12 December 2022
During an inspection looking at part of the service
Hambleton Court Care Home is a residential care home providing accommodation and personal care to up to 18 people. The service provides support to older people, some of whom may be living with dementia. At the time of our inspection there were 14 people using the service.
People’s experience of using this service and what we found
Improvements had been made in the services governance systems; however, further work was needed in this area. Audits had failed to pick up the shortfalls found on the inspection. People had not come to any harm; however, we could not be fully assured about the quality systems in the service.
People received care from staff who knew them well. Care records needed expanding to ensure people’s needs and preferences were documented and known to all staff, particularly those who were new or providing agency support.
People received their medicines when needed and staff were suitably trained in this area. However, audits had failed to pick up when best practice guidance was not met. We have made a recommendation in this area.
People were appropriately supported at mealtimes; they told us they enjoyed the food and were given choice. More detailed information was needed to help ensure staffs knowledge of modified diets, we have made a recommendation about this.
The service has been struggling with the effects of the COVID-19 pandemic and recruitment had been an issue. Due to this, activities offered to people were limited, and people were not supported to follow their hobbies and interests. The provider was working to address this at the time of the inspection and a new activities coordinator was due to being employment.
Efforts had been made to improve the environment, making this more tailored for people living with dementia. Further improvement plans were in place which focused on outstanding maintenance, decorating bedrooms and increasing access to the garden.
People and their relatives gave positive feedback about the service, they felt safe and well cared for. One person told us, “Yes, I do feel safe. This is because it is nice here, the home is nice and clean, and I feel relaxed.” One relative told us, “I am more than happy with the way things have gone for [relative]. I have recommended the home to a neighbour.”
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.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 20 October 2021) and there were breaches of regulation. 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 the provider had made improvements, however, they remained in breach of regulations.
At our last inspection we recommended that the provider consider best practice guidance on medicines management and review their supervisions and appraisals process. At this inspection we found that improvements had been made and staff supervisions were currently underway. However, more work was needed to ensure the service’s medicines management met best practice guidance. We have made a recommendation about this.
The last rating for this service was requires improvement (published 20 October 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 21 August 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.
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, Responsive and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hambleton Court Care Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to the standard of records and quality assurance systems at this inspection.
We have made a recommendation in relation to the services management of medicines, their effectiveness in meeting people’s dietary needs and their complaints handling procedures.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.