CQC report explained · a residential care home
What the CQC found at Hulse Road
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Are people protected from harm? Staffing, medicines, infection control, safeguarding.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Good
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Good
- The manager was described as approachable and had a clear plan for improvement. Quality checks were in place, and the report says earlier management and communication problems had been improved.
What inspectors found, February 2019
Hulse Road was rated Good; inspectors found safe, kind and personalised care, with earlier problems improved.
This was an unannounced inspection on 19 December 2018. The inspector reviewed care records for four people, recruitment and training records, audits and meeting minutes. They observed staff, spoke with staff and the manager, and spoke with relatives of one person.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that medicines were managed safely, risks were assessed, staff understood safeguarding, and people were supported to make choices and stay independent.
People had accessible information, person-centred care plans and a broad range of activities. Staff knew people well, supported family contact and helped people use local services and activities.
The home had previously been rated Requires Improvement in October 2017 and November 2016. Inspectors found that the earlier concerns about staffing, medicines guidance, mental capacity records and management checks had been addressed.
Improvement since earlier inspections
The home had acted on the concerns found at its two previous inspections. Inspectors found the required improvements had been made.
“At this inspection we found that improvements had been made and the rating has now changed to Good.” from the report
Choice and independence
People were supported to make choices in ways that suited their communication needs. They were also encouraged to take part in everyday tasks and activities.
“People were supported to be as independent as possible when preparing food.” from the report
Accessible communication
The home used pictures, easy-read documents, Makaton and other visual tools to help people understand choices, appointments and changes.
“Information was made available in an accessible format and the home complied with the Accessible Information Standard 2016 (AIS).” from the report
Activities and community life
People had activities linked to their interests, including craft sessions, swimming, exercise, parties and community volunteering.
“People enjoyed varied social lives, specific to their interests and hobbies.” from the report
Caring staff
Inspectors observed friendly and respectful interactions. Staff knew people's routines, preferences and communication needs.
“People continued to be supported by a kind and caring staff team.” from the report
Kitchen maintenance
needs fixingSome kitchen maintenance problems would have made effective cleaning and infection control harder. A new kitchen was due to be installed one week after the inspection.
“There were some areas of the maintenance of the kitchen that would prevent effective cleaning and infection prevention and control.” from the report
Previous medication errors
needs fixingThere had been one extra dose and two missed doses because of staff error. The report says these were reported and reviewed, and there were no further occasions for the staff member involved in the extra dose.
“There was one incident of an additional dose of medicines being given and two incidents where medicines were not given.” from the report
- 01Has the new kitchen been installed, and have the cleaning and infection control issues been fully resolved?
- 02What changes were made after the extra medication dose and two missed doses?
- 03How do you check that staffing levels after 4pm remain enough for people's needs?
- 04How are people's communication tools and accessible information kept up to date?
- 05How do you make sure the improvements found at this inspection continue?
This was an unannounced inspection covering all five CQC questions and the overall quality of the home; the previous ratings from October 2017 were reviewed. This explanation was written from the published report of 13 February 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 2017
Rated Requires Improvement; inspectors found caring and responsive support, but concerns about safety, consent, medicines and management.
Inspectors visited the home without warning on 5 October 2017. Four people were living there. They spoke with one person fully, spoke a little with another, observed all four people, and spoke with staff, the manager and relatives.
The home was rated Good for caring and responsive support. People were treated with dignity, supported to make choices, and helped to take part in activities. Staff knew people well and inspectors saw relaxed, respectful relationships.
The home was rated Requires Improvement for safe, effective and well-led care. Inspectors found risks had not always been assessed, medicine records and guidance were not always complete, consent records needed work, and quality checks were not effective. The overall rating means the service was not consistently meeting the expected standard.
Kind and respectful care
Inspectors saw warm relationships between staff and people. People’s dignity, privacy and choices were respected.
“Staff had developed caring relationships with the people they supported and we observed positive interactions between people and staff.” from the report
Personalised support
Care plans described people’s routines, preferences and communication needs. Staff supported people to make choices and remain independent.
“Care, treatment and support plans were personalised and recorded information clearly on how to support people with their preferred daily living routines.” from the report
Activities and community life
People were supported to go out, follow their interests and take part in activities such as shopping, music and adapted cycling.
“People were supported to follow their interests and take part in social activities.” from the report
Staff understood safeguarding
Staff knew how to recognise possible abuse and what action to take. People also had accessible information about different types of abuse.
“Staff had the knowledge and confidence to identify safeguarding concerns and act on them to protect people.” from the report
Staffing and front-door safety
seriousAfter 4pm, one staff member was responsible for supporting everyone. Inspectors found a risk that someone could leave or answer the door without staff knowing.
“We recommend that the provider review the staffing levels after 4pm and address accordingly to minimise the potential of risk to people in the home.” from the report
Medicine records and guidance
seriousSome medicine protocols were not specific enough, storage temperatures were not checked, and one medicine administration record had a missing signature.
“We observed one gap on a person's medicine administration record (MAR) where a signature was not documented.” from the report
Consent records
seriousSupport plans did not show that people had agreed to live at the home and receive support. Some mental capacity information was also incorrect or incomplete.
“We saw that people's support plans did not show evidence that people had consented to live in the home and receive support.” from the report
Weak quality checks
needs fixingThe manager recorded when audits had taken place, but there were no checklists showing what had been examined or what needed fixing.
“However there were no audit checklists in place that the registered manager followed or that could record what areas if any were found to need improvement.” from the report
Communication with relatives
needs fixingSome relatives said they did not receive enough information about their loved one’s activities and experiences. The manager recognised this needed development.
“Communication could be better, what people are doing, how they are, haven't been impressed with that lack of feedback and it's been a long term thing.” from the report
- 01What staffing level is now in place after 4pm, and how do you prevent anyone leaving or answering the front door without support?
- 02How are medicine storage temperatures, PRN instructions and medicine administration records checked now?
- 03How do you record that each person has consented to live here and receive support, including when they may lack capacity?
- 04What audit checklist do you now use, and how do you make sure identified problems are fixed?
- 05How will you keep relatives informed about people’s activities, wellbeing and care reviews?
This was an unannounced inspection covering all five CQC questions, with observations, discussions and records reviewed; some people could not be fully interviewed because of complex communication needs. This explanation was written from the published report of 17 November 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 Hulse Road
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- February 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 2 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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