CQC report explained · a nursing home
What the CQC found at Hodge Hill Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2020
Hodge Hill Grange was inspected but not rated; inspectors found good infection control arrangements during the COVID-19 pandemic.
This was an announced, targeted inspection on 11 August 2020. Inspectors looked at infection prevention and control measures as part of a national COVID-19 review.
Inspectors were assured that the home used personal protective equipment safely, supported testing, followed shielding and social distancing rules, and had arrangements to prevent or manage outbreaks. They also found measures to support family contact and reduce cross-contamination in the laundry.
The home was inspected but not rated. This means the visit was not a full inspection of all five areas of care, so it does not provide an overall quality rating.
Family contact
The home arranged visits at suitable times and spaced them out to reduce the risk of infection spreading between visitors.
“People were supported to maintain contact with their family and friends.” from the report
Reducing cross-contamination
The laundry had a restricted area for designated staff, and clean clothes trolleys had protective coverings.
“The service had implemented a red line area in the laundry, where only designated staff were allowed to enter to avoid the risk of cross contamination.” from the report
Daily oversight
Managers recorded daily information about temperatures, staffing and personal protective equipment supplies to monitor the situation.
“The manager recorded key information daily such as temperature readings, staffing levels and PPE supplies.” from the report
Staff support
Staff were supported to discuss anxieties and were signposted to health and wellbeing services when needed.
“Discussions were held with staff to reduce any anxieties they felt; in particular to staff in high risk groups” from the report
Inspectors raised no specific concerns in this report.
- 01How are visitors currently booked and supported, and what infection control steps are required during visits?
- 02How do you check that personal protective equipment is available and used safely by staff?
- 03How do you test people living here and staff, and what happens when someone has a positive result?
- 04What arrangements are in place to prevent or manage an infection outbreak?
- 05How have the infection prevention and control arrangements changed since the inspection in August 2020?
This was a targeted inspection of infection prevention and control measures during the COVID-19 pandemic; the service was inspected but not rated and the other care areas were not assessed. This explanation was written from the published report of 27 August 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, April 2019
Rated Requires Improvement; inspectors found kind, person-centred care, but medicines records, staff training and oversight needed improvement.
This was an unannounced planned inspection on 27 February 2019. Inspectors spoke with people, relatives, staff and health professionals. They observed care and reviewed care files, medicines records, recruitment, training, incidents, complaints and quality checks.
The home was rated Good for Caring and Responsive. Inspectors found staff were kind and respectful, knew people well, supported choices and provided personalised care. People had access to activities, healthcare and support with food, drink and end of life care.
The home was rated Requires Improvement for Safe, Effective and Well-led. Topical medicines were not always recorded, some staff training was out of date, and mental capacity records were not always clear or decision-specific. Quality checks had not found or fixed these problems. The overall rating remained Requires Improvement, the same as at the previous comprehensive inspection in 2017.
Kind and respectful care
Inspectors saw staff supporting people patiently and compassionately. People and relatives spoke positively about the care and staff knew people well.
“Staff adopted a kind and compassionate approach to their work, and had taken the time to get to know people well.” from the report
Personalised care
Care plans described what mattered to each person and were reviewed regularly. Staff were expected to follow them.
“People's care plans were individualised and included information about what mattered most to them, to promote a person-centred approach.” from the report
Support with food and drink
People could choose what they ate and drank. Dietary risks and special diets were assessed and managed, with specialist advice when needed.
“Staff promoted a positive, unrushed and social mealtime experience.” from the report
Risk and infection controls
The home assessed individual risks and maintained care equipment and premises. Inspectors also found effective infection control procedures and positive comments about cleanliness.
“The provider had effective procedures in place to protect people, staff and visitors from the risk of infections, and people commented positively on the overall cleanliness of the home.” from the report
Topical medicines
seriousStaff did not always record when topical medicines were given, and instructions were sometimes unclear. This meant managers could not reliably check that medicines were applied as intended and increased the risk of skin damage.
“The administration of people's topical medicines was not always recorded by staff.” from the report
Out-of-date staff training
needs fixingInspectors were not assured that training needs were consistently monitored. Some safeguarding, health and safety, and food safety training was late or expired.
“We were still not assured staff learning and development needs had been consistently monitored and addressed.” from the report
Mental capacity records
seriousFormal assessments were not specific to the decision being made. Some care files gave conflicting information about people's mental capacity.
“The formal mental capacity assessments we looked at were not decision-specific.” from the report
Quality checks did not fix problems
seriousThe provider had audits and monitoring systems, but these had not identified or dealt with the shortfalls found during the inspection. This led to a breach of Regulation 17.
“The provider's governance and quality assurance systems and processes were not sufficiently robust or effective.” from the report
Activities and staffing consistency
minorSome relatives wanted more social and recreational activities and more access to the local community. Relatives and staff also had mixed views about staffing levels and monitoring of communal lounges.
“Some people's relative felt their loved ones' support with social and recreational activities still needed to improve.” from the report
- 01How are topical medicines now recorded and checked, and how do you make sure the directions for using them are clear?
- 02Which staff training was late or expired at the inspection, and has all required refresher training now been completed?
- 03How are mental capacity assessments made specific to each decision, and how do you prevent conflicting information in care records?
- 04What action did you report to CQC after the Regulation 17 breach, and what evidence can you show that the action was completed?
- 05How many staff are usually on duty in each unit, and what has changed to improve monitoring of communal lounges and community activities?
This was an unannounced planned inspection of the care home, including the premises and care provided, and it considered all five CQC questions. This explanation was written from the published report of 3 April 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 Hodge Hill Grange
3 rated inspections over 3 years: the service has slipped, from Good to Requires improvement.
- August 2020Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- April 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- December 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- April 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- October 2011
Registered with the Care Quality Commission on 31 October 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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