Hayward Care Centre

Updated 1 September 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 three inspectors.

Service and service type

Hayward Care Centre 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. Hayward Care Centre is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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 received about the service since the last inspection. 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

We spoke with five people who lived at the service about their experiences of care received. We also spoke with twelve members of staff, the registered manager and area operations manager. We reviewed 14 people’s care and support plans, two staff recruitment files, multiple medication records, incident forms, health and safety records, meetings minutes and quality monitoring records.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

We reviewed training data, the homes service improvement plan and policies and procedures.

Updated 1 September 2022

About the service

Hayward Care Centre is a care home with nursing for up to 80 people over three floors. People had their own rooms and access to communal rooms such as bathrooms, dining rooms and lounges. People had access to outside space as the home had large gardens around the building. At the time of the inspection there were 68 people living at the home, some of whom had dementia.

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

People’s medicines were not always managed safely. People did not always receive the medicines they had been prescribed. During June 2022 there were eight incidents in which people were either not supported to take their medicine at all, or they received a lower dose of medicine than they had been prescribed. We also found one person had no stock of their medicine and had missed 14 doses due to a delay by the supplying pharmacist.

The provider did not have effective systems to assess the quality of the service and make improvements. The registered manager had identified the high number of medicines errors and had included actions to address this on a service improvement plan. Despite the actions that had been taken, the number of medicine errors had increased since January 2022. No formal survey of people who used the service had been completed by the provider in the previous two years. During the inspection people told us it was clear there were insufficient staff to meet their needs. The provider had not obtained feedback from people about staffing levels to assess whether their staffing tool was effective.

People told us there were not always enough staff and they had to wait a long time to receive care. Staff told us there were not enough staff available to provide care in the way they wanted to. Our observations demonstrated staff did not always have the time to create positive social interactions with people living with dementia. There had been three occasions since October 2021 when the home did not have a registered nurse in the building for a period.

The home was clean throughout. Staff were wearing appropriate personal protective equipment (PPE). We were told the provider had good stock of PPE and staff had never been without supplies through COVID-19.

People had visitors when they wished, and people told us they liked living at the home. People told us they felt safe and they liked the staff.

Risks to people’s safety had been identified and risk management plans were in place to give staff guidance where needed. Staff reviewed them regularly and updated them when needed. Systems were in place to make sure health and safety checks were carried out.

Staff worked in partnership with local professionals to make sure people’s health needs were met. The registered manager knew who to contact in the local authority if they needed guidance on COVID-19.

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 23 September 2020).

Why we inspected

The inspection was prompted in part due to concerns received about management of medicines. 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.

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 deteriorated 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 Hayward Care Centre 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 and will take further action if needed.

We have identified breaches in relation to medicines management, staffing and systems for governance at this inspection.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.