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Inspection carried out on 12 December 2017

During a routine inspection

This inspection took place on 12, 13 and 15 December 2017 and was unannounced on the first day.

The service was last inspected on 23 March 2016 where we conducted a focussed inspection to look at the safe domain only. We found that improvements were still required and made a recommendation was for the registered manager to ensure that handover notes contain pertinent and legible information to ensure effective information exchange between staff shifts. Staff need to be fully updated and aware of the current care and support needs of each person they will be caring for during each shift.

The provider sent us an action plan giving details of how they intended to address the recommendation made. During this inspection we found that the action taken had addressed the findings detailed in that recommendation.

Hyde Nursing Home is one of a number of care homes in Tameside owned by Meridian Healthcare Limited, part of HC-One Limited. The service is situated in the Hyde area of Tameside. It is a purpose built care home and is registered to provide accommodation for people who require nursing and residential care. There are 60 bedrooms and the home is divided into three units; Godley Court and Newton Court provide nursing care for up to 35 people in total. Werneth Court is a unit providing nursing care for up to 25 people living with dementia. Godley and Werneth Courts are split over two floors, each with upstairs and downstairs units. Each unit has a lounge, dining area, kitchenette and individual, ensuite bedrooms. The main kitchen and large laundry are located on the top floor of the home.

At the time of our inspection there were 53 people living at Hyde Nursing Home.

There was a registered manager in post at the time of the inspection. 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 2008 and associated Regulations about how the service is run.

Medicines were managed safely.

Staffing levels were sufficient at the time of the inspection to meet the needs of people who were cared for and supported by the service.

Staff understood their role in keeping people as safe as possible and had received training in safeguarding adults.

A robust recruitment system was in place to minimise the risk of unsuitable people being employed to work in the service.

Risk assessments were in place to minimise the potential risk of harm to people during the delivery of their care.

Both the registered manager and deputy manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant that people who may lack capacity were being appropriately supported to make their own decisions whenever possible.

Staff were provided with relevant training and had access to online information and support. Staff confirmed that the training they received supported them to carry out their job roles effectively.

We observed staff treat people with kindness, respect and dignity and staff understood the needs of people which was demonstrated by the way they communicated with them.

People had access to various activities on a daily basis and were supported by appropriately trained staff.

There was a complaints procedure displayed throughout the home and a record of all complaints and the action taken to resolve them was kept.

Regular meetings were held for staff teams, people who used the service and their relatives. This gave people the opportunity to express their views and raise any concerns about the service. This indicated that the culture of the service was open and transparent.

Inspection carried out on 23 March 2016

During an inspection to make sure that the improvements required had been made

We carried out an unannounced comprehensive inspection of this service on 12 October 2015. At that time we found there was one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider did not ensure there were always sufficient numbers of staff available to meet people's needs.

After the comprehensive inspection, the provider wrote to us to say what action they would take to meet legal requirements in relation to the breach. We undertook a focused inspection on the 23 March 2016 to check that they had followed their plan and to confirm that they now met the legal requirements.

During this inspection we found some improvements had been made to staffing with regards to the recruitment of ancillary staff, such as kitchen assistants and domestic staff. These new staff were in place to relieve care staff during the busy lunchtime periods. Additionally, recruitment to permanent care and nursing staff was on-going to remove the need for agency workers.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Hyde Nursing Home’ on our website at www.cqc.org.uk.

Hyde Nursing Home is a purpose built care home and is registered to provide accommodation for people who require nursing and personal care. There are 60 bedrooms and the home is divided into three units; Godley Court and Newton Court provide nursing care for up to 35 people in total. Werneth Court is a unit providing nursing care for up to 25 people living with dementia. Godley and Werneth Courts are split over two floors, each with upstairs and downstairs areas. Each unit has a lounge, dining area and individual, en-suite bedrooms.

At the time of our inspection there were 51 people living at Hyde Nursing Home.

The home’s registered manager had worked in the role since October 2015. 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.

The registered manager told us that they had recruited new care and nursing staff and still had 130 hours care staff vacancies to recruit to. This meant that the home was using fewer agency staff but this did not equate to a net increase in care and nursing staff levels on the three units. However, fewer agency and more permanent staff meant that carers were able to get to know people and their care and support needs.

People told us that staff were very friendly and one person told us that they did not feel that they had to wait too long for assistance. However, another person told us that they often had to wait for assistance. We saw that staff were kind and caring whilst providing support.

Handover notes lacked information or were incomplete leading to insufficient information exchange between staff during staff changeover times.

We have made one recommendation for the registered manager to ensure handover notes are improved around information and legibility.

