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Hazeldown Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 3 January 2019

Our most recent inspection took place on 13 November 2018 and was unannounced. We last inspected this service on 10 and 11 May 2017. At our last inspection we rated the service requires improvement overall and requires improvement in four out of the five questions we inspect against. We identified three breaches of regulation of The Health and Social Care Act 2008. We found that there were not always enough staff to support people with their assessed needs. We also had concerns about the support and training offered to staff to help them be more effective. We found the overarching quality assurance systems were poorly developed and did not identify areas for improvement. We also found the service had not notified us of a recent event in which a person using the service was at risk.

Following the inspection, the provider sent us their action plan telling us how they were going to address our concerns and comply with regulation. At our inspection on 13 November 2018 we found vast improvements in the way the service was managed with regular input and support from the registered provider. We found one repeated breach of regulation.

Hazeldown is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care home can accommodate up to 18 people in one adapted building. There were 12 people at the time of our inspection. The service is situated in the high street in a small village with some amenities. People have their own room and shared amenities including two lounge areas a main kitchen and a separate resident’s kitchen and dining area.

There is a registered manager. 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 previous breach in relation to staffing had been addressed. There were now enough staff to meet the assessed needs of people using the service. Staff recruitment processes were sufficiently robust and staff once employed were well supported. They received the training necessary for their job role.

The service had improved with strong leadership and provider oversight which helped ensure good outcomes of care for people. However, there were still a number of issues regarding the safety and upkeep of the service. These had not been identified by the registered provider and could result in avoidable harm for people using the service.

The registered manager had since the last inspection familiarised themselves with what needed to be notified to the CQC. The service had very few incidents and people all reported feeling safe and well supported by staff. Staff spoken with were aware of their responsibilities to support people and had undertaken training to help them recognise abuse and knew what actions to take.

Staff supported people to take their medicines safety and as intended. They supported people to maintain good health and see health care professionals when appropriate to do so. People were offered a balanced diet and encouraged to think about their food choices in line with their assessed needs and food preferences. There was guidance for staff about people’s health needs and staff undertook specific training when appropriate. Most people had been supported to see the dentist and there were oral hygiene assessments in place.

We have made a recommendation about implementing The National institute of Clinical Excellence, (NICE) guidance in relation to oral hygiene.

Everyone apart from one person was deemed to have capacity and there were no unnecessary restrictions for people. Staff asked people for their co

Inspection areas

Safe

Requires improvement

Updated 3 January 2019

The service was safe.

There were adequate numbers of staff to support people and manage the risks to people’s safety. We did have some concerns about unidentified risks posed by people’s environment. Staff recruitment processes were sufficiently robust.

People received their medicines as intended by staff who were sufficiently trained.

The service was suitably clean with effective infection control measures.

Staff received training in safeguarding people from abuse so knew how to recognise abuse and what actions they should take.

Effective

Good

Updated 3 January 2019

The service was effective.

Staff were supported in their job role and received regular and updated training which supported their professional development.

People were supported to stay healthy and access health services when required. People had access to a balanced diet and weight was monitored when necessary.

The staff acted lawfully to support people when receiving care and treatment. Consent was sought before supporting people.

Caring

Good

Updated 3 January 2019

The service was caring.

People were supported by staff who demonstrated empathy and treated people with respect.

The service was provided in consultation with people and considered their wishes and personal preferences.

People were encouraged to stay independent and staff tried to motivate people and promote their well-being.

Responsive

Good

Updated 3 January 2019

The service is responsive.

People’s needs were assessed and kept under review. This helped ensure that the service continued to respond to people’s needs and provide appropriate care and support.

People had opportunities and were given encouragement to go out and participate in the wider community and do things they enjoyed.

The service took account of people’s feedback in the way the service was provided. There was an established complaints procedure which was accessible should people need it.

Well-led

Requires improvement

Updated 3 January 2019

The service was not always well-led.

Significant improvements had been made since the last inspection and we had increased confidence with the service provided.

There were still areas of concern regarding unassessed risks and lack of management oversight of this.

There were improved systems to obtain feedback about the service and this was used to improve the experiences of people using the service