Hulton House Care Residence

Updated 8 August 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

Three inspectors and 1 Expert by Experience carried out the inspection. 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

Hulton House Care Residence is a ‘care home’ with nursing care. 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. 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. The manager had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 19 July 2023 and ended on 26 July 2023. We visited the service on 19 July 2023.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service since the last inspection. We sought feedback from Healthwatch, the local authority and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people and 3 relatives about their experience of the care provided. We spoke with 26 members of staff including the manager, regional and deputy managers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with members of the management team, nurses, advanced practitioners, senior carers, carers, housekeeping and laundry staff. We also spoke with activities staff, administration maintenance and catering staff. We had a walk around the home to make sure it was homely, suitable, and safe. We observed the administration of medicines and the care and support people received. This helped us understand the experience of people who could not talk with us.

We reviewed a range of records. This included 10 people's care records and a further 5 people’s records related to any restrictions they had in place. We reviewed 6 staff files in relation to recruitment and a variety of records relating to the administration of medicines, and the management of the service, including policies and procedures.

Updated 8 August 2023

About the service

Hulton House Care Residence is a dementia specialist care home providing personal and nursing care to 53 people at the time of the inspection. The service can support up to 74 people across four separate units, each unit has separate adapted facilities. Two of the units specialise in providing care to people living with complex dementia nursing needs.

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

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Staff were recruited safely and there were sufficient staff to meet people's needs, however some concerns were raised from people, staff, and relatives about staffing levels. The provider increased staffing levels in response to the feedback shared during our inspection. Improvements had been made to the quality and the safety of the service, although the provider's systems needed further oversight to ensure they remained effective. People told us they were safe; systems were in place to protect people from abuse and concerns had been appropriately reported.

People received their medicines safely and the provider was working to reduce the use of 'as and when required' medicines. Staff were suitably trained for their roles and understood risks to people's safety and well-being and worked to lessen these risks. The building was clean, tidy and people could visit family members without restriction.

The manager, provider and management team had been responsive in implementing positive change and worked with health and social care professionals to improve people’s quality of life. We received positive feedback about the manager, deputy manager and the culture of the service. People and their relatives had been included in the development of the service.

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 inadequate (published 01June 2023) and there were breaches of regulation. 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 improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended that when risk assessments identified a change was required to keep people safe, immediate steps were taken to implement that change. We recommended preadmission information ensured people's needs could be met upon admission and for each service user type supported, there is the associated service user band on their registration with us. The provider had made changes to address these concerns.

This service has been in Special Measures since 25 February 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

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 carried out an unannounced inspection of this service on 09 November 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, safeguarding service users from abuse and improper treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe and Well-led which contain those requirements. 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 changed from inadequate to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hulton House Care Residence on our website at www.cqc.org.uk.

Follow up

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