At our focused inspection on 23 March 2016, we found that a number of changes had been made and our observations on the day showed that the lunchtime experience overall for people who live at Hyde Nursing Home, had improved from the previous inspection.

Inspection carried out on 12 October 2015

During a routine inspection

This was an unannounced inspection which took place on 12 October 2015. We had previously inspected this service in March 2015 when we identified five breaches of the Health and Social

Care Act 2008 (Regulated Activities) Regulations 2014. These related to staffing levels, support for staff, management of medicines, care and treatment of people who used the service and ineffective quality assurance systems.

Following the inspection in March 2015 the provider wrote to us to tell us the action they intended to take to ensure they met all the relevant regulations. This inspection was undertaken to check whether the required improvements had been made.

Hyde Nursing home is a purpose built care home and is registered to provide accommodation for people who require nursing and personal care. There are 100 beds in total, 60 of the beds are in use by Hyde Nursing Home. Godley Court and Newton units provide general nursing care for up to 35 people in total. Werneth is a unit providing care for up to 25 people living with a dementia. There were a total of 46 people using the service at the time of the inspection.

The service did not have a registered manager in place. 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 2008 and associated Regulations about how the service is run. A new manager had been in post since May 2015. They had submitted an application to register with CQC as manager for Hyde Nursing Home.

During this inspection we found a breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because there were not always sufficient numbers of staff available to meet people’s needs. You can see what action we have told the provider to take at the back of the full version of the report.

People who used the service told us they felt safe in Hyde Nursing Home and had no concerns about the care they received.

Staff had received training in safeguarding adults. They were able to tell us of the correct action to take should they witness or suspect any abuse had occurred. Staff also told us they would feel confident to use the whistle blowing procedure in the service to report any poor practice they observed.

Staff had been safely recruited. Records we reviewed showed staff had received the induction, training and supervision they required to be able to deliver effective care. Staff told us they enjoyed working in the service and received good support from the manager. They told us the atmosphere in the service had improved since our last inspection.

Although improvements had been made to the way medicines were managed in the service, some aspects of the new procedures introduced had yet to be fully implemented.

All areas of the home were clean and well maintained. Procedures were in place to prevent and control the spread of infection. Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply. Regular checks were also in place to ensure staff were aware of the action they should take in the event of a fire at the service.

People’s care records contained sufficient information to guide staff on the care and support required. People told us they always received the care they needed. The care records showed that risks to people’s health and well-being had been identified and plans were in place to help reduce or eliminate the risk. We saw that staff had made referrals to health professionals to help ensure people received effective care.

We saw that appropriate arrangements were in place to assess whether people were able to consent to their care and treatment. The manager was aware of the action to take to ensure any restrictions in place were legally authorised under the Deprivation of Liberty Safeguards (DoLs).

People told us they generally enjoyed the food provided in Hyde Nursing Home. We observed the food to be well presented and nutritionally balanced. Although there were systems in place to help ensure people’s nutritional needs were met, we observed people did not always receive the individual assistance they needed to eat their meals.

People we spoke with told us that staff in Hyde Nursing Home were always kind and caring. Although we observed kind and respectful interventions between staff and people who used the service, we also saw there were occasions on which staff interventions with people were limited and mainly task focused.

A programme of activities was in place to help promote the well-being of people who used the service. Records we reviewed showed people were supported to access activities on both a group and individual basis.

There were effective systems in place to investigate and respond to any complaints received by Hyde Nursing Home. All the people we spoke with told us they would feel confident to raise any concerns they might have with staff or the manager.

Quality improvement processes in the service had improved since our last inspection. The manager had introduced daily meetings with staff from each part of the service to help monitor the quality of the service provided.

Inspection carried out on 11 March 2015

During a routine inspection

This inspection took place on 12, 13 and 15 December 2017 and was unannounced on the first day.

The service was last inspected on 23 March 2016 where we conducted a focussed inspection to look at the safe domain only. We found that improvements were still required and made a recommendation was for the registered manager to ensure that handover notes contain pertinent and legible information to ensure effective information exchange between staff shifts. Staff need to be fully updated and aware of the current care and support needs of each person they will be caring for during each shift.

The provider sent us an action plan giving details of how they intended to address the recommendation made. During this inspection we found that the action taken had addressed the findings detailed in that recommendation.

