22 November 2022
During an inspection looking at part of the service
About the service
Hamble Heights is a nursing home providing personal and nursing care to up to 60 people. The service provides support to older people some of whom may be living with dementia. At the time of our inspection there were 46 people using the service. Hamble Heights provides care for people over 4 floors, each floor providing specialist care to people living with different needs, for example, one floor delivers specialist dementia care and another residential care.
People’s experience of using this service and what we found
People using the service were not always kept safe. We could not be assured risks associated with people’s needs were always assessed appropriately or managed. A lack of robust record keeping meant we could not be assured people were getting enough daily fluids and being repositioned in line with their care plan.
We could not be assured risks associated with people’s needs were always assessed appropriately or managed. Care plans sometimes lacked information to keep people safe.
Environmental risks were not always managed effectively; Staff did not have regular fire evacuations to keep people safe. Peoples risk assessments were sometimes missing key information to keep them safe and to support staff.
Medicines administration records (MAR) confirmed people had received their medicines as prescribed. However, we found some concerns with medicines that wasn’t always safe. The service has since put in some measures to improve medicines. Health professionals felt people were not always kept safe as improvements were required to meet people’s clinical needs, especially around pressure area care.
Governance systems were not always effective in promoting a person-centred culture. A new manager was in place and was working to ensure new systems were in place and effective and was getting to know people at the service. There were systems in place to monitor the quality and safety of the service provided, however these were not always effective in identifying areas for improvement or where safety had been compromised.
Relevant recruitment checks were not always completed. For one staff member there were gaps in their employment history which meant the service could not check the staff members employment history to make sure they were of good character and had the necessary skills. Staff received support and one to one sessions or supervision to discuss areas of development. They completed training but some further clinical training was required. Systems were in place to protect people from abuse. Sufficient staff were deployed to meet people's needs.
People were supported with their nutritional needs. People received varied meals including a choice of fresh food and drinks. Staff knew people well and treated people with kindness and compassion
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 CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 29 January 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last 3 consecutive inspections. We will describe what we will do about the repeat requires improvement in the follow up section below.
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 remained in breach of some regulations.
Why we inspected
The inspection was prompted in part due to concerns received about poor pressure care, lack of fluids and staffing. 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 remained requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment and governance at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
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.