CQC report explained · a nursing home
What the CQC found at Hurstway Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2022
Hurstway Care Home was rated Requires Improvement; inspectors found risks in medicines, monitoring and management systems, although staffing and some care arrangements were positive.
This was an unannounced focused inspection after concerns about skin health and pressure wounds. Inspectors visited on 06 July, 20 July and 21 July 2022. They spoke with people living in the home, relatives and staff, and reviewed care plans, medicines records and other documents.
The home was not always safe. Inspectors found gaps in medicines records, inaccurate stock counts, unsafe storage of thickener, hazards around the building and weak monitoring of weight loss, dehydration and pressure wounds. Staffing numbers were suitable, but recruitment records were incomplete.
Care plans did not always give staff enough guidance about medical conditions. Some relatives had not been involved in care plan reviews. The home supported people to access health professionals and people said they enjoyed the food, but some areas were tired, damaged or unclean.
The overall rating was Requires Improvement. Safe, Effective and Well-led were also rated Requires Improvement. Caring and Responsive were not inspected during this visit, so their previous ratings were carried forward when calculating the overall rating. The home had been rated Requires Improvement at the previous inspection and for the last three inspections, after previously being rated Inadequate.
Staffing levels
Inspectors found there were enough staff to meet people's needs.
“People were supported by adequate numbers of staff.” from the report
Safeguarding awareness
Staff had received safeguarding training and understood how to recognise and report concerns.
“Staff had completed safeguarding training and were able to describe signs of abuse and what action they would take.” from the report
Food and mealtimes
People were not rushed when eating, and people told inspectors they enjoyed the food.
“People told us they enjoyed the food offered to them.” from the report
Health partnerships
The home worked with other health and care professionals to support people's needs.
“Staff worked in partnership with other agencies to provide the care people needed.” from the report
Medicines records
seriousInspectors found four recent gaps in medicines administration records and inaccurate stock counts. This meant staff could not be sure medicines had been given as prescribed.
“This meant staff could not be sure people had been given their medicines as prescribed.” from the report
Pressure wounds and hydration
seriousFood, fluid, wound care and repositioning records were not completed consistently. This left people at risk of dehydration, weight loss and pressure wounds.
“People were at risk of dehydration and development of pressure wounds due to ineffective monitoring of the identified risks.” from the report
Safety of the building
seriousInspectors found fire risks, unsecured wardrobes, unclean areas and food that was not stored safely. Some walls and ceilings were damaged.
“Hazards and risks around the home had not been identified and removed.” from the report
Care plan involvement
needs fixingCare plans did not always contain enough guidance about medical conditions, and some relatives said they had not been involved in reviews.
“Relatives told us they were not involved in the reviews of people's care.” from the report
Management checks
seriousThe management team had introduced new checks, but had not ensured they were being used effectively. Problems with medicines and fluid monitoring continued.
“The management team had failed to introduce and establish effective systems to ensure safe care.” from the report
Condition of the home
minorMany areas needed repair and redecoration. Inspectors also found holes in walls and ceilings and some unclean kitchen areas.
“The décor in many areas of the home needed refreshing.” from the report
- 01What has been done to prevent gaps in medicines administration records and to check medicines stock counts are accurate?
- 02How are you now recording and checking fluid intake, food intake, wound care and repositioning for people at risk?
- 03How do staff access clear written guidance about each resident's medical conditions, including when agency or newly recruited staff are working?
- 04What repairs and cleaning have been completed since the inspection, and what work remains?
- 05How are relatives and residents now involved in care plan reviews and decisions about their care?
This was a focused inspection of Safe, Effective and Well-led after concerns about skin health and pressure wounds; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 17 November 2022 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, February 2022
Rated Requires Improvement; inspectors found gaps in medicines safety, staffing arrangements and management checks.
This was an unannounced focused inspection. Inspectors visited on 7 December 2021 and continued inspection work until 14 December. They spoke with people, relatives and staff, observed care, and checked care, medicine, staff and management records.
People and relatives generally said people felt safe, and the home was clean. However, inspectors found medicines records and storage were not always safe. Staff were sometimes too busy at mealtimes, and a lounge was left without the staff member required by the home's own policy.
The home had made some improvements since the previous inspection, including clearer care files and an electronic medicines system. However, checks by managers had not found several problems. The home remained in breach of Regulation 17 on good governance.
The overall rating remains Requires Improvement. Safe, effective and well-led were all rated Requires Improvement. Caring and responsive were not inspected during this visit, so their previous ratings were carried forward.
People felt safe
People and relatives told inspectors they felt safe. Inspectors also found safeguarding procedures and staff training were in place.
“People and their relatives told us they felt safe.” from the report
Healthcare support
Staff worked with health professionals when people's needs changed. Referrals were made in a timely way.
“Staff worked closely with the local GP surgery.” from the report
Care records improving
Inspectors saw work to make care files clearer and give staff better guidance about people's support.
“We could see much work had been done to improve the quality of peoples care files.” from the report
Positive partnership working
The home worked with other agencies to help people receive suitable support and move to more appropriate accommodation when needed.
“The registered manager and the nursing team had developed positive relationships with other agencies and services” from the report
Medicines controls
seriousGuidance for medicines given when needed was missing at first, reasons for giving them were not always recorded, and one out-of-date cream was left in a person's room.
“One of these creams was out of date.” from the report
Staffing and supervision
seriousStaff could be too busy during mornings and meals. The staffing tool allowed too little time to help people eat, and five people were seen eating in a lounge without staff present.
“We saw five people were eating in the lounge, no staff member was with them.” from the report
Management checks
seriousAudits and daily checks did not identify several problems with medicines, call bells, mealtime staffing and staff task allocation. This led to a breach of Regulation 17.
“We found no evidence that people had been harmed, however, the provider failed to ensure adequate systems were in place to improve the safety and quality of the service.” from the report
Consent and choice
needs fixingStaff sometimes told people what would happen instead of asking what they wanted. Inspectors also found that people's sexual orientation was not considered in assessments.
“We saw staff sometimes told people what they were doing rather then asking them.” from the report
Training and communication records
needs fixingTraining records were not fully up to date, and some staff said they did not receive supervision or clinical supervision. Staff also did not take part in handovers, which affected information sharing.
“At the time of the inspection the training records were still being developed.” from the report
Meaningful activities
needs fixingPeople and relatives said they were bored and lacked meaningful activities. An activity coordinator had recently been recruited but was not yet in post during the visit.
“People and their relatives told us they were bored and did not have anything meaningful to do to pass the time.” from the report
- 01What checks now make sure 'when required' medicines have clear guidance and reasons for use are recorded?
- 02How do you ensure prescribed creams are stored safely and are in date?
- 03How has the staffing tool been changed so people receive enough help to eat at their own pace?
- 04How do you make sure a staff member is present in the lounge whenever people are using it?
- 05How are staff handovers, training records and relatives' involvement in care planning being improved?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 11 February 2022 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 Hurstway Care Home
7 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- November 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2022Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- June 2021Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- January 2021Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- April 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- March 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2014
Registered with the Care Quality Commission on 28 April 2014.
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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