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Inspection carried out on 17 March 2021

During an inspection looking at part of the service

Hartland House is a residential care home providing accommodation and personal care for up to 32 people aged 65 and over. Accommodation is provided over two floors with several communal areas and accessible garden areas. At the time of this inspection there were 28 people living at Hartland House.

We found the following examples of good practice.

Prior to anyone entering the building a range of checks were completed including taking temperatures, completing a risk assessment and the use of a rapid lateral flow test (LFT) for COVID-19. Visitors were able to spend time seeing people in a suitable safe space by arranged appointments or face to face. Families had been supported to spend time with people at the end of their lives in a safe and dignified manner.

People who required isolating were supported in their own rooms. A dedicated team of staff were also allocated who could support all their needs. People had access to and were supported in the use of technology and social media to keep in touch with friends and family.

The registered manager followed safe procedures when people were admitted to the home. Regular home testing was in place for both people who used the service and for the staff working there. People required a negative COVID-19 test result before they moved into the home and were supported to self-isolate in their rooms in line with current guidance and recommended practices.

Staff had been trained in infection control practices including any changes relevant to COVID-19. The home was clean and hygienic. There was a designated cleaning staff team and audits on cleanliness and infection prevention and control were completed.

People had been supported to access their own GP as and when they needed to. People had also been supported to be seen by the community nurses to receive care and treatment as they required. The registered manager had kept up to date with national guidance on working safely in care homes and had regularly shared best practice with the staff. There were robust and up-to-date infection prevention and control policies and procedures in place.

Inspection carried out on 4 February 2020

During a routine inspection

About the service

Hartland House is a residential care home providing accommodation and personal care to 30 people aged 65 and over at the time of the inspection. The service can support up to 32 people.

The home is owned and operated by the Abbeyfield Lakeland Extra Care Society Limited, an affiliate of the national Abbeyfield charity, through a volunteer board of trustees. Accommodation is provided over two floors with several communal areas and accessible garden areas to sit in and private car parking.

People’s experience of using this service and what we found

Safeguarding systems were in place to protect people from the risk of abuse or unsafe care. Staff were aware of the procedures, had received training on it and knew what action to take. The provider had recruited staff safely. The registered manager made sure sufficient numbers of staff were on duty throughout the day and night to make sure people received the support as they needed. People received their medicines safely and as their doctor had prescribed.

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. People and their families had been fully involved, where relevant, in planning and reviewing the care and support provided. People received good nutrition and hydration in line with their personal choices. Everyone we spoke with said the food served was excellent.

All the people we spoke with told us they were happy with the staff and care they received. One person said, “All the staff are nice and considerate.” Another person told us, “They [staff] give you plenty of time to express what you want and any time you wish to talk they will.” People were treated with respect and their dignity and privacy were actively promoted by the staff supporting them. People were fully supported to maintain their independence.

The provider planned people's care to meet their needs and take account of their choices. Care plans had been reviewed regularly and people told us they had been involved. One person said, “My care plan was reviewed recently. I am very happy with it. I am happy with everything here.” Another person told us, “I have my care plan in my drawer. I also have a hospital bag in my wardrobe just in case I get taken to hospital in a rush.” People could see their families and friends as they wished. People knew how they could raise concerns about the service provided.

The provider and registered manager regularly monitored the quality and safety of the service. Governance and quality assurance were well-embedded within the service. The leadership of the service promoted a positive, open culture. The registered manager and staff team worked closely with other agencies and healthcare professionals to make sure people had good care. A visiting professional told us, “I look forward to my sessions at Hartland House and always receive a warm welcome.”

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 May 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.

Inspection carried out on 23 May 2017

During a routine inspection

This comprehensive inspection took place on 23 May 2017 and was unannounced. We last inspected Hartland House in August 2014. At that inspection we found that the service met all of the essential standards we looked at.

Hartland House provides accommodation and personal care for up to 32 older people It is owned and operated by the Abbeyfield Lakeland Extra Care Society Limited, an affiliate of the national Abbeyfield charity, through a volunteer board of trustees. It is a detached two storey building with garden areas to sit in and private car parking. It is situated on the edge of the small market town of Milnthorpe. The home has a range of adaptations including a passenger lift to assist people to access the accommodation on the first floor.

There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the (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.

During the inspection we saw there were sufficient numbers of suitably qualified staff to meet people’s needs and promote people’s safety.

Where safeguarding concerns or incidents had occurred these had been reported by the registered manager to the appropriate authorities and we could see records of the actions taken by the home to protect people.

When employing fit and proper persons the recruitment procedures had included all of the required checks of suitability.

We saw medicines were being administered and recorded appropriately and were being kept safely.

People’s rights were protected. The registered manager and staff team were knowledgeable about their responsibilities under the Mental Capacity Act 2005.

Staff had completed training that enabled them to improve their knowledge in order to deliver care and support safely.

People were supported to maintain good health and appropriate referrals to other healthcare professionals were made.

