CQC report explained · a residential care home
What the CQC found at The Hailey Residential Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some risks to people's health, safety and welfare were not consistently assessed or managed. Medicines were usually given correctly, but recording and guidance for prescribed creams needed improvement.
- Effective?
- Good
- This question was not inspected during this visit. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this visit. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this visit. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Requires improvement
- Checks, audits and feedback systems were not consistently effective. The home did not have a reliable system to identify shortfalls, act on feedback and show that improvements had been made.
What inspectors found, July 2023
The Hailey Residential Care Home is rated Requires Improvement; inspectors found caring staff but gaps in risk management and oversight.
This was an unannounced inspection on 25 May 2023. Two inspectors spoke with seven people and seven staff, and reviewed care records, risk assessments, medicines records, recruitment files, audits and training records.
The home was not always safe. Some risks were not properly assessed or managed, including risks linked to distress, catheters and prescribed creams that could increase fire risk. Medicines were generally given as prescribed, but records for prescribed creams were incomplete. Recruitment records also had gaps.
The home was not always well-led. Checks and audits had not found all the problems, and feedback was not properly analysed or followed up. The overall rating fell from Good at the previous inspection, published in December 2018, to Requires Improvement.
Regular staff team
There were enough regular staff to support people, including with activities and appointments. Staff knew people well and created a friendly atmosphere.
“People were supported by a regular staff team who knew people well.” from the report
Safeguarding
Staff understood how to recognise and report abuse or other concerns. People said they felt able to raise concerns and were taken seriously.
“People were protected from the risks of abuse, harm and discrimination by staff who were able to recognise potential signs of abuse.” from the report
Choice and legal safeguards
Inspectors found that staff supported people to make choices and worked within the principles of the Mental Capacity Act. Required safeguards were in place when needed.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.” from the report
Support from other services
People were supported to see relevant health professionals when needed. Mental health services were contacted when people's mental health appeared to decline.
“People were supported to see health care professionals, such as the community mental health team or speech and language therapists, as needed.” from the report
Risk assessments
seriousSome people did not have clear guidance for staff about managing distress, catheter problems or possible infection. Fire risks from prescribed creams were also not managed in line with existing assessments.
“Risks to people's health, safety and welfare were not consistently assessed and managed.” from the report
Cream medicines records
needs fixingStaff did not always record when prescribed creams had been applied, and body maps were not used consistently. Some creams lacked clear guidance about where and why they should be applied.
“When people needed prescribed creams, to help keep their skin healthy, body maps were not used consistently to show staff where to apply the creams.” from the report
Recruitment checks
needs fixingTwo of the three staff files reviewed did not show a complete employment history. Gaps had not been explored and recorded, although references and criminal record checks had been completed.
“Two of the 3 staff files reviewed did not evidence a full employment history.” from the report
Weak quality monitoring
seriousAudits had not identified all the shortfalls, and there was no effective action plan to track improvements. Feedback from people and staff was not properly analysed or followed up.
“There were no systems in place to show how feedback had led to improving the quality of service.” from the report
- 01What has been done to complete and regularly review risk assessments for distress, catheter problems and fire risks from prescribed creams?
- 02How are prescribed creams now recorded, including where they should be applied and whether they are working?
- 03What checks are now made to ensure every new staff member has a complete employment history and that any gaps are explored?
- 04What action plan is in place to deal with the two breaches, and how will families be shown that improvements have been completed?
- 05How are residents' and staff feedback, meetings and complaints now recorded, analysed and followed up?
This was a focused inspection of Safe and Well-led only; the other key question ratings were not inspected and were carried forward from the previous inspection. This explanation was written from the published report of 7 July 2023 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, December 2018
Rated Good; inspectors found safe, kind and personalised care, with end-of-life care plans still needing development.
This was a comprehensive, unannounced inspection on 15 October 2018. Two inspectors reviewed care plans, staff records, medicines, audits and safety records. They spoke with people living at the home, staff, a relative and health professionals, and observed care.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that medicines were managed safely, risks were assessed, staff were trained, and people were supported to maintain their health and independence.
People were described as comfortable and at ease with staff. Care plans reflected people's preferences, needs and goals. The home had systems for complaints, quality checks and working with other professionals.
The rating had not changed since the previous inspection. Inspectors found no evidence of serious risks or concerns. They did identify that more detailed end-of-life care plans should be developed, although nobody was receiving end-of-life care at the time.
Safe medicines
Inspectors found that trained staff gave medicines safely and that regular audits checked ordering, storage, administration and returns.
“People continued to receive their medicines safely from trained staff.” from the report
Kind relationships
Staff knew people well and supported them in a respectful, person-centred way. Inspectors saw relaxed and positive interactions.
“Staff continued to demonstrate strong, supportive relationships with people.” from the report
Personalised care
Care plans included people's likes, dislikes, goals, relationships and cultural or religious wishes. People were involved in reviewing their support.
“Care plans were updated to reflect people's likes and dislikes, their interests, goals and aspirations and relationships that were important to them.” from the report
Health support
People were supported to attend appointments and staff worked with mental health and other health professionals when needs changed.
“People were supported to live healthier lives and staff continued to work proactively with external health professionals.” from the report
Learning from feedback
The home used audits, surveys and resident meetings to identify improvements. Suggestions from residents were acted on, including changes to the menu.
“Regular resident meetings took place, during which people were asked for their feedback about the home, the food and the activities.” from the report
End-of-life plans
needs fixingSome basic end-of-life information was recorded, but inspectors asked the home to develop fuller plans so staff would know people's wishes clearly. Nobody was receiving end-of-life care during the inspection.
“We discussed developing end of life care plans with the registered persons, so that they could be sure staff were clear about the care people wanted to receive.” from the report
Staffing assessment
minorThe home did not use a formal tool to assess staffing dependency. The manager said staffing was adjusted to people's needs, and inspectors saw consistent staffing numbers in the previous four weeks.
“A formal dependency tool was not in place.” from the report
- 01How have you developed end-of-life care plans since this inspection, and how are people's wishes recorded now?
- 02How do you assess the number and skills of staff needed when people's needs change, given that the report said there was no formal dependency tool?
- 03How often are medicines audits completed, and what happens if an error or missed dose is found?
- 04How are people involved in reviewing their care plans, including their mental health relapse indicators and independence goals?
- 05What improvements have been made through resident, relative and staff feedback since the inspection?
This was a comprehensive inspection covering all five questions, including the premises and care provided. This explanation was written from the published report of 4 December 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 The Hailey Residential Care Home
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- July 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at The Hailey Residential Care Home →
- December 2018Goodstayed GoodSafe: GoodWell-led: Good
Read what inspectors found at The Hailey Residential Care Home →
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 16 November 2010.
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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