About the service Hartford Court provides accommodation and residential care for up to 68 people, some of whom have a dementia related condition. At the time of our inspection there were 57 people using the service.
People’s experience of using this service and what we found
People had not always received their medicines in a safe and timely manner. The risk people faced in their day to day lives had not always been addressed.
People’s needs and choices were assessed but care plans lacked some important details. Records did not always accurately and fully reflect people’s care needs.
Quality assurance systems had not always been effective in finding the issues we had during the inspection. During feedback, the senior management team said they had fallen short of the providers expectations and would work to address issues raised.
People were helped to eat and drink and maintain a healthy diet. We received some mixed views about food and drinks from people and their relatives.
Communication within the service needed to be improved. This included within the staff team particularly in connection with record keeping and when communicating with health care professionals.
The service was clean and tidy, but staff had not always followed infection control guidance fully. We have made a recommendation about this.
The service needed some decoration and new carpeting; however, the provider had a refurbishment plan in place to rectify this.
Information around people’s capacity, consent to care and best interest decisions were in place in some care files but not others. We have made a recommendation about recording how staff are following the principles of the MCA.
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; however, the policies and systems in the service did not support always this practice.
People told us they felt safe. Staff understood their responsibilities to report any safeguarding concerns. People were complimentary about the kind nature of the staff team.
There were enough staff and staff were recruited appropriately. However, there had been some shortages from time to time due to the COVID-19 pandemic and there was still some use of agency staff. The provider was actively recruiting to fill vacant posts. Staff had received training, but further updates were required to better help staff support people living with dementia who had distressed behaviours.
We received mixed views about leadership within the home. Some staff felt they were not always supported effectively by management. During the inspection, the registered manager resigned.
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 good (published 18 January 2020). At this inspection we found the provider had deteriorated to requires improvement.
Why we inspected
The inspection was prompted in part due to concerns received about the care people received, including food quality, nutrition and medicines. A decision was made for us to inspect and examine those risks.
We undertook a focused inspection to review the key questions of safe and well-led but after further review of information, this was broadened to include effective.
For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating.
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. You can see what action we have asked the provider to take at the end of this full report.
The management team were responsive to our inspection feedback and had appointed a ‘turnaround’ manager to support the home.
You can read the report from our last inspection, by selecting the ‘all reports’ link for Hartford Court on our website at www.cqc.org.uk.
Enforcement and Recommendations
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 safe care and treatment and good governance at this inspection.
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 from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside 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.