Hampton Grange Nursing 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

Safe – this means we looked for evidence that people were protected from avoidable harm. At our last inspection this key question safe was rated good. At this assessment we did not assess all quality statements within this key question. The overall rating for this key question remains good based on the findings at the last inspection.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

On the first day of our inspection people told us they did not always feel safe in their own bedrooms. One person told us, “If they come into my room, I put my arm around them and tell them they are in a wrong room, or I call for carers.” One person told us they had told staff if a resident entered their room again without permission, they may harm this resident in order to prevent this. We discussed this with the provider who took appropriate action and resolved this issue by the second day of our inspection. People told us they felt safe with staff working for the provider. One person told us, “The nurse is a really lovely person: if you have a problem, she would sit with you.”

Staff were aware of their responsibilities for protecting people against the risk of avoidable harm and abuse. They were able to give us hypothetical examples of the risk of someone being abused and the steps they would take to protect that person. Staff told us they were able to recognise signs of abuse. A member of staff said “If I suspected abuse, I would report this to the management team.” Staff were knowledgeable of people’s past and what could work with people to minimise the risk of behavioural incidents.

On both days of the inspection we saw that people were relaxed and comfortable with staff, each other and within their environment. The atmosphere within the service was welcoming and relaxed and staff had positive and caring relationships with the people they were supporting.

The provider did not always keep accurate records of behavioural incidents. There were inconsistent timelines recorded and body maps were not always completed. Some incident reports lacked important information which resulted in people’s relatives and other professionals not always receiving full picture of incidents. We raised this with the provider on the first day of our inspection. On the second day of our inspection the provider showed us a new incident reporting form designed in a way that staff had to complete all necessary sections. The new incident reporting form aimed at improving record keeping, however, due to the short period of time since the form had been introduced it was impossible to state if this form was effective.

People and their relatives told us that people’s needs were assessed, and they felt involved in the assessment process. However, on the first day of our inspection some people told us that they did not receive oral care in line with their assessed needs and care plan. We checked people’s toothbrushes and found that 10 people’s toothbrushes were dry on the first day of our inspection. This could indicate people had not received oral care. We raised this with the provider and on the second day of our inspection we found no dry toothbrushes in people’s bedrooms.

We observed good practice by staff when supporting people. We saw that staff applied correct moving and handling techniques and followed people’s care plans and risk assessments. We saw that people were repositioned on a regular basis, however, this was not always recorded by staff. Some repositioning charts had gaps, however, none of the people supported by the service had notifiable pressure sores. We reported this to the provider. The provider assured us they were going to raise this with staff during the following team meeting and individual supervisions.

Individual risk assessments had been undertaken to enable people to retain their independence and make their own choices, whilst minimising risk. Systems were in place to identify and reduce risks to people using the service. Risks associated with people’s health and welfare, including the risks of falls, nutrition, dehydration, incontinence, developing pressure wounds and using bed rails had been assessed. Staff were provided with relevant guidance to follow to minimise the risk of harm. Each person had a personal emergency evacuation plan (PEEP). A PEEP sets out the specific physical and communication requirements that each person has to ensure that people can be safely moved away from danger in the event of an emergency.

People and their relatives told us they felt the environment was safe. One person’s relative told us, “Her room is a bit scruffy but clean, it has got new curtains.” People praised the grounds around the service, including the garden and felt this was safe to use. One person told us, “The gardener is an exceptional one-off gardener, and when grass really starts to grow, he has got plenty work to do.” Staff understood how the environment might pose risks to people. Staff told us they reported any safety concerns about the environment to the provider.

We saw that on both days of the inspection the environment was clean and well maintained to prevent the risk of infection. People’s wardrobes were secured to walls and all equipment was appropriately tested and ready to use. Care staff and nurses wore protective plastic gloves and aprons when delivering personal care to reduce the risks of cross contamination. On the first day of the inspection, we found one person’s air pressure mattress settings did not correspond with the person’s weight. We raised this with the provider and the pressure air mattress settings were changed to reflect the person’s weight

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

People’s medicines were administered as prescribed. This included administration of topical creams and dermal patches. One person told us how staff always ensured their patches were in place. The person told us, “My patch is checked every week, and they check if the patch came off.” Staff supported people to take their medicine, and they did so in a gentle and unhurried way. Staff administering medicines wore a red tunic to reduce interference from other staff members and visitors. We saw evidence that following each routine visit from a GP a complete list of residents and any action required by the GP regarding medicines was attached to the medicine administration records (MAR) chart file. This ensured good communication for staff administering medicines.

The registered manager told us the service worked well with other health professionals to ensure regular reviews of people’s medicines. Staff interviewed had a good knowledge of people and medicines prescribed.

Medicine administration records (MARs) confirmed people had received their medicines as prescribed. There were appropriate arrangements in place for the recording and administering of prescribed medicines. There were also effective processes for the ordering of stock and checking the stock at the home to ensure the medicines provided to people were correct. For prescribed medicines to be administered ‘as and when required’, there was clear guidance in place when these should be given to people, for example, if they required pain relief. This meant staff had access to information to assist them in their decision making about when such medicines could be used.