Hart Care Residential Home

Updated 18 November 2022

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 Health and Social Care Act 2008.

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, an assistant inspector, a medicines 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

Hart Care is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Hart Care is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection, we spoke with one of the providers, the registered manager, deputy manager, four carers, the chef and the head housekeeper. We spoke with ten people living at the service and three family members. We contacted five health professionals and received three responses.

We reviewed a number of medication administration records (MAR). We reviewed a range of records. This included eight people's care records. We looked at three staff files in relation to recruitment. We also looked at staff training and staff supervision. A variety of records relating to the management of the service were reviewed including accidents and incidents and quality checks and audits.

Updated 18 November 2022

About the service

Hart Care is a residential care home providing the regulated activity of personal and nursing care to up to a maximum of 54 people. The service provides support to older people. At the time of our inspection there were 30 people using the service.

People’s experience of using this service and what we found

Since our last inspection, the provider had taken action to ensure the service was now well led. A new management team was in place who had the skills, knowledge and experience to perform their roles and improve the quality of care provided. The quality of the service people received was monitored and audited to help ensure it was consistently good.

Improvements had been made in how the service managed people’s medicines. People’s medicines were now administered safely and as prescribed for them. Staff received medicines training and had their competencies checked to ensure safe practice. Medicine audits and checks were in place to identify and issues or concerns. However, we made a recommendation in relation to ensuring best practice is followed in relation to medicines given through a patch on people's skin.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, we made a recommendation with regards to records relating to mental capacity assessments and best interests’ decisions.

Risks to people were regularly assessed with measures in place to mitigate them. However, we made a recommendation about updating care plans and risk assessments to ensure they reflect actions taken to manage risk.

People told us they were happy living at the service, they felt safe, and staff treated them with respect and kindness. Staff understood the importance of safeguarding people wherever possible from poor care and harm. When staff had any concerns about people, they knew where to escalate and report these concerns.

Staffing levels were sufficient to meet people's needs and staff were recruited safely.

Staff were being supported to complete a new mandatory training programme and refresher courses, to ensure they had the skills required to complete their roles. The induction training was also being improved and aligned to the Care Certificate.

The provider had infection control procedures in place to protect people and prevent the spread of infection. Staff accessed personal protective equipment (PPE) and acted in accordance with government guidance.

Staff told us they felt supported by the managers and provider and morale within the staff team had improved.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 20 August 2021)

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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and well-led which contain those requirements.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.