, conversations, records and audits. This explanation was written from the published report of 29 July 2017 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 Hazelhurst Nursing Home
2 rated inspections over 3 years: the service has improved, from Good to Outstanding.
- February 2020Outstandingcurrent ratingup from GoodSafe: GoodEffective: OutstandingCaring: GoodResponsive: OutstandingWell-led: Good
- July 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2016
Registered with the Care Quality Commission on 22 August 2016.
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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