Hunningley Grange Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People were not assisted by suitably qualified or supported staff. The manager had recognised this concern and was currently completing supervisions for staff and implementing staff training. Medicines were managed safely. We could not be assured safeguarding incidents and accidents were appropriately monitored due to a gap in records. Improvements were also required about how staff recorded incidents. Risks posed to people were not effectively managed, including risks posed to people from the environment. The service was not promoting safe infection, prevention and control practices and the home was visibly dirty. Whilst systems had recently been implemented to monitor people’s safety, these required embedding into practice.

This service scored 38 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We could not be assured lessons were learned following accidents and incidents, as we found several gaps in records. This potentially placed people at risk of avoidable harm.

As accidents and incidents had not previously been recorded, any lessons learned from incidents was not shared with the staff team. We also found a recent incident which was not appropriately recorded by staff. The manager told us they were now implementing new records logs, which would be used moving forwards.

Improvements were required to ensure all accidents and incidents were appropriately recorded, monitored and action taken to learn lessons from these.

The service had not received any recent admissions or discharges. One person told us they had asked to move from the service on several occasions over a long period of time. This was brought to the attention of the manager on the day of inspection, and they told us they had started this process and informed this person’s social worker.

Staff told us they could record using handheld devices. However, some staff told us they would benefit from training about how to use the handheld devices. One staff said, “Some staff need training on how to use the app to record things.”

We received negative feedback from partners who worked with the service. They told us improvements were required and an ongoing action plan was in place to improve the quality and safety of care people received. One professional told us, “We still have a huge amount of concerns.”

Improvements were required about how the service worked with partners to establish and maintain safe systems of care. Clear systems were in place to carry out pre-admission assessments for people prior to them living at the service, should this be required in the future.

People told us they felt safe living at the service. Comments included, “I feel safe and settled.” And “It is a nice place, I think it is safe.”

Some staff required safeguarding training, to ensure they understood their responsibilities about how to protect people from the risk of abuse. We received mixed feedback from staff about them feeling comfortable to report concerns. One staff said, “If I voice any concerns I am listened to.” Whilst another staff said, “I can report to the manager, but not other seniors or the provider.” Another staff also told us, “I don’t know about safeguarding, I haven’t had that training.”

We saw staff interacting with people in a kind and calm manner.

We could not be assured all safeguarding concerns had been appropriately recorded or investigated, due to several gaps in records. New records logs had recently been implemented to ensure the management team appropriately recorded and investigated safeguarding incidents moving forward, and we found recent incidents had been reported externally as required.

Risks posed to people were not always robustly assessed. Whilst we found no harm to people, some records required improvements. For example, there was a lack of guidance in kitchen areas relating to people’s dietary needs and a lack of robust guidance about how staff safely utilise lifting equipment to move people.

Some staff told us the service did not have enough equipment, such as wheelchairs, to safely support people. This was fed back to the manager at the time of the inspection, who assured us new equipment was being ordered. A staff member said, “We only have 3 wheelchairs and there are 5 people who need a wheelchair. We also need more pressure cushions.” Most staff told us people were safe. One staff member said, “People are well looked after and kept safe.”

Where people were at risk of falls, risk assessments were in place and staff were allocated to monitor people. However, some people were observed to not be wearing appropriate footwear, which may place them at an increased risk of falling.

We found gaps in records relating to people’s pressure area care, meaning we couldn't be assured people were receiving repositioning or prescribed creams as required. New systems were in place to ensure it could be monitored by the management team when staff had completed well-being checks.

Risks posed to people from the environment were not always effectively managed and there was no recent health and safety audits. We found some areas of the service to be cold due to heating control systems, the manager assured us they would monitor the temperature of the building and adjust the heating system as required. However, some people told us the home was cold. One person said, “I always keep my cardigan on.”

Some staff told us there were environmental concerns, whilst others told us they had enough equipment and the environment was improving. One staff member said, “Some of the wardrobes are not secured to the wall. It takes a long time for hot water to come through.” Another staff said, “Things are improving. I have had moving and handling training, and we have equipment such as slide sheets to help us.” Another staff member said, “We have the proper equipment, we have hoists and stand aids.”

