Archived: Hampden Hall Care Centre

Updated 7 August 2019

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 Care Act 2014.

Inspection team

The inspection team included a CQC pharmacy inspector who attended on day one, a specialist advisor who attended two days, an inspector who attended four days and two Experts by Experience one attended one day and the other attended two days. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Hampden Hall Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced.

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 and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection-

We spoke with 20 people and 19 relatives of people living in the service. We spoke with four agency care staff, six permanent care staff, three nurses, four senior staff, the registered manager the nominated individual and a director. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with two healthcare professionals.

We reviewed 12 people’s care plans and 12 people’s medicines records. We examined staff recruitment records, training, supervision and appraisal records. Additional documents we viewed included safeguarding notifications, minutes of meetings with staff, and incident reports amongst others. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

We continued to seek clarification from the provider to validate evidence found. Information was sent to us by the nominated individual regarding systems of communication for people, and training information. We spoke with a member of the local authority contract commissioning team.

Updated 7 August 2019

Hampden Hall Care Centre is a nursing home providing personal and nursing care to 109 people aged 65 and over at the time of the inspection. The service can support up to 120 people in one adapted building.

Accommodation is provided on three floors. People living with dementia reside on the ground floor. Nursing care is provided on the first floor with both nursing and residential care on the second floor.

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

Some people told us they felt safe living in the service, whilst others did not. We found the service was in breach of regulation 12 (Safe care and treatment) of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was due to poor medicine management and a lack of accurate up to date recordings in relation to health needs and risk assessments.

People and their relatives told us “One of the problems is there's not enough staff.” They were concerned about the welfare of the staff and that people may not receive care in a timely way. The provider was aware and was attempting to address this issue by offering financial incentives to staff. Staff were knowledgeable about infection control and safeguarding people from abuse.

Records related to the risk of people suffering from malnutrition and/or developing pressure ulceration were not accurately completed. There were concerns about the competence of staff to provide catheter care, and to accurately record or set air mattresses correctly. Nursing staff were not able to demonstrate correct knowledge and expertise in dealing with diabetic hypoglycaemia (low blood sugar levels). People had access to a GP and other health professionals when necessary.

The ground floor environment was not conducive to caring for people with dementia because the environment was noisy and lots of people were gathered in the same area. 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.

There was a mixed response from people with regards to how they were treated by staff. Some people told us they weren’t always treated in a respectful way by staff. Others praised the staff for their kindness and support. People told us how their dignity was protected, others felt the attitude of some staff was “off.” Communication between staff and people was not always positive or skilled. We have made a recommendation about how to improve the care for people living with dementia.

There was a mixed response from people regarding the activities in the service. The activities were not always person centred or meaningful to people. We observed people being left for long periods without any stimulation and conversely enjoying a glitz and glamour day with staff and visitors.

The provider had tools in place to meet people’s communication needs. Complaints were dealt with in a timely way. We received positive feedback from the relatives of people who had died. People and staff were treated equally, and people’s cultural needs were catered for.

The service was going through a period of change and it was clear from our findings there had been a lack of oversight of records, and the support offered to people daily. Quality assurance audits had not identified the areas of concern we found. The provider was open and honest with us about the challenges the staff and people faced to improve the service. Plans were in place to improve the service to people. The provider had been proactive throughout the inspection to rectify what areas they could.

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

Rating at last inspection

The last rating for this service was good (published 13 October 2017).

Why we inspected

The inspection was prompted in part due to the number of safeguarding notifications we had received. A decision was made for us to inspect and examine those risks.

Enforcement

We have identified breaches in relation to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 due to a lack of accurate information relating to people’s health needs and records. Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 due to a lack of effective governance, including assurance and auditing systems or processes. Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 due to care and treatment that did not meet people’s needs. We identified these breaches during this inspection.

We have found evidence that the provider needs to make improvements. Please see the full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hampden Hall Care Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.