Archived: Hungerford Care Home

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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service. This was an unannounced inspection.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The Hungerford Care Home provides accommodation and nursing care for up to 59 older people who have nursing or dementia care needs. There were 52 people living at the home when we visited.

People gave us complimentary comments about the service they received. People felt happy and well looked after. However, our own observations and the records we looked at did not always match the positive descriptions people and relatives had given us.

People’s safety was being compromised in the home. Some equipment was not cleaned or well maintained, procedures to control the spread of infection were not robust, and there was insufficient support for people who became distressed or who were unable to make their needs known.

People’s health care needs were assessed. However, staff did not always provide support and care in an effective way. People were not always supported to eat and drink enough to meet their nutrition and hydration needs. In some cases, this either put people at risk or meant they were not having their individual care needs met.

Although people told us they felt their privacy and dignity was respected and made positive comments about staff, we saw that care was mainly based around completing tasks and did not take into account people’s preferences. Some people living at the home were not engaged in meaningful activities or did not have opportunities for social engagement. People who use the service were not always treated with consideration, and their privacy and dignity respected while receiving their care and support.

The provider had a system to assess staffing levels and make changes when people’s needs changed. The rota demonstrated the provider had the right numbers of staff on duty to support people. However, they could not be sure that at all times the staff had the appropriate knowledge and qualifications to meet people’s needs.

Staff training records included mandatory training considered by the provider as being appropriate training for the staff. However, not all staff were up to date with, or had received their mandatory training. We saw evidence that learning was not always put into practice when staff supported people.

Staff were following the principles of the Mental Capacity Act 2005 (MCA) when supporting people who lacked capacity to make decisions. The manager was knowledgeable about Deprivation of Liberty Safeguards (DoLS) and MCA. They had taken appropriate action with the local authority to ensure where restrictions were placed on people, these were reviewed and agreed. Where people’s liberty was restricted, this was carried out in the least restrictive way in order to help protect people’s rights and freedom.

The registered manager investigated and responded to people’s complaints, according to the provider’s complaints procedure. Most people and relatives told us they did not have any complaints. One person told us they had made one complaint and it was responded to appropriately. People and relatives told us they knew they could speak to staff or address the issues with the manager.

The manager had a system in place to assess and monitor the quality of care. However, we saw this system did not work effectively to identify all issues or concerns with the home and practices. Without an effective system the home was not able to make improvements where and when necessary so that people could receive support and care they needed.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.