Hyde Nursing Home is one of a number of care homes in Tameside owned by Meridian Healthcare Limited, part of HC-One Limited. The service is situated in the Hyde area of Tameside. It is a purpose built care home and is registered to provide accommodation for people who require nursing and residential care. There are 60 bedrooms and the home is divided into three units; Godley Court and Newton Court provide nursing care for up to 35 people in total. Werneth Court is a unit providing nursing care for up to 25 people living with dementia. Godley and Werneth Courts are split over two floors, each with upstairs and downstairs units. Each unit has a lounge, dining area, kitchenette and individual, ensuite bedrooms. The main kitchen and large laundry are located on the top floor of the home.

At the time of our inspection there were 53 people living at Hyde Nursing Home.

There was a registered manager in post at the time of the inspection. 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 2008 and associated Regulations about how the service is run.

Medicines were managed safely.

Staffing levels were sufficient at the time of the inspection to meet the needs of people who were cared for and supported by the service.

Staff understood their role in keeping people as safe as possible and had received training in safeguarding adults.

A robust recruitment system was in place to minimise the risk of unsuitable people being employed to work in the service.

Risk assessments were in place to minimise the potential risk of harm to people during the delivery of their care.

Both the registered manager and deputy manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant that people who may lack capacity were being appropriately supported to make their own decisions whenever possible.

Staff were provided with relevant training and had access to online information and support. Staff confirmed that the training they received supported them to carry out their job roles effectively.

We observed staff treat people with kindness, respect and dignity and staff understood the needs of people which was demonstrated by the way they communicated with them.

People had access to various activities on a daily basis and were supported by appropriately trained staff.

There was a complaints procedure displayed throughout the home and a record of all complaints and the action taken to resolve them was kept.

Regular meetings were held for staff teams, people who used the service and their relatives. This gave people the opportunity to express their views and raise any concerns about the service. This indicated that the culture of the service was open and transparent.

Inspection carried out on 26 November 2013

During a routine inspection

At the time of our inspection there was a programme of refurbishment taking place in the dementia unit. This was to support the Harmony project which promotes caring for people with dementia.

The people who we spoke to who used the service were happy with Hyde Nursing Home and had no complaints. Comments included “It is very nice here and you can have a laugh with them (staff).” And “Staff are alright here they speak politely and kindly.” Another person said “They are genuine people who do their best for you.”

Relatives of people who used the service were also satisfied. One relative said “You can’t fault the staff and I have confidence in the nurses.” And another relative said “The staff are efficient.”

We spoke with people who lived in the home and those who were able to express their views told us that they were satisfied with the care and support they received from staff. The care plans we observed had a comprehensive assessment and identified risk to promote people’s safety and welfare.

Staff had received safeguarding of vulnerable adults training. We found the provider worked with the local safeguarding team and responded to safeguarding incidents appropriately.

We found that the home was clean and people who use the service commented that “They (the cleaners) are always cleaning here.”

Staff working at Hyde Nursing home appeared to enjoy their work. Comments included “I like the satisfaction of helping people and seeing them smile at you.” The staff felt they received appropriate training to do their job.

Inspection carried out on 20 December 2012

During a routine inspection

During this visit we did not inspect the intermediate care service provided by Pennine Care NHS Foundation Trust.

When we spoke with people living in the home, they told us that they were happy and satisfied with the care and support they received from care staff. Comments included:

"The staff are kind and caring and do their best to help."

"I have been very happy here."

We spoke with three relatives of people living in the home. Comments we received from them were positive. One person said, "The staff are very good, my xxx always looks lovely. The staff make sure people keep their dignity. The care staff are very pleasant and they know what care my xxxx needs." One other person told us,"I had a minor concern , the staff were very responsive and they addressed the issues I raised."

We looked at care records of three people. These contained the relevant documentation and provided staff with the information they needed to provide safe care and support to people living in the home.

There were appropriate policies and procedures in place so that people received their medication in a safe way. Appropriate arrangements were in place for obtaining, recording, storing, administering and disposing of medication.

Training records showed that the service prioritised training for staff. Relatives of people living in the home told us they felt confident in the abilities of staff to provide safe appropriate care.

Inspection carried out on 26 January 2012

During a routine inspection

We spoke to a number of people who use this service and all of them were very positive about the way in which staff provided care and support. Comments from these people included:

"The girls (Staff) are very good. They are always helpful. I feel in charge of the way I live and I find the staff will listen to me."

"We get looked after very well, but if I had a concern I would have no hesitation in reporting it to a senior member of staff."

"I feel safe here; there is always someone about to help."

"I'm very happy here. I like to have a joke with the staff. They definitely listen to me about how I want to be cared for."

Visitors were complimentary about the service. They told us that when concerns had been raised they had always been addressed.

Staff told us that they felt supported with the supervision arrangements and that they had plenty of access to training and development opportunities.

Reports under our old system of regulation (including those from before CQC was created)