Hyne Town House

Updated 17 November 2023

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 conducted by two inspectors, an assistant inspector, medicines inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Hyne Town House is a ‘care home’. People in care homes receive accommodation personal care as a single package under one contractual agreement dependent on their registration with us. Hyne Town House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 the operations director and operations manager supporting the service. We spoke with 12 members of the staff team, including care staff, cleaning and maintenance staff and the chef. We observed interactions between staff and people and spoke to 9 people who use the service and 2 family members.

We reviewed a range of records relating to the management of the service, for example, records of cleaning, maintenance and premises, medicines management, risk assessments, accidents and incidents, quality assurance systems, and recruitment records. We looked at 10 people's care and support plans and associated records.

After the site visit, we continued to seek clarification from the operations direcrtor to validate evidence found and received additional documents and information to support our inspection. We sought feedback from 5 health and social care professionals who engaged with the service and received 2 responses.

Updated 17 November 2023

About the service

Hyne Town House is a residential care home providing personal care for up to 45 people. The service provides support to older people some of whom are living with dementia. At the time of our inspection there were 20 people using the service.

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

The provider did not have effective systems in place to monitor the quality of care and support that people received. Audits had not been effective in identifying and addressing where improvements needed to be made. We found where improvements had been made at the last inspection, these had not been sustained.

People were not always protected from risks associated with their environment. Where risk had been identified, people’s care plans and risk assessments lacked detail and did not always guide staff about how to manage or mitigate risk.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Mental capacity assessments and best interests decisions were not always in place where people had restrictions placed on them.

Care plans did not always contain sufficiently detailed person-centred information to guide staff on how to meet people’s needs. Despite some activities happening at the service, people continued to tell us they felt bored, and they were not always supported to follow their interests and take part in activities they enjoyed doing.

We made a recommendation to the provider about seeking guidance and understanding of The Accessible Information Standard.

People told us they were happy, they felt safe, and staff understood how to keep them safe. People told us staff were kind, caring and treated them with respect.

People were supported by staff who were recruited safely and there were enough staff to keep people safe and meet their needs.

People were protected by good infection control processes and lived in an environment that was clean and hygienic.

Medicines were managed safely.

People were supported to eat and drink enough and had access to healthcare when they needed.

Staff felt supported within their roles and felt confident to discuss any concerns they had with the management team.

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 (focused inspection published 12 January 2021).

Following the last comprehensive inspection in 2019 the provider completed an action plan to show what they would do and by when to improve.

At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last comprehensive inspection in 2019.

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.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, person centred care, the Mental Capacity Act and governance oversight systems at this inspection. We have also made a recommendation in relation to the Accessible Information Standard.

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 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 the provider's progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.