Archived: Hazel Bank Residential Home

At our first visit to the service on 1 August 2013 people we spoke with told us they were happy living at Hazel Bank. They said they enjoyed the meals and activities provided and made many positive comments about the staff employed in the home.

People told us they felt safe living in the home and said they would speak to a member of staff if they had any concerns about the support or services provided.

People told us,

'The staff are very nice, you only need to ask if you want anything',

'We get plenty to eat',

and said, 'We're looked after well'.

We saw that care staff treated people with respect and gave them choices about the support they received. We saw many positive interactions between the staff on duty and people who used this service. These positive interactions supported individuals' wellbeing.

We found that, although some improvements had been made since our previous inspection in February 2013, the service was still not meeting a number of essential standards. Further improvements were required including in care planning, safe handling of medication, protecting people from the risk of infection, staff training and in how the quality and safety of the service was monitored.

On 8 August 2013 the community nursing team, which supported people who lived at Hazel Bank, told us that a person had been admitted to the home inappropriately. They told us that the services and facilities at Hazel Bank were not suitable to meet the person's needs and arrangements had been made for them to move to another service. The community nurses told us that other people who lived in the home had not received the support they needed because the staff at Hazel Bank had been busy trying to support this individual.

This was passed to the local authority that was responsible for safeguarding vulnerable adults. Social workers visited the home on 8 August 2013 to ensure the safety of the people who lived there. The social workers found that the acting manager had left the service before the end of their shift and there were only two staff to support the people in the home.

In response to these concerns, we carried out a second visit to Hazel Bank on 9 August 2013 to check that the people still in the home were safe and that there were sufficient staff to care for people. We found that one person had been admitted to the home on 7 August 2013 but had then moved to another service as the care and facilities at Hazel Bank were not suitable to meet their needs. We also found that other people in the home had not received the care they needed because the care staff were engaged in supporting this individual. We found this had placed people at risk.

The registered provider for the home told us that the acting manager had left the home before the end of their shift on 8 August 2012 and would not be returning to the home in the foreseeable future. They said another member of staff was also absent and would not be returning to the service in the near future.

Following our visit on 9 August 2013 the registered provider sent us information showing how they had ensured there would be sufficient staff to meet the needs of the people in the home. We carried out a brief visit to the service on 13 August 2013 to check that there were sufficient staff to support people who lived in the home. At this visit we found that the actual staffing levels matched the staffing rosters that we were given by the provider.

We asked health and social care professionals for their views on the service provided by Hazel Bank residential home. We were told that recent social worker reviews of people who used this service had identified some concerns.

We found that relatives and people who used the service had been asked for their views about the home via a questionnaire. The questionnaires indicated that most people were "satisfied" or "very satisfied" with the service.

We spent some time in the lounge with people who used this service. One person told us of some of the things they had been doing at the home and of the things they enjoyed. We observed the activities co-ordinator working enthusiastically with the people who used this service.

Our observations of staff working with the people who lived at Hazel Bank were mostly positive but we saw evidence of people's dignity not being protected by staff and of poor care practices.

We found that care plans were recorded as being reviewed each month, but evaluations and the actual care plans had not been updated to reflect changes in people's needs. Records relating to the management of high risk medications were inadequate, had not been updated and had not been followed by staff.

One person said "the food is really good, there is plenty of choice and if I don't like something I can have something else."

Some people commented that the staff were 'nice' and that they "can have a laugh with them."

Others said "I like joining in with activities but if I don't want to that's fine."

Care plans had been reviewed but we did not see that service users had been consulted or involved with this. Plans included more detail to reflect peoples' needs. There were gaps and inaccurately recorded information placing people at risk of receiving inappropriate care and support.

We saw that activities were taking place e.g. a Christmas musical event in the lounge, most people joined in this activity.

Meals and menu choices had improved. Suitable aids and adaptations were used to help people remain independent with eating and drinking. Nutritional assessments had been reviewed but there was inaccurate and poorly documented information about the nutritional needs of some people.

The provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

There were no plans for the long term maintenance and upkeep of the property. There was no manager or any contingency plans for dealing with emergencies. We did not see how staffing levels had been determined and training was poorly documented.

The people we met during our visit spoke favourably about the service they received. Two of the people we spoke with were 'unsure' if they had a plan of their care and support needs.

Some of the people who used this service told us about the food and meals at the home. One person told us that 'the food is very good and suits me. If I don't like something then staff would get me something else. Others said the 'food was good' and that they 'liked it'. They said they were able to 'choose what they had to eat'. We did not see this on the day of our visit.

We did not find that there were effective systems in place to reduce the risk and spread of infection. We found that the provider had not taken steps to provide care in an environment that was adequately maintained.

We found that there were not enough staff employed at the home and that staff were not properly trained and supervised with their work. The lack of appropriately skilled staff placed people using this service at risk from harm. However, the people we spoke to during our visit told us that 'staff were kind and helpful'. We did not receive any adverse comments about the staff at the home.