6 July 2022
During an inspection looking at part of the service
Hurstway Care Home is a nursing home providing personal and nursing care to up to 42 people. The service provides support to older adults including those living with dementia. At the time of our inspection there were 29 people using the service. Hurstway Care Home is a purpose built home consisting of two separate floors. People have their own bedrooms and en-suite bathrooms. They have shared use of lounges, dining areas and a garden.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Some hazards and health and safety issues around the home had not been identified or addressed. Monitoring of some people’s risks around weight loss and skin integrity was not robust. Some gaps in medicines administration records were found and stock counts were not always accurate. Staffing levels were appropriate to people’s needs.
Care plans lacked detailed guidance for staff around supporting people with some medical conditions. Some relatives told us they had not been involved in developing or reviewing people’s care plans. We saw some improvement in the personalisation of people’s rooms, but the home décor was tired and in need of redecoration and repair. People told us they enjoyed the food.
Systems and processes in place to monitor and identify risk were not always effective. In some cases risks had been identified but not addressed in a timely way. Relatives told us communication with staff was not always effective. Staff were positive about the new management team and the changes being introduced.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 10 February 2022) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations. This service has been rated requires improvement for the last three consecutive inspections and prior to that was rated inadequate.
Why we inspected
We undertook a targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about the management of skin health and the risk of pressure wounds. A decision was made for us to inspect and examine those risks.
We inspected and found there was a concern with the management of skin health and the risk of pressure wounds, so we widened the scope of the inspection to become a focused inspection which included the key questions of Safe, Effective and Well-Led.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-Led sections of this full report. The provider took action to address the concerns identified during the inspection.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hurstway Care Home on our website at www.cqc.org.uk.
Enforcement
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 governance and management of safety and risk in the home at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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.