CQC report explained · a residential care home
What the CQC found at Little Hayes
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, May 2021
Rated Good; inspectors found safe, effective and well-led care, with minor concerns about medicines storage and some redecoration.
Two inspectors visited on 12 May 2021. They spoke with people, staff, relatives and a visiting health professional. They checked medicines, staffing, recruitment, infection control, care records, the building and management records.
People said they were happy and felt safe. Staff numbers were sufficient, care plans and risk assessments were detailed, and people received their medicines, food, drinks and healthcare support. Infection control arrangements were in place, including testing, protective equipment and visitor safety measures.
There was a minor concern about medicines stored in the fridge. Staff had recorded temperatures above the safe range without recording action, but the manager addressed this after the inspection. Some areas needed redecoration, although an improvement programme was under way.
The overall rating was Good. Safe, Effective and Well-led were each rated Good. This was a focused inspection, so Caring and Responsive were not inspected and their previous ratings were used in the overall rating.
Enough staff
Inspectors found enough skilled staff to meet people's needs safely and without rushing them. People described staff as available and calm.
“There was a relaxed atmosphere in the home and staff had time to chat to people and support them in a calm and unhurried way.” from the report
Detailed care planning
Care plans and risk assessments gave staff clear information about people's individual needs. These records were reviewed and updated regularly.
“People's care plans and risk assessments contained detailed information about them and their care and support needs, to help staff deliver care that was individual to each person.” from the report
Good support and training
Staff had training for their roles and people's specific needs. They also received regular supervision and support from management.
“There was a robust induction programme in place, which new staff were required to complete before working on their own.” from the report
Open management
People, relatives and staff described management as approachable and supportive. The home used meetings, surveys and discussions to gather views.
“The manager had an 'open door,' so both people and staff felt able to approach them at any time.” from the report
Medicine fridge checks
minorStaff had recorded medicine fridge temperatures above the safe range without recording what action they took. The manager investigated and addressed this after the inspection.
“We noted that staff had been regularly recording higher than safe temperatures for the medicine's fridge, with no indication of any action having been taken.” from the report
Some areas needed redecoration
minorInspectors found that some parts of the home needed redecoration. An ongoing refurbishment programme was being followed.
“Some areas of the home were in need of re-decoration, however, there was an ongoing refurbishment programme in place, which was being followed and actions were being taken as required to address this.” from the report
- 01What changes were made after the inspection to prevent medicine fridge temperatures from going above the safe range?
- 02How often are medicine fridge temperatures now checked, and who reviews the records?
- 03Which areas still need redecoration, and what is the timetable for completing the refurbishment?
- 04What are the current ratings and most recent inspection findings for Caring and Responsive?
- 05Has the acting manager's application to become registered with the CQC been completed?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 27 May 2021 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, March 2019
Little Hayes was rated Requires Improvement; inspectors found kind, personalised care but safety, consent and management systems needed further work.
This was an unannounced planned inspection on 7 and 11 February 2019. Inspectors spoke with people, relatives, staff and a healthcare professional. They reviewed care records, medicines, accidents, complaints and quality checks.
People were generally happy and said staff were kind, competent and caring. Inspectors rated Caring and Responsive as Good. People were supported to make choices about daily routines, meals, activities and their care.
There were important safety concerns. These included unsafe windows and heating equipment, hazardous liquids, medicines not always being managed correctly, and possible unlawful restrictions on people's freedom. End of life wishes were also not recorded clearly enough.
A new management team was making improvements, but its quality monitoring systems were not fully established. The overall rating remained Requires Improvement, as did Safe, Effective and Well-led. This was the same overall rating as the previous inspection.
Kind and respectful staff
People were treated with compassion and staff understood their individual needs, backgrounds and preferences.
“We observed people were treated with kindness and compassion.” from the report
Personalised choices
People were supported to make everyday choices, including when to get up, where to eat and how to spend their day.
“People were empowered to make their own decisions and choices.” from the report
Good food support
People had choices at mealtimes, regular snacks and drinks. Staff acted when people were at risk of losing weight.
“People's dietary needs were assessed and met consistently.” from the report
Activities and communication
The home offered varied activities and used accessible information, pictures and large print to help people make choices.
“People had access to a wide range of activities.” from the report
Environmental safety
seriousTwo upper-floor windows lacked restrictors. An unprotected hot water cylinder, uncovered radiators and unlocked hazardous liquids created risks of falls, burns or poisoning.
“Two upper floor windows did not have restrictors in place to prevent people falling through them;” from the report
Medicines records and administration
seriousReturned medicines were not recorded promptly, and some medicines were given at the wrong time, not given as prescribed or not applied often enough.
“This meant the medicines in the cupboard were not accounted for, for up to four weeks; this posed a risk that managers would not be aware if any went missing during this period.” from the report
Possible unlawful restrictions
seriousOnly two DoLS authorisations had been made and one was awaiting assessment, despite most people having cognitive impairment and locked doors. This meant some people may have been deprived of their liberty unlawfully.
“This meant some people might have been deprived of their liberty unlawfully.” from the report
End of life planning
needs fixingPeople's end of life wishes and preferences were not recorded in care plans. An end of life care plan was also missing for someone who had recently died.
“people's end of life wishes and preferences were not recorded in their care plans” from the report
Quality oversight
needs fixingThe new quality systems, management roles and responsibilities were not fully established. A required notification about the previous registered manager leaving had not been sent to CQC.
“Although these had not been fully embedded at Little Hayes, work was in hand to achieve this.” from the report
- 01What has been done to fit window restrictors, protect radiators and hot water equipment, and secure hazardous liquids?
- 02How are returned medicines recorded now, and how do you check that medicines are given at the correct time and as prescribed?
- 03Has every resident's DoLS position been reviewed, and have further applications been made where needed?
- 04How are each person's end of life wishes and preferences recorded, updated and shared with relevant staff and healthcare professionals?
- 05How are the new quality checks and management responsibilities monitored to make sure improvements are completed?
This planned comprehensive inspection looked at all five key questions and checked the whole service, including accommodation and nursing or personal care. This explanation was written from the published report of 22 March 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 Little Hayes
4 rated inspections over 4 years: the service has held its Good rating throughout.
- May 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- February 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- August 2016
Registered with the Care Quality Commission on 1 August 2016.
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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