Background to this inspection
Updated
4 February 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.
This was a targeted inspection to check on a concern we had about the management of environmental risks and the risks this posed to people.
Inspection team
This inspection was conducted by one inspector.
Service and service type
The Hylands Retirement Home is a ‘care home’. 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. The Hylands Retirement Home 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 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 registered manager, who is also a director. We spoke with 2 deputy managers and one care worker.
We conducted a tour of the service to look at environmental risks. We reviewed three people’s risk assessments and accident and incident records.
Updated
4 February 2023
About the service
The Hylands Retirement Home is a residential care home providing personal and nursing care for up to 46 people some of whom are living with dementia. At the time of the inspection there were 41 people living at the service.
The care home accommodates people in one large adapted building with several communal areas. The service is located close to local amenities and is situated on the sea front.
People’s experience of using this service and what we found
Potential risks to people were not always well-managed. Elements of the recruitment and induction process were not robust. Staff had not always had the required training to ensure they were knowledgeable and competent in their role. Staffing levels at night were not safe and regular fire drills had not been undertaken to ensure staff knew what actions to take in the event of an emergency. Quality assurance processes had not been effective in identifying the issues found during the inspection. The registered manager started taking actions to address these issues during the inspection.
We observed that staff were kind and patient in their interactions with people and people provided positive feedback about their experience of the service. Staff felt supported in their role.
Documentation did not demonstrate that people were supported to have maximum choice and control of their lives. Staff did support them in the least restrictive way possible and in their best interests.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 13 December 2018).
Why we inspected
The inspection was prompted in part about concerns we received about the management of people’s skin in addition to there been an outbreak of COVID-19 within the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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 reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the Safe and Well-led sections of this report.
Enforcement
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 to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safe care and treatment, governance and staffing 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 for the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.