Archived: Hunter Hall Care Home

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found '

Is the service caring?

We saw people's needs were assessed and care was planned in line with their assessed needs. One relative told us, "I think it is a very good home; there is nothing I could find fault with.' Another relative said, "We've used other homes for respite. Put it this way, this is the best of all we looked at.'

We observed staff delivering care and noted that w they were patient and compassionate and supported people to be as independent as possible or addressed people's needs where they were unable to do so themselves.

We spoke to a general practitioner who was visiting the home at the time of our inspection. He told us that there were still some issues over communication but generally he thought that action was being taken to improve work between the surgery and the home and this had improved the overall care provided to people.

Is the service responsive?

People's needs were assessed and their care plans reviewed and revised in line with their changing needs. People had access to a range of outside services to ensure their health and wellbeing was maintained including doctors, opticians and district nurses.

We observed staff delivering care and found that they mostly supported people appropriately and responded to people's individual needs.

We noted there were some activities available to people and one relative told us, 'There is painting and jigsaws. They have a singer now and then.' However, we found that the range and consistency or activities was poor, that assessments of people's needs in relation to meaningful activity was incomplete and people's individual likes and dislikes were not recorded or acted upon. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Is the service safe?

We walked around the home on arrival and found that the premises were clean, tidy and generally well maintained.

Staff we spoke with had a good understanding of infection control issues. Staff were able to talk in detail about the need to use personal protective equipment (PPE), such as aprons and gloves, and the need to change PPE between tasks. They were also able to discuss the need for good hand hygiene within the home. We observed staff wore PPE when providing personal care to people and during meal times.

On the day of our inspection a fire alarm test was carried out to ensure the systems worked effectively. We noted that alarms could be heard throughout the building and automatic doors closed when the system was tested.

We noted that one person's meal was left out to cool and then reheated in the food trolley before being left to cool again. The manager said this should not have happened and that she would take action to prevent similar incidents.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager told us that one application in relation to DoLS had been submitted and the person's care plan reflected this. The majority of people who used the service were assessed as not having significant capacity to make decisions about their life and there was an indication that best interest decisions would be made, where necessary. Staff within the home had received training on DoLS and the Mental Capacity Act 2005.

Is the service effective?

People's care records indicated that the provider worked closely with other professionals and services to supports people's needs. We saw that where necessary district nurses, speech and language therapists and palliative care staff were involved in people's care.

Relatives told us they were happy with the care that had been delivered and that their relative's needs had been met. One person we spoke with told us, 'The girls are lovely, they really help me.'

It was clear from our observations and from speaking to staff that they understood people's care and support needs. One staff member said, 'You always ask people if they are happy. Be aware of their expression; show them, give them a physical choice, if possible.'

Is the service well led?

The name of the manager does not appear in this report. This is because she is new to the home and is in the process of formally registering with the CQC.

The home had a range of quality assurance systems in place to monitor the quality and consistency of care. The manager carried out a range of checks and audits. We saw copies of documents regarding checks on nutrition, equipment and the general environment within the home.

We saw that complaints and safeguarding incidents were investigated and, where necessary, action taken to change or improve care delivery.

Relatives of people who used the service confirmed that there were meetings and we saw a copy of minutes from the most recent meeting. One relative told us, 'There has been a meeting, although I did not go. But I can talk to the manager anytime about any issues I have.'

Staff confirmed that there were regular staff meetings and we saw minutes from this meeting. Staff told us, and records confirmed that they had regular supervision with a senior member of staff and yearly appraisals.

People told us their views were respected and they or their next of kin were consulted about their care. One person told us, 'I'm getting old now, so don't always remember things. But the staff are nice and always ask me about things.' A relative told us, 'I am regularly involved in discussions about care.'

People's needs were assessed and care was planned in line with assessed needs. One person told us, 'They couldn't do anything better to look after me.' Relatives told us, 'The carers are wonderful. They really look after my sister', 'Care on the whole is quite good' and 'The care is fine.'

Care workers told us they felt current staffing levels were acceptable and allowed them to care adequately for people. Some staff indicated it was often difficult to complete paperwork during shifts because they were providing direct care. One relative told us, 'She always looks nice and her clothes are always changed. Her bed is changed every day.'

The provider had in place effective systems to identify, assess and manage risks to the health, safety and welfare of people using the service.

Recording systems were in place and records were accurate, fit for purpose and stored securely.

We saw the ground floor accommodation had been fully refurbished, was bright, appropriately furnished and decorated and was comfortably warm. Doors leading to the bathrooms and toilets had been painted a different colour to other rooms and had visual signage on them to help people identify these facilities. Lounges on both floors had been fitted with a fire place to provide a focal point for people.

We noted bathrooms contained modern easy access baths, with integrated chairs, lifting equipment and temperature controls. Wet rooms with showers were clean and bright with good access and space. This meant that people had a range of facilities to use to help them maintain a healthy lifestyle. One person who used the service told us, 'I much prefer a shower, but I might have a bath.' One member of staff told us about the baths, 'It's all mechanised with its own thermostat, so the water is at a constant temperature.'

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

Due to a flood in June 2012, the ground floor was closed for refurbishment and people had been moved to the first floor or to another home until building work was completed. However there was no risk assessment in place to manage the building work at the home and the heating and hot water were intermittent. We concluded that the provider had not taken steps to provide care in an environment that was adequately maintained.

We found that there was not enough equipment to promote the independence and comfort of people who used the service because there was not an effective maintenance programme in place.

We found that staff received appropriate professional development and were able to obtain further relevant qualifications.

People and relatives told us they felt able to raise any concerns or comments about the service. We concluded that people's complaints were fully investigated and resolved, where possible, to their satisfaction.