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Archived: Haddon Court Nursing Home Requires improvement

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Inspection report

Date of Inspection: 23 June 2014
Date of Publication: 22 July 2014
Inspection Report published 22 July 2014 PDF


Inspection carried out on 23 June 2014

During a routine inspection

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at this time.

At the time of this inspection Haddon Court was providing care and support to 49 people, some of whom had a diagnosis of dementia. We spoke with 12 people living at the home, and three visiting relatives to obtain their views of the support provided. We also spoke with the home manager, the company director and seven members of staff.

We considered all the evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service told us they felt safe. Comments from people included, "I like it here. It�s a pleasure to be here,� �Staff are very nice. There are no arguments� and �Nobody upsets me."

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

We found risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant that people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their lives.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. One application had been submitted which confirmed to us that relevant staff had been trained to understand when an application should be made and how to submit one. This meant that people would be safeguarded.

We found people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

We have asked the provider to send us a report setting out the action they will take to meet this standard. We will check to make sure that this action is taken.

Is the service effective?

One relative told us the home had made contact with them in the early hours suggesting they might like to come as their family member was unwell. They said, �Our [family member] has been looked after very well. They were admitted to the home with their spouse and until this period they had been given adjoining rooms. Their spouse has Alzheimer�s so is not entirely aware of situation but arrangements are being made to bring the couple together today.�

During our visit, we found people were provided with the support they needed. However we observed people often had to wait as staff were very busy. We found staff knew people well and were aware of their individual preferences. We found staff treated people in a kind manner.

Care files we checked confirmed that initial assessments had been carried out by the staff at the home before people moved into the home. This was to ensure the home was able to effectively meet the needs of the people. Specialist mobility and equipment needs had been identified in care plans where required. People and their relatives said they had been involved in writing them and they reflected their current needs. Visitors confirmed they were able to see people in private and that visiting times were flexible.

Staff were provided with training to ensure they had the skills to meet people�s needs. Managers� were accessible to staff for advice and support. Staff were provided with formal individual supervision and appraisals at an appropriate frequency to ensure they were adequately supported and their performance was appraised.

Is the service caring?

People who used the service and their relatives said staff treated people respectfully. Relatives told us, �Staff do a good job. I wouldn�t do their job for anything� and �Everyone is respectful and our [family member] has been treated with dignity.�

Other comments made to us by people who used the service were, �They [staff] tell me what to do,� �They�re always picking on you. They [staff] tell you what to do all the time and I don�t like it,� �I get up at 6.15 and nobody comes near me. If I go and ask for a cup of tea, they say �in half an hour� and then they don�t get me one.� One person said that when her relative had visited recently, staff had been laughing about their last name and its pronunciation.

During our observation we saw friendly interactions between staff and people who used the service and there was kindness in staff�s tone of voice when speaking with people. Staff addressed people by their preferred names and people seemed comfortable in the presence of staff. Interactions between staff and people who used the service were relaxed and unrushed.

We found staff skills in recognising and respecting the diversity and human rights of people who use the service varied significantly. Some staff were able to tell us how important it was for people, other staff were less understanding of the concepts of privacy, dignity and independence.

Is the service responsive?

Staff and a relative told us the care and support provided was flexible to the person�s needs and adjustments could be made where required. Staff said they informed the manager if they felt any change in needs was required and the support was reviewed. For example, one person was requiring palliative care and this was being provided.

On the day of the inspection the activity worker was asked to work as a carer because a member of staff was sent home ill. When we looked at the record of activities provided we found there had been a significant number of days over the last month where the activity worker had worked as a carer to cover staff shortage. This meant very little activity had been provided for people.

People knew how to make a complaint if they were unhappy. Five people who used the service said, �Everything here has improved in the last six months.� One person also said, �Management is more easy going.�

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

All people spoken with said they weren�t aware of any �residents meetings�. One person said, �That would be a good idea.� Another person who used the service told us the manager came to see them twice a week and this gave them the opportunity to raise any concerns they may have.

On the notice board we saw a �relatives meeting� was planned for the end of the week. Staff told us relative meetings took place every �few months� and we saw the minutes recorded at the last meeting in March 2014.

Staff had regular meetings with the manager and were kept updated about any information they needed to know about the service. This helped to maintain consistency in the running of the service and to ensure staff were aware of relevant information.

The service carried out a yearly �Quality Assurance Survey�. Feedback was sought by way of customer satisfaction surveys sent to people who used the service, their relatives and friends, staff and healthcare professionals. This showed people had the opportunity to put their views across.

The service had a quality assurance system. Monthly and weekly audits were completed regarding such things as medication, care plans, the environment, staffing and infection control. We found there was not always an action plan with a timescale of the action required to ensure improvement. This meant there was a risk that intervention and improvements may not be made within a reasonable timescale.