Whilst we found some equipment checks had taken place, such as lifting equipment checks, not all environmental safety precautions had been undertaken. For example, there was a lack of bed rail and wheelchair checks. We also found some radiators which were not covered, to protect people from the risk of scalding. This had been identified through a refurbishment plan and plans were in place to undertake several works to the environment. Some wardrobes were not appropriately secured, following our inspection this was undertaken.

Whilst a risk assessment and some fire safety checks had been completed, staff fire evacuations were out of date and required commencing. Not all appropriate checks were in place to protect people from the risk of legionnaires disease. Unused outlets had not been flushed on a weekly basis as required and there was a concern relating to the water temperature in several areas of the home. Plans were in place to rectify this concern, however this remained an issue at the time of our inspection. The new manager had implemented several systems and records logs to improve environmental safety, these required fully embedding into practice.

Enough staff were in place, in line with people’s dependency needs, however we received mixed feedback from people and relatives about staffing. One person said, “It would be better if there were a few more staff.” Whilst a relative said, “There seems to be enough staff around.”

Some staff told us more staff were needed. They told us this was due to some people requiring 2:1 support and other staff being based in the lounge areas, to ensure people were monitored. Some staff told us the training had improved, whilst some told us they had not been trained in some subjects. One staff member said, “There is enough staff at the moment.” Whilst another staff member said, “I haven’t had any supervisions. I don’t think there is enough staff, if there are incidents it is hard. I have had an email to start some training, but I have not yet had most of my training here.” Another staff member said, “We don’t always get chance to hourly checks on people.”

Whilst we observed enough staff to be on duty, some people who lived in the home appeared unkempt, indicating a lack of suitable staff. Daily records did not always evidence people had their day-to-day needs met. For example, we found gaps in records relating to a person receiving oral care.

Whilst plans were in place to provide more robust training and improvements had been made, at the time of our inspection staff were not suitably trained. Several staff were overdue training and staff required training in Positive Behaviour Support (PBS) and catheter care. Staff had also not received regular supervisions or appraisals, although these had recently been undertaken. Staff were recruited safely, and all appropriate pre-employment checks were in place, such as references and police record checks.

Whilst people did not raise concerns to us regarding cleanliness, through our observations of the environment and records reviews, we could not be assured people were supported in a safe and clean environment. One person said, “Staff come and make my bed.” And a relative said, “Staff clean the room, they do that quite a lot.”

Staff told us things were improving in relation to IPC and some new equipment had been purchased. However, most staff told us the home required a deep clean. One staff member said, “We have new cleaning schedules. We have had some mattresses replaced, but we need some replacing still.” Another staff member said, “We have enough PPE, the building is getting better, but it needs a deep clean.”

Whilst some improvements had recently been made, such as providing PPE stations and increasing domestic staff hours, several areas of the home were found to be visibly dirty. We found soiled chairs and mattresses and there was a malodour throughout the service. Areas of exposed wood were observed to several handrails, meaning these could not be effectively cleaned and kitchen areas were visibly dirty.

Systems and processes did not always promote safe Infection, Prevention Control (IPC) practices. A recent external IPC audit showed poor scoring in several areas. Refurbishment plans were in place, and some areas of the service were undergoing building works and redecoration. Plans were also in place to replace several chairs and mattresses, however this required completion at the time of our inspection.

People were given their medicines safely and in a timely manner. This was recorded on their medicines administration record (MAR). Staff interacted kindly with people whilst conducting the medicines administration round. Care plans were detailed and ensured staff knew how to support people’s individual needs.

Staff were trained to ensure that medicines were used safely and effectively. Staff were trained in medicines administration. This ensured staff could safely administer medicines.

There were processes in place to ensure the safe and effective use of medicines. However, audits around medicines use were completed routinely, but had not identified the areas for improvement that we found during our inspection.