Hulton Care Home

Updated 5 October 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by three inspectors (which included a medicines inspector).

Service and service type

Hulton Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Hulton Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 7 July 2022 and ended on 26 July 2022 when we delivered feedback remotely.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 11 May 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We spoke with three people who used the service, two relatives and two visiting professionals from a local hospice about their experience of the care provided. We spoke with eight members of staff including the registered manager, deputy manager, the provider, senior care worker, care worker, cook and a member of the domestic staff. During the inspection, we visited both floors of the home and we reviewed a range of records. This included reviewing five people's care records in detail. We reviewed ten medicine administration records (MAR) and looked at medicines related documentation. We observed medicines administration and checked storage of medicines. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 5 October 2022

About the service

Hulton Care Home is a care home provides accommodation and personal care for up to 30 people. The service provides support to adults, elderly people and people living with dementia. At the time of our inspection there were 26 people using the service. The care home accommodates people across two floors in one building.

People’s experience of using this service and what we found

Medicines were not always managed safely or recorded accurately. Risks were not always being appropriately managed and risk assessments were either not in place or not readily available for our review. Practices relating to safe infection prevention control was not always being followed, though the home was clean and tidy during our site visit. Appropriate staffing levels were in place; however, staff recruitment practices required some improvement. We have made a recommendation about this. Lessons learned were taking place and appropriate safeguarding practices were being followed.

Quality assurance systems were not always robust and various records required reviewing. Staff meetings were taking place, meetings for people that use the service were less frequent and relative’s meetings had not taken place. We were told relatives were kept up to date via telephone or during visits. Feedback from staff and people about the management was positive, however, feedback from relatives was mixed. Staff worked in partnership with various professionals to ensure people received necessary support. The registered manager spoke about being open and honest when things go wrong and reported necessary incidents appropriately.

People records were not always person centred and several peoples care plans contained duplicate/incorrect details. We made a recommendation about this. Although a complaints log was in place, we were not assured that this was accurate. We made a recommendation that the provider ensures complaints are logged and actioned appropriately. People were able to take part in activities and the home had an activities coordinator. End of life training was available for staff to complete and the home had an end of life policy in place. The registered manager was aware of how to meet people’s communication needs.

People’s dietary requirements and wishes were being followed and people received appropriate support with their healthcare needs. Staff received an induction once recruited and were supported through supervisions. A variety of training courses were available for staff to complete. The home had appropriate signage in place and some necessary adaptations had been made to the service.

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. Though paperwork relating to people’s capacity needed to be improved. We have made a recommendation regarding the providers MCA and DoLS processes.

People's equality, diversity and dignity needs were being respected and people were encouraged to be as independent as possible. However, people’s records were not always safely stored and the general data protection regulation (GDPR) policy was out of date. We have made a recommendation regarding this. People were able to express their views and could access advocacy services when needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 18 May 2021 and this is the first inspection. The last rating for the service under the previous provider was good, published on 8 August 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to medicines management, infection control, risk and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.