Background to this inspection
Updated
25 May 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: This inspection was carried out by one inspector and an expert by experience. 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: Hepworth House is a residential care home providing accommodation for older people, who may be living with dementia, a sensory impairment or a physical disability, who require nursing or personal care. Hepworth House is a small service consisting of three floors. At the time of our inspection 17 people were using the service and being supported with the regulated activity.
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: This inspection took place on 25 and 26 April 2019. The inspector and expert by experience attended the inspection on 25 April 2019. One inspector attended the inspection on 26
April 2019.
Before the inspection we gathered and reviewed information that we received from the provider on the provider information return (PIR). This is a document that the provider sent us saying how they were meeting the regulations, identified any key achievements and any plans for improvement. We also reviewed all information received from external sources such as the local authority and reviews of the service.
During the inspection we:
• Spoke with eight people using the service, five relatives, two care staff, one senior care staff,
the registered manager, the provider and the cook.
• Observed staff members supporting and interacting with people at the service.
• Spent time looking at the premises and how it had been adapted to meet people's needs.
• Gathered information from four care files which included all aspects of care and risk.
• Looked at two staff files including all aspects of recruitment, supervisions, and training records.
• Records of accidents, incidents and complaints.
• Audits, surveys and minutes of staff and professional meetings.
• Policies and procedures relating to the management of the service.
Following the inspection, we received further evidence from the provider showing their quality auditing systems and processes. We also received updates from the provider about the immediate actions that were being taken to improve the premises following the first day of our inspection.
Updated
25 May 2019
About the service: Hepworth House is a residential care home providing accommodation for older people, who may be living with dementia, a sensory impairment or a physical disability, who require nursing or personal care. Hepworth House is a small service consisting of three floors.
People’s experience of using this service: People were not always kept safe from the risk of harm as actions were not taken to address potential risks caused by environmental and infection control issues at the service. These were rectified at once following the first day of our inspection.
The premises were not designed to support people living with dementia. There was no signage or decorations to support people to orientate themselves to their environment.
People’s needs relating to living with their dementia were not thoroughly explained and detailed in their care plans.
People with complex communication needs did not have access to communication methods to help them make choices or express their views.
We have made a recommendation about adapting the premises and communication methods for people living with dementia.
People told us that there were limited activities to take part in during the day. We saw that people were left for long periods of time with little to do and were not given opportunities to choose or take part in new activities.
People were supported to take their medicines safely.
Necessary recruitment checks were completed before staff members started working at the service. Staff received training and supervisions to perform their job roles effectively.
People were positive about the food and drink at the service and we saw that people were supported to maintain a balanced diet depending on their needs.
People were supported to live healthy lives and saw relevant health professionals when they needed to.
People were positive about the care they received. People were treated with kindness respect and compassion. People’s privacy, dignity and independence was promoted.
People and their relatives were involved in decisions about their care.
People’s preferences for the end of their life were recorded and people were treated with dignity and respect at this time.
The registered manager and provider completed a variety of audits to monitor the quality of the service.
Feedback was collected from people, their relatives and the staff team and was used to improve the service.
The registered manager and provider were positive about improving the service and had several service improvement plans and actions to achieve these improvements.
We identified a breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to good governance. Details of action we have asked the provider to take can be found at the end of this report.
Rating at last inspection: This was the services first inspection since registering with the Care Quality Commission on 12 January 2018.
Why we inspected: This was a planned inspection based on when the service first registered with the Care Quality Commission.
Follow up: We have asked the provider to send us an action plan telling us what steps they are to take to make the improvements needed. We will continue to monitor information and intelligence we receive about the service to ensure good quality is provided to people. We will return to re-inspect in line with our inspection timescales for Requires Improvement services.