CQC report explained · a residential care home
What the CQC found at The Hurst Residential Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, November 2022
The Hurst Residential Home is rated Requires Improvement; inspectors found continued safety and management failures, although medicines, staffing and partnership working were positive.
This was an unannounced focused inspection on 6, 12 and 14 October 2022. Three inspectors spoke with people, staff and health professionals, observed care and reviewed care records, medicines, staff files, training, rotas and safety records.
The home was not always safe. Some new residents had no care plans or risk assessments, important incidents were not always reported or followed up, and some fire safety and building problems remained. Infection control arrangements, including cleaning and use of protective equipment, did not consistently meet guidance.
Inspectors found that medicines were managed safely and staffing levels were enough at the time of the inspection. People and staff mostly gave positive feedback, and health professionals described good partnership working.
The overall rating remained Requires Improvement. Safe and well-led were both rated Requires Improvement. This was the third Requires Improvement rating since the home was rated Inadequate in 2019, and the provider remained in breach of Regulations 12 and 17.
Medicines
Medicines were stored, given and disposed of safely. Staff who administered medicines had training and competency checks.
“Medicines were stored, administered and disposed of safely.” from the report
Staffing
Inspectors found staffing levels were consistent and enough to meet people's needs during the inspection. Recruitment checks and essential training were in place.
“There were enough staff at the service to safely support people.” from the report
Working with professionals
Health and social care professionals gave positive feedback about working with the home and supporting people's care.
“Feedback from health professionals was positive and indicated that the registered manager and staff team had listened to advice and worked alongside them to improve the service and outcomes for people.” from the report
Missing care and risk information
seriousSome people, including a recent respite resident, did not have care plans or risk assessments. Staff did not always have the information needed to provide safe and consistent care.
“There were people who had not had a care plan created and had no risk assessments undertaken to provide consistent safe care.” from the report
Incidents were not always followed up
seriousSerious incidents, including self-harm leading to hospital treatment, were not always reported or added to care records. This meant lessons were missed and risks could recur.
“Not all serious incidents /accidents were escalated to other organisations such as safeguarding teams and CQC.” from the report
Fire and building safety
seriousSome fire safety actions had remained outstanding since February 2022. Inspectors also found non-functioning smoke detectors and a bedroom window without a working restrictor.
“Some fire doors were propped open and this was due to the door guards not working, this had been highlighted at fire inspection in February 2022 and was still outstanding.” from the report
Infection control
seriousCommunal toilets and bathrooms needed better cleaning and maintenance. Staff were not always using protective equipment in line with government guidance, and there was no specific cleaning schedule.
“We were not assured that the provider was using PPE effectively and safely.” from the report
Weak management checks
seriousThe home's quality monitoring systems did not consistently identify or manage risks. There was no deputy manager, and some records were not accurate, complete or in place.
“The provider had failed to sustain and operate effective governance systems to assess, monitor and mitigate the risks to people's health, safety and welfare.” from the report
- 01Have all residents now got complete, up-to-date care plans and risk assessments, including people arriving for respite care?
- 02What action has been completed on the fire doors, emergency lighting, fire systems, fire extinguishers and smoke detectors?
- 03How are serious incidents, accidents and safeguarding concerns now recorded, reported and reviewed?
- 04What cleaning schedule and protective equipment checks are now used to meet infection control guidance?
- 05Who supports the registered manager with daily management and checking care records, given that the report found no deputy manager?
This was an unannounced focused inspection of Safe and Well-led, including infection control; the report gives no separate current ratings for Effective, Caring or Responsive. This explanation was written from the published report of 16 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, January 2022
The Hurst Residential Home is rated Requires Improvement; inspectors found risks in infection control, care records and management systems.
This was an unannounced focused inspection on 3 and 6 December 2021. Two inspectors spoke with people and staff, observed care, checked the home and reviewed care records, medicines records, staff files, training and management documents. They also spoke with three health professionals after the visit.
The home was not always safe. Some people did not have care plans or risk assessments when they arrived, and staff did not always have enough information about their health needs. Infection control arrangements did not fully follow government guidance. The home had enough staff, medicines were managed safely, and cleanliness had improved.
The home was also not consistently well-led. There was no deputy manager or senior care staff, and important records and audits were not always up to date or complete. The overall rating and the ratings for Safe and Well-led stayed at Requires Improvement, the same as at the previous inspection.
Kind and open staff
Inspectors found staff were kind, open and wanted to provide good care. People said they felt safe and supported.
“Staff were open and transparent during the inspection.” from the report
Safe medicines practice
Medicines were stored, given and disposed of safely. Staff who administered medicines had training and competency checks.
“All staff who administered medicines had the relevant training and competency checks that ensured medicines were handled safely.” from the report
Enough staff
Inspectors found there were enough staff to support people safely, and staffing levels were consistent with people's needs.
“There were enough staff at the service to safely support people.” from the report
Fire safety arrangements
The home had detailed fire risk assessments and personalised evacuation plans for people.
“People had laminated Personal Emergency Evacuation Plans (PEEPs) to ensure they were supported in the event of a fire.” from the report
Improved cleanliness
The cleanliness of the premises had improved significantly, although the cleaning schedule needed more detail about high-touch areas.
“The overall cleanliness of the premises had improved significantly.” from the report
Infection control gaps
seriousVisitors were not always checked for signs of infection or asked suitable health questions. Individual COVID-19 risk assessments had not been completed.
“Visitors were not checked for any signs of infection and were not asked suitable health questions to minimise the risk of spreading infections.” from the report
Missing care plans and risk assessments
seriousSome people who had recently arrived did not have care plans or risk assessments. Staff had limited information about at least one person's health needs, including diabetes.
“Some people had not had their individual needs assessed and documented.” from the report
Weak management systems
seriousAudits and records did not always identify or manage risks. Care documents had not been reviewed since July 2021 in some cases, and records for people who had left remained in the system.
“The provider had failed to sustain and operate effective governance systems to assess, monitor and mitigate the risks to people's health, safety and welfare.” from the report
Limited management support
needs fixingThe registered manager had overall responsibility but there was no deputy manager or senior care staff. This left limited support for day-to-day running, care planning and staff management.
“The management structure was not robust and did not include any a deputy manager or any senior staff.” from the report
Unsafe radiator
seriousAn unguarded, hot radiator remained in an occupied room from the previous inspection. It was turned off during this inspection and alternative heating was provided.
“One radiator in an occupied room was unguarded, and was hot to the touch.” from the report
- 01How do you now make sure every new person has a care plan and risk assessments covering their individual health needs?
- 02What checks are now made on visitors for signs of infection and their health before they enter?
- 03Who provides senior cover when the registered manager is away, and has a deputy manager or senior care staff member been appointed?
- 04How often are care records, risk assessments and incident records now reviewed and audited?
- 05What action has been taken to prevent another unsafe radiator or similar premises risk?
This was a focused inspection about safety, infection prevention and management of risk, so only Safe and Well-led were rated; the other key question ratings were not given in this report. This explanation was written from the published report of 13 January 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 The Hurst Residential Home
9 rated inspections over 7 years: the service has improved, from Inadequate to Requires improvement.
- November 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2022Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2020Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- June 2019Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- May 2018Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvement
- July 2015InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 January 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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