We carried out a review of the data available to us about Hazelmead Residential Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hazelmead Residential Care Home, you can give feedback on this service.
Hazelmead is a residential care home providing personal care for 5 people with physical and learning disabilities. There were 5 people living there at the time of the inspection. The home is a bungalow that had been designed to support people with physical disabilities.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support: 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 practices around documenting decisions were not in line with guidance.
Staff enabled people to access specialist health and social care support in the community. Staff knew people well and provided person-centred care. Care documentation included clear guidance on how to care for people.
Medicines were managed safely. 'When required' medicines had clear guidance on when to administer these medicines when people might not be able to ask for this themselves.
Right Care: Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. Staff had training on how to recognise and report abuse.
Risks to people were assessed and regularly reviewed when people's needs changed. The building was well maintained, and health and safety risks were assessed. The service had enough appropriately skilled staff to meet people's needs and keep them safe. People were supported by staff who had been trained in how to care for their specific needs.
Right Culture: The provider’s quality assurance and monitoring systems were not always effective. We could not be assured lessons had been learnt and shared with staff following incidents or accidents. The quality monitoring systems had not identified the issues we found during the inspection.
There was a positive culture in the service. Staff said the management team were supportive. People enjoyed living at the service and felt listened to. People, their relatives, advocates and healthcare professionals were involved in planning their care.
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 23 August 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service. We have found evidence that the provider needs to make improvements. Please see the effective and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘All inspection reports and timeline’ link for Hazelmead Residential Care Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to the need for consent and the governance processes 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 provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Hazelmead is a residential care home providing personal care for five people with physical and learning disabilities. There were five people living there at the time of this inspection. The home was a bungalow that had been designed to support people with physical disabilities.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People received a personalised service from friendly, supportive staff. People said they liked the staff and enjoyed being with them. Staff knew people’s needs and preferences very well. Relatives said the staff were “very caring” and made sure people had enjoyable experiences and a happy social life.
People were encouraged to make their own decisions and staff understood how people communicated their choices. People were supported to achieve independent living goals. Staff made sure that people were treated with dignity and respect and in a way that was free from discrimination.
People were safe and happy at the home. They described the staff as “like family”. Management and staff understood their responsibilities to report any concerns.
People’s medicines and accommodation were managed in a safe way. Staff were well trained and supported to provide the right care.
People were fully involved in planning menus, shopping and preparing their own meals. They were as involved as possible in the running of their home, including the recruitment of staff.
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.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Staff, relatives and external professionals said the service was well-run. They praised the values of the management and staff team. The service aimed to provide personalised support for people to live fulfilled lives as part of their local community.
The management team were open, approachable and supportive. The provider carried out checks to ensure the quality and safety of the home and was committed to continuous improvements 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
The last rating for this service was good (published 10 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Hazelmead Residential Care Home provides care and accommodation for up to five people with learning disabilities. On the day of our inspection there were five people using the service.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Hazelmead Residential Care Home was last inspected by CQC on 20 March 2015 and was rated Requires Improvement in two areas, Effective and Well-led. We re-visited these areas as part of this inspection.
Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place for people who used the service and staff and described potential risks and the safeguards in place. Staff had been trained in safeguarding vulnerable adults. Medicines were stored safely and securely, and procedures were in place to ensure people received medicines as prescribed.
The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.
There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The registered provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff were suitably trained and training sessions were planned for any due refresher training. Staff received regular supervisions and appraisals.
The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following the requirements in the Deprivation of Liberty Safeguards (DoLS).
People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of visits to and from external health care specialists.
People who used the service and family members were complimentary about the standard of care at Hazelmead Residential Care Home. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.
Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person centred way.
Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.
People who used the service and family members were aware of how to make a complaint however there had been no formal complaints recorded at the service.
The service regularly used community services and local facilities.
Staff felt supported by the registered manager and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service.
The inspection took place on 17, 18 and 20 March 2015 and was announced.
