Archived: Hickling House

Hickling House provides residential care for up to 29 people, some of whom may be living with Dementia. Accommodation is over two floors and, all bar one, every room has en-suite facilities. The home has a lift, conservatory, dining room and a number of communal lounges. At the time of our inspection, 28 people were living in the home.

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 2008 and associated Regulations about how the service is run.

The people living at Hickling House were supported by staff who were well trained and had the skills and knowledge to perform their roles. Appropriate recruitment checks had taken place to ensure that only those staff that were safe to work in care had been employed. Staff felt supported in their roles and worked well as a team. There were enough staff to meet people’s individual needs in a timely and person-centred manner.

The service understood the importance of staff development and staff received regular support and supervision to assist them in developing their skills and performance. Staff had received training in areas specific to the people they were supporting and this assisted in ensuring people received care individual to their needs.

Staff understood how to prevent, protect and report incidents of abuse. They were knowledgeable in the types of abuse that people could experience and were able to give us examples of these. Staff had knowledge of the agencies they could speak to if they had any safeguarding concerns. Risks to people had been identified, assessed and reviewed on a regular basis. People received their medicines on time and in the manner the prescriber intended. The service safely stored, managed and administered medicines.

People had confidence in the staff that supported them and found them kind, caring and patient. People told us they were encouraged to be as independent as possible and make their own choices. Staff demonstrated a respectful, professional and cheerful approach to their work and had time for the people they cared for. People’s dignity and privacy was promoted and staff demonstrated a discreet approach to this. Staff were quick to respond to people’s needs and could effectively offer reassurance and comfort to those needing it.

The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. Although the service had not recorded the capacity assessments they had made on the people they supported, the principles of the MCA had been adhered to and staff had knowledge of this. The service had made some appropriate DoLS applications but we identified that two more were needed. The registered manager told us this would be completed following our inspection. Staff had a strong understanding for the need to gain people’s consent before assisting them and people told us this took place.

People received care and support that was personal to them. Care plans were detailed and person-centred and manged in a way that gave staff the information they needed to offer care and support. People’s needs had been identified, assessed and reviewed on a regular basis. People’s personal histories were available to assist staff in forming meaningful relationships with them.

The service had good working relationships with healthcare professionals that ensured people’s health and wellbeing was properly maintained. The service liaised with healthcare professionals promptly and appropriately. Those that we spoke with talked highly of the service and said their recommendations were always followed by staff.

People told us their social and leisure needs were met. The service encouraged people to maintain their interests and provided a range of activities for people both inside, and outside, of the home.

The management team was visible and people told us they had confidence in them. They found the registered manager easy to talk to and responsive in addressing any issues or concerns. The service promoted accountability amongst its staff. It demonstrated it took concerns and complaints seriously and investigated them fully.

People were encouraged to provide feedback on the service and, although regular meetings did not take place, felt they could openly talk to the staff and registered manager about any concerns they may have. People told us they felt listened to. The service had systems in place to monitor the quality of the service and these were used to develop the service further.

We observed a number of other people who used the service being well supported by staff and being spoken to respectfully.

We spoke with three relatives who were visiting on the day of our inspection. All spoke very positively about the care and support provided.One person said, "It's like home from home. I come and stay here myself sometimes." One person said, "They are really brilliant to mum" and another person said, "You don't have to ask them for everything, they come to you".

We spoke with four staff who spoke very positively about working in the home and said that they felt well supported.

We looked at a range of records including care plan records, risk assessments, reviews training records and supervision and appraisal records.These records were stored securely, were readily available, accurate and fit for purpose.They provided us with evidence that the service was maintaining the information we required.

Staff received appropriate support and training to carry out their duties.

People and their family members were involved in all stages of their needs assessment, care planning and review processes. They said they felt fully involved and were listened to. Staff responded to their comments so that care was very personalised.

Staff were well trained and were described as being very patient, especially with people living with dementia. Staff received support from senior staff and there were opportunities for professional development. We saw and heard staff speaking respectfully with people, providing encouragement and support when necessary.

People knew who to speak with if they were unhappy about the service and each person had a copy of the service user guide, which contained a copy of the complaints procedure. People told us they were confident they would be listened to if they had concerns and they felt able to speak up.