CQC report explained · a nursing home
What the CQC found at Huntercombe Hall Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, May 2018
Rated Good overall; inspectors found kind, safe care and major improvements, but the home was rated Requires Improvement for being well-led.
Inspectors visited without notice on 8 March 2018. They spoke with five people, three relatives, staff and a health professional. They reviewed care records, staff files and records about how the home was managed.
The overall rating was Good. Safe, effective, caring and responsive care were all rated Good. People were treated kindly, received suitable food and medicines, and had care that reflected their needs and preferences.
The well-led rating was Requires Improvement. Inspectors found significant progress under the new registered manager, including better checks and action plans. However, they wanted to see that these improvements continued over time. The home had previously been rated Inadequate for well-led.
Kind and respectful care
Staff were caring and compassionate. They involved people in their care, protected privacy and treated people with respect.
“Staff showed kindness and compassion towards the people they supported and their families.” from the report
Safer medicines and staffing
Medicines records were complete and staff administering medicines had training and competency checks. Staffing levels met assessed needs during the period reviewed.
“MAR were accurately and fully completed which showed people received their medicines as prescribed.” from the report
Improved meals and dementia support
The dining experience had improved since the previous inspection. Staff supported people living with dementia to eat and drink in ways suited to them.
“People living with dementia were supported to eat and drink in a way that met their individual needs.” from the report
Activities and relationships
People could take part in activities seven days a week, while choices to spend time alone were respected. Staff also supported important family relationships.
“The service employed three activity staff which enabled the service to provide an activity programme seven days a week.” from the report
Management improvements
The new registered manager had introduced monitoring systems, daily checks and action plans. Staff and relatives reported that the home had improved.
“At this inspection we found significant improvements had been made.” from the report
Improvements needed to last
needs fixingThe well-led rating remained Requires Improvement because the CQC wanted evidence that recent changes would continue. This follows an earlier Inadequate rating for well-led.
“Therefore, we need to be satisfied that these changes are being sustained.” from the report
Dementia lounge needed repair
minorInspectors found that the lounge for people living with dementia needed repair and decoration. The provider shared refurbishment plans after the inspection.
“The lounge area for people living with dementia was in need of repair and decoration.” from the report
- 01What changes from the refurbishment plan have been completed in the lounge for people living with dementia?
- 02How are you checking that the improvements in management and quality monitoring are continuing?
- 03What action is taken when audits identify a problem, and can families see the progress?
- 04How will you make sure meals and drinks continue to be adapted for each person's needs?
- 05How are care plans reviewed when a person's mobility, health or end of life needs change?
This was an unannounced inspection covering all five CQC questions, with the well-led rating carried forward as Requires Improvement while the CQC checked that recent improvements were sustained. This explanation was written from the published report of 16 May 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.
What inspectors found, September 2017
Rated Requires Improvement; inspectors found safe and responsive care, but poor leadership, repeated mealtime problems and failures to protect dignity.
This was an unannounced inspection on 19 and 20 July 2017. Inspectors spoke with people living in the home, relatives and staff. They reviewed care files, staff records and management records, and observed care using a structured observation method.
People were generally safe. There were enough staff, medicines were given as prescribed, and recruitment checks had been completed. Staff understood safeguarding and people had access to healthcare professionals.
There were important weaknesses. People living with dementia did not always receive person-centred support with meals. Some staff used unsuitable language, people's privacy was not always protected, and staff did not always receive regular supervision or mandatory training.
The overall rating was Requires Improvement. Safe and Responsive were rated Good. Effective and Caring were rated Requires Improvement. Well-led was rated Inadequate because the home's checks had not fixed problems identified at earlier inspections.
Medicines
Medicines were given as prescribed and records showed when they had been administered. Medicines were stored securely, including controlled drugs.
“We observed staff administered medicines to people in line with their prescription.” from the report
Safety and staffing
Inspectors found enough staff to meet people's needs. Call bells were answered within a reasonable time and recruitment checks had been completed.
“Throughout our inspection we saw that people had access to call bells to gain assistance from staff and that call bells were responded to within a reasonable time frame.” from the report
Knowledge of people's needs
Care plans included people's preferences, important life events and personal information. Staff could explain the support people needed.
“Staff we spoke with were knowledgeable about the person centred information within people's care records.” from the report
Responding to changing needs
The home arranged healthcare referrals when people's weight or swallowing needs changed. Staff followed professional advice recorded in care plans.
“Staff were responsive to people's changing needs.” from the report
Activities
People could take part in activities including gardening, music, church services, flower arranging and manicures.
“There was a range of activities for people to engage with.” from the report
Mealtime support
seriousPeople living with dementia did not always receive person-centred support with food and drink. Staff sometimes left people without support and did not always consider why people behaved in particular ways during meals.
“People did not receive food and drink in a way that was person-centred.” from the report
Dignity and privacy
seriousInspectors heard language that was not appropriate and saw personal food, fluid and repositioning records left in a communal area. People's adult status and privacy were not always respected.
“People were not always treated with dignity and respect as we saw that some of the language used by staff was not always appropriate.” from the report
Staff supervision
needs fixingStaff did not always receive regular one-to-one supervision. Records showed no supervision for registered nurses in 2017 at the time of inspection.
“Staff did not always receive regular supervisions.” from the report
- 01What has changed in the dementia unit's mealtime support since this inspection, and how do you check that people are supported throughout their meal?
- 02How do staff record and respond when a person mixes food and drinks or shows distress during a meal?
- 03How do you make sure staff use respectful language and protect people's privacy in communal areas?
- 04Have all staff, including registered nurses, received regular supervision and completed the provider's mandatory training?
- 05What evidence can you show that the new manager's audits and action plans have fixed the issues identified in this report?
This was an unannounced inspection of the overall service, covering all five CQC questions, with observations, discussions and reviews of care, staff and management records. This explanation was written from the published report of 14 September 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 Huntercombe Hall Care Home
4 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- May 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Inadequate
- January 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2013
Registered with the Care Quality Commission on 4 July 2013.
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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