The home was last inspected in September 2013 when we found the provider was meeting all the regulations we inspected.
Hazelmead provides care for up to five people who have learning disabilities. There were five people living there at the time of the inspection.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
People told us they felt safe. Staff knew what action to take if abuse was suspected.
We saw that the building was well maintained and clean. We saw that medicines were managed safely. We noted however, that medicines audits did not cover all aspects of medicines management.
Some staff and one relative told us that more staff would be beneficial to enable people to access the local community more. However, all people, relatives and staff said that people’s needs were met by the number of staff on duty. We saw that safe recruitment procedures were followed.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005 (MCA). These safeguards aim to make sure that people are looked after in a way that does not inappropriately restrict their freedom. The registered manager was submitting DoLS applications to the local authority in line with legal requirements. The local authority had approved two DoLS applications.
We noted that it was not always clear whether people’s capacity had been assessed and best interests decisions carried out for certain decisions for example the refusal of certain medical checks such as mammograms and cervical smears.
We have made a recommendation that decisions are always sought in line with the Mental Capacity Act 2005.
Staff informed us that there was training available. We noted that staff had carried out training in safe working practices. However, not all staff had carried out training to meet the specific needs of people who lived at the service.
We have made a recommendation about staff training on the subject of learning disabilities.
People told us that they were happy with the meals provided at the home. We observed that people were supported with their dietary requirements.
People and the relatives with whom we spoke told us that staff were caring. People said that they were happy living at Hazelmead. One relative said, “We are perfectly happy with [name of person]. The staff are superb.” Another stated, “It’s a happy, family environment with very caring staff who are willing to go that extra mile and improve the services.”
People were supported to maintain their hobbies and interests and housekeeping skills were encouraged to help promote people’s independence. One relative said, “They encourage [name of person] to independent. They are very happy there.”
There was a complaints procedure in place. The registered manager told us that there had been one complaint in the past year. We found that informal concerns were not always documented so actions taken could be evidenced. The registered manager told us that she would address this immediately. There were a number of feedback mechanisms to obtain the views from people, relatives and staff. These included meetings and surveys.
The nominated individual was not currently monitoring the service because of an ongoing investigation which was not connected with Hazelmead. A nominated individual has responsibility for supervising the way that the regulated activity is managed. We requested that an interim nominated individual be appointed eight months ago; however this had not yet happened.
While we had no concerns about the registered manager or her leadership; we considered that improvements were needed with regards to the nominated individual situation to ensure that clear and transparent processes were in place for all staff to account for their decisions, actions, behaviours and performance.
We found that people's care needs were assessed and their care and treatment was planned. People received care which reduced the risk of poor nutrition and dehydration. Where necessary external healthcare professionals had been consulted about people's care needs.
We looked at how the home managed medicines and found there were appropriate arrangements in place for the safe administration, recording, obtaining, handling, storage and disposal of medicines.
We found the provider had a structured staff selection and recruitment policy in place which aimed to ensure staff were suitably skilled, experienced and qualified to deliver care safely.
The records held in relation to people's care and treatment were suitably maintained in order to ensure that their care needs were met and their health and welfare promoted. Other records related to the management of the service were also well maintained.
People told us their consent was gained prior to care being delivered and we found that staff acted in accordance with their wishes.
We found that people's care and support needs were appropriately assessed and their care was planned. They received care safely, and to an appropriate standard.
People were cared for in a clean and hygienic environment and we found that the service had appropriate measures in place to monitor and manage infection control.
There were enough suitably skilled and qualified staff on duty to met people's needs safely and appropriately. We saw the provider had a complaints policy and procedure in place and people told us they were confident the manager would deal with any complaints they raised.
People said they liked how the manager knew all of their names, and the care staff always made sure any concerns were passed onto her. One said they were "happy any problems would be sorted out" and any complaint or concern would be taken seriously by the service. No one we spoke with had needed to use the complaint process.