Background to this inspection
Updated
14 May 2021
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.
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
This inspection was carried out by one inspector.
Service and service type
The Hamptons is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 did not have 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. However, we saw evidence that the new manager was in the process of registering with CQC.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we held about the service. We sought feedback from the local authority commissioning team. 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. We took this into account when we inspected The Hamptons and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke about The Hamptons with one person, four staff and the manager and area manager. We walked around the building to carry out a visual check. We did this to ensure The Hamptons was clean, hygienic and a safe place for people to live.
We looked at records related to the management of the service. We did this to ensure the provider had oversight of the home, responded to any concerns and led The Hamptons in ongoing improvements. We checked care records and looked at medication procedures, infection control protocols, leadership and quality oversight.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at their training records, as well as relevant policies and quality assurance systems.
Updated
14 May 2021
The inspection visit at The Hamptons took place on 22 and 24 August 2018 and was unannounced.
The Hamptons provides nursing care and treatment of disease, disorder or injury for a maximum of 76 people who live with dementia and/or a physical disability. At the time of our inspection there were 39 people living at the home. The Hamptons is situated in a residential area of Lytham St Annes close to local shops and amenities. There are two floors offering single room accommodation for people who live at the home. There are ample toilet and bathing facilities and multiple large communal areas for people's use.
The Hamptons is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, both of which we looked at during this inspection.
A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The Hamptons was newly registered on 21 August 2017. Consequently, this was their first inspection. A visiting professional said the home had come a long way in a short time and had really developed into a very good service.
During this inspection, people and their relatives told us staff went above and beyond in the delivery of their care. One relative commented The Hamptons was, “A lovely home run by lovely people.” The team approach achieved enhanced quality of life for people and helped them to flourish through an excellent, person-centred culture. We found multiple examples of how staff attitude and care delivery had a highly positive impact on the lives of those who lived at the home. A relative said staff respect was, “Absolutely fantastic.”
The Hamptons supported people with complex mental health issues and used positive, self-affirming language in every aspect of care. Support plans focused on the individual’s skills, rather than their dependency. Records were of a high standard and centred on understanding the person and jointly made decisions about the model of support they desired. Care plans detailed each person’s cultural, spiritual and emotional support, along with their wishes in relation to treatment.
We saw staff strengthened this through compassionate engagement, meaningful conversation, appropriate touch and an in-depth knowledge about each person. The registered manager told us staff worked tirelessly to help people live life to the full and regain their freedom and independence.
The provider heavily invested in the home and respected the importance of a quality environment to people’s care. Those who lived there said the ambience had a huge impact on their welfare because they felt it was their home. We saw this was highly effective upon their care and wellbeing because they were fully relaxed during the day.
Excellent staffing levels meant engagement, fun activities, and one-to-one support was constantly available to optimise people’s welfare. A staff member told us, “Staffing levels are good, I feel we have enough staff to get everything done and we can really take our time to speak with the residents as we support them.” People and relatives we spoke with said they felt safe at The Hamptons because high staffing numbers meant they received care and treatment quickly. One person said, “Yes, I feel there are a lot of staff around and managers.”
We found The Hamptons medication system had data errors in stock checks. The system was confusing and did not always retain robust oversight. The registered manager was working closely with the local authority and Clinical Commissioning Groups to resolve ordering issues outside of their control. Although staff had a good understanding of each person’s topical creams, body mapping and instructions were not always well-defined.
We have made a recommendation about good oversight and administration of people’s topical medication.
We found staff had a good understanding of safeguarding procedures to protect people against abuse or poor practice.
Care files we saw held risk assessments intended to mitigate a variety of risks. The registered manager’s accident and incident procedures focused on analysis of events and lessons learnt. The Hamptons had a clean, tidy and well-maintained environment.
Staff files we looked at held relevant checks obtained before personnel started in post. The training manager explained staff completed induction and refresher training. They then completed a personal development training plan and built up a profile for each staff member.
Staff training was of a good standard and was underpinned by supervision and competency-testing to check their practice. A staff member commented, “We have supervision every two months. It’s really good to look at my progress or if I need to develop anything further. I find it useful.”
Dining was of a restaurant standard, with high quality table dressings and a variety of seating to maximise relaxation and socialising. Care records included assessments to guide staff to minimise the risk of malnutrition. One person told us, “There’s always drinks and snacks available.”
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Staff worked very hard to ensure people consented to every aspect of their care.
We found under each care planned area, staff worked with people and their relatives monthly in the review and update of their support. Assessments reviewed their physical, mental and social health needs and agreed support in line with their wishes. A visiting professional stated any advice they gave was always followed through.
The registered manager strongly focused on developing The Hamptons, as a new service, slowly to build a cohesive workforce and manage people’s welfare. Everyone we spoke with told us they felt well-supported and confident giving feedback about the quality of care. A staff member stated, “We have a lot of support from our management, that’s so important to me so I’m glad about that.” The registered manager completed audits to monitor the safety and quality of service provision.