CQC report explained · a residential care home
What the CQC found at Hubbard Close
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and there were enough trained staff. Risk assessments, safeguarding training and medicine checks were in place, but guidance for some medicines given when needed was not always recorded in people's medicine files.
- Effective?
- Good
- People received suitable assessments, staff had relevant training and people were supported with food, healthcare and healthy living. Some capacity records did not clearly show how people had been involved.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. They knew people's preferences and encouraged them to make choices and develop independence.
- Responsive?
- Good
- Care plans reflected people's likes, dislikes, strengths and support needs. People could choose activities, use preferred communication methods and take part in community life.
- Well-led?
- Good
- The manager and staff promoted a positive, person-centred culture. Audits, meetings and feedback were used to monitor and improve the service.
What inspectors found, December 2019
Hubbard Close was rated Good overall, with kind and personalised care, but some medicine and capacity records needed improvement.
The inspection took place without advance notice on 19 November 2019. One inspector spoke with four people, four staff members and two relatives. They also reviewed care, medicine, staff and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People were treated with kindness and respect. Staff knew people well, supported choice and independence, and helped people take part in activities and community life.
Inspectors found two recording shortfalls. Guidance for some medicines to be given when needed was not always in the medicine records. Some mental capacity records did not clearly show how people had been involved. The provider said these records would be reviewed.
The previous rating was Requires Improvement, published in November 2018, with multiple breaches. Inspectors found improvements had been made and that the home was no longer in breach of regulations.
Kind, respectful support
People and relatives gave positive feedback about the care. Staff treated people as individuals and respected their privacy, dignity and choices.
“People were supported with kindness, respect and compassion by a staff team who had gotten to know people as individuals.” from the report
Choice and independence
People were encouraged to make decisions, learn daily living skills and do things for themselves. Staff supported people in ways that were not intrusive.
“The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.” from the report
Activities and community life
People were supported to attend day centres, clubs, shops, social events and other activities of their choice. Their requested activities were discussed and arranged.
“People were encouraged to participate in the wider community.” from the report
Staff knew people well
Staff understood people's communication methods, preferences, interests and support needs. Care plans contained detailed personal information.
“It was clear that people were well known by staff who were responsive to their needs.” from the report
Improved management
The manager used audits, meetings and feedback to monitor the service. Inspectors found that improvements had been made since the previous inspection.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Guidance for medicines given when needed
needs fixingSome records did not explain clearly when people should receive medicines prescribed to be given when needed. Inspectors recommended that the provider review these records so staff have guidance to follow.
“People did not always have had protocols in place for 'as and when required' (PRN) medicines which told staff when a person may need these medicines.” from the report
Recording involvement in capacity decisions
needs fixingSome mental capacity assessments did not clearly record how the person had been involved. The provider said it would review the records and include the involvement of people, relatives and advocates.
“Some capacity assessments had not clearly documented how the service had involved the person in the assessment.” from the report
- 01How are medicines prescribed to be given when needed recorded now, including when staff should give them?
- 02How do you check that staff understand and follow the guidance for these medicines?
- 03How do you record a person's involvement in mental capacity assessments?
- 04How are relatives and advocates involved in capacity assessments when appropriate?
- 05What improvements have been made since the previous inspection's Requires Improvement rating?
This was a planned, unannounced inspection covering all five CQC questions, following the previous Requires Improvement rating. This explanation was written from the published report of 17 December 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.
What inspectors found, November 2018
Rated Requires Improvement; inspectors found kind care, but important gaps in safety, consent, personalisation and management.
Inspectors visited on 20 September 2018. They spoke with people, staff and the registered manager. They observed care and staff interactions, and checked care records, medicines records, recruitment files, safety records and audits.
The home was caring. Staff were kind, respectful and encouraged people to be independent. People had access to health services, enjoyed the food and took part in activities and community events.
However, risk assessments and care plans were not always complete or up to date. Staff controlled one person's cigarette access without properly checking consent. Recruitment checks, fire safety follow-up, medicines auditing and management checks also had gaps.
The overall rating changed from Good in December 2015 to Requires Improvement. The home breached three legal regulations covering consent, safe care and treatment, and good governance.
Kind and respectful staff
People had positive relationships with staff. Inspectors saw staff speak gently, respect privacy and encourage independence.
“We found that staff treated people with kindness and thought throughout our time at the home.” from the report
Food and healthy choices
People helped choose meals and inspectors found that healthy options were promoted. People said they enjoyed the food.
“People were supported to have enough to eat and drink.” from the report
Activities and community life
People took part in social events, shopping, learning activities and events with friends. Their interests were recorded in care assessments.
“People did access social events and were able to maintain existing friendships through the support they received at the home.” from the report
Incomplete risk planning
seriousSome risks, including possible self-harm and being unsafe in the community, were not fully assessed. Staff did not always have clear instructions to follow.
“People's risk assessments were not up to date and they did not always give clear guidance to staff about managing these risks.” from the report
Consent and restrictions
seriousStaff controlled one person's cigarette supply without a properly recorded capacity assessment, consent process or regular review. This did not meet the legal requirements on consent.
“Staff maintained control over a person's daily activity.” from the report
Weak checks and follow-up
seriousRecruitment checks were not fully evidenced. Medicines audits missed recording errors, and some fire and building issues were not dealt with promptly.
“The provider and registered managers audits were not effective or robust.” from the report
End of life plans
needs fixingSome plans did not fully record people's wishes, including where they wanted care and who they wanted involved. The report recommended reviewing these plans.
“People had end of life plans in place, but these were not person centred.” from the report
Tired and impersonal spaces
needs fixingSome bedrooms and communal areas had marks and chips. Staff equipment was visible in two bedrooms, and the garden was not fully accessible to everyone.
“We found that people's bedrooms and parts of the home's communal areas looked tired with marks and chips on the walls.” from the report
- 01How have you updated the risk assessments and staff guidance for people who may harm themselves or become unsafe in the community?
- 02How do you now check that any restriction, such as controlling cigarette access, is agreed, legally supported and regularly reviewed with the person?
- 03What changes have you made to recruitment records, medicines audits and staff competency checks?
- 04Which building and fire safety issues identified in the report have now been resolved, and when?
- 05How are people now involved in making end of life plans and improving their bedrooms and shared spaces?
This was a comprehensive inspection of all five areas, including care, premises, records, medicines, staffing, safety checks and management systems. This explanation was written from the published report of 20 November 2018 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 Hubbard Close
3 rated inspections over 4 years: the service has held its Good rating throughout.
- December 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 23 March 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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