We observed staff displayed caring and meaningful interactions with people and treated them with respect. We observed people’s dignity and privacy were actively promoted by the staff supporting them. People living in and visiting the home spoke highly of the staff and told us they were very happy with their care and support.

There was a clear management structure in place and staff were very happy with the level of support they received.

People living in the home were supported to be independent and access activities and pass times of their choice.

Auditing and quality monitoring systems were in place that allowed the service to demonstrate effectively the safety and quality of the home.

Inspection carried out on 18 November 2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014. 

Hartland House provides accommodation and personal care for up to 32 older people, some of whom may suffer from dementia. It is owned and operated by the Abbeyfield Lakeland Extra Care Society Limited, an affiliate of the national Abbeyfield charity, through a volunteer board of trustees.

Hartland House is a modern detached two storey building on the outskirts of Milnethorpe. The home has a range of adaptations including a passenger lift to assist people to access the accommodation on the first floor.

There was a registered manager in post at the time of our inspection visit.  A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

At the last inspection visit in December 2013 we found that this service met all the national standards we looked at. Since then there has been no incidents or concerns raised that needed investigation.

We spoke to people in their own rooms and those who were sitting in the communal areas. People told us they were happy with the care and support they received. Comments included, “I love it here and I decided myself to make it my home”.

People told us they felt safe living in Hartland House. We found staff were aware of their roles and responsibilities to keep people safe at all times. There were procedures to follow if staff had any concerns about the safety of people they supported.

The service worked well with external agencies such as social services and mental health professionals to provide appropriate care to meet people’s physical and emotional needs.

We saw that staffing levels were good throughout all areas of the service. Staff training was up to date. All staff were supported by the management team through regular staff supervision and appraisals. Procedures in relation to recruitment and retention of staff were robust and ensured only suitable people were employed to care for and support those using this service.

The provider had an effective system in place to monitor the care and support given to those who lived in Hartland house.

Focussed inspection 18 November 2014

During our visit we spoke to people who lived in Hartland House and they told us they always felt safe living in the home and there was always staff on hand to help them. They said, “I have always found there to be enough staff in the day and three on duty through the night is enough assistance if we want it”.

We asked people if they received their medicines at the time they should. They replied, “I have never had to wait for medicines or any cream. I know some people need their morning tablets early and I see the senior taking their tablets round before breakfast”. We spoke to the registered manager about the administration of medicines, including prescribed creams and were told it was extremely rare for medicines to be late arriving.

We asked the registered manager and the care managers about the concerns raised about ‘favouritism’ on the part of the registered manager. We also asked the staff who were on duty during our time in the home. The registered manager confirmed this accusation had never been made before and the support staff we spoke told us they had never seen any actions that would lead them to believe there were any favourites among the staff or people who lived in the home.

Our findings following this focussed inspection evidenced that the anonymous concerns were unfounded

Inspection carried out on 18 November 2014

During Reference: R6 not found

Inspection carried out on 10 December 2013

During a routine inspection

People told us they were very happy living in Hartland House. Comments included,

�The care here is very good and I am well looked after�.

�I am so happy here and the staff are lovely. Have you tasted the mince pies?�.

�The staff encourage me to do things for myself which I like as I want to remain as independent as possible�.

We saw that people were able to join in meaningful and sociable activities if they wished. Staff were pleasant and polite and we saw that people who used the service and their visitors were treated with respect and dignity.

We found that people�s care and support needs had been assessed and kept under regular review to help ensure people received the care they needed. We saw that people had access to health and social care professionals. The people we spoke with told us they received the help they needed when they needed it and that staff did encourage them to remain as independent as possible.

There were clear policies and procedures in place for medicines handling and storage. Medicines records were up to date and regularly checked to ensure medicines were administered correctly.

We found that all the records pertaining to the operation of the service were in place and up to date with current legislation.

Inspection carried out on 13 November 2012

During a routine inspection

We spoke with some of the people living in the home and one said, �I only came for a short time and it is so nice I decided to stay�. One person commented, �I think everything is marvellous. No one comes into my room without knocking first as they say this is my home.�

We found good standards of care and support were delivered in a warm and caring manner and that people were relaxed in their surroundings. Records were up to date and reviewed regularly.

People spoken with felt that their privacy, dignity and independence were promoted.They told us they felt safe living in the home and that they would be able to voice concerns, if they had any, without feeling uncomfortable.These values were underpinned by the essential training that staff had received. People spoke very positively of the staff team describing them as, �Helpful and kind.�

Inspection carried out on 21 December 2011

During a routine inspection

People living at Hartland House told us the care provided in the home was �Excellent� and said they and their families were included in making all decisions about their lives in the home.

People said they enjoyed the meals provided in the home and took part in a range of activities of their choosing.

People told us:

�You get plenty of choice and if you don�t like what�s on the menu the cook will always make you something else.�

�The staff are all lovely, you couldn�t ask for better.�

�You couldn�t do anything to improve this place.