Hilbre House

Updated 30 March 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

We received information of concern about infection prevention and control measures/visiting arrangements/staffing at this service. This was a targeted inspection looking at the infection prevention and control measures the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 7 February 2022 and was unannounced.

Updated 30 March 2022

Hilbre House is a residential care home providing personal care and accommodation for up to 22 people, in one adapted building. At the time of the inspection 10 people were using the service. The home is a detached building, in a residential area with a coastal location and views over Liverpool Bay.

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

There was no staff team at Hilbre House. Nearly all the staff who had been working at the home had recently left their employment. The provider put in place an interim emergency rota for care staff. Staffing at the home was stretched and unsustainable and people were mostly receiving care from staff that they were not familiar with.

The provider recognised that the current staffing arrangements lacked stability and were taking steps to improve this.

Medication was not always stored and administered safely. Medication recording errors had not been investigated within a reasonable timeframe. The provider arranged for a refresh of medication training and practices at the home within a short period of time.

Aspects of the home’s environment were not safe and some practices at the home did not ensure people were kept safe from the spread of infection. There was no staff member who was taking the lead with infection prevention and control (IPC)

The management of the home was unstable. Prior to our inspection the provider had made the registered manager of the service redundant. This meant that the service did not have a registered manager in place.

The provider had failed to effectively monitor the care and accommodation being provided to people to ensure it was safe and of high quality; and had failed to take appropriate action when things went wrong.

People’s care plans showed that they had been consulted with, in regard to choices about their care. Family members told us that communication with the home was fine.

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 good (published 18 December 2019).

Why we inspected

The inspection was prompted in part due to concerns received about staffing arrangements at the home. A decision was made for us to inspect and examine those risks.

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.

We have found evidence that the provider needs to make improvements. Please see the “Is the service safe?” and “Is the service well-led?” sections of this report.

The provider took prompt action to mitigate the risks in relation to the homes environment and quickly sought appropriate medication training.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hilbre House on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to failing to ensure safety monitoring was effective at the home, staffing and good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.