Background to this inspection
Updated
6 July 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of one adult social care inspector and one assistant inspector.
Service and service type
Hatfield House is care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection visit because it is a small residential care home and we needed to be sure that they would be in.
What we did
Before the inspection we reviewed the information we held about the service. This included notifications the provider is required by law to send us about events that happen within the service such as serious injuries. Due to technical problems, the provider was not able to complete a Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We sought feedback from the local authority and other professionals who work with the service such as Healthwatch. Healthwatch is an independent organisation which collects people's views about health and social care services. The feedback from these organisations was used in planning the inspection and helped identify some key lines of enquiry.
During our inspection we spoke with four people and two relatives about the care people received. We also spoke with the registered manager and three members of support staff.
We reviewed two people’s support plans in full and looked at specific issues relating to risks and care within other people’s care records.
We looked at staff induction and training records, medicine records and quality monitoring records the provider used to assure themselves of the quality of service provided.
Updated
6 July 2019
About the service
Hatfield House is a residential care home that provides accommodation and personal care to four people who are living with a learning disability or autistic spectrum disorder.
The service has been developed and designed in line with the principles of CQC’s policy ‘Registering the Right Support’ and other best practice guidance. This aims to ensure people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People's experience of using this service:
People told us they felt safe. Staff understood how to keep people safe and how to report any concerns they may have.
Risks associated with people’s care had been assessed and were identified in risk assessments, but they lacked detail. It was not always clear how decisions within risk assessments had been reached to keep people safe.
Staff were recruited safely, and processes checked the background of potential new staff.
People received their medication as prescribed. However, improvements were required to some medication processes.
People’s needs, and wishes were assessed before they started to use the service. These needs and wishes were recorded in people's care plans. Care plans were regularly reviewed to ensure staff had up to date and relevant information about people's care needs.
Staff knew people well and understood their individual needs and preferences. People were offered choices. For example, in the meals and drinks they were offered.
Referrals were made to healthcare professionals where required to ensure people’s health needs were met.
People had identified goals they wished to achieve but there was no information in care records about what staff could do to support people to achieve these goals.
People and relatives told us staff were caring, kind and respected their privacy and dignity.
Staff received the training and guidance they needed to complete their role. Staff understood how to prevent the spread of infection.
People received information about the service in a way that was appropriate to their needs.
People made their own decisions about their care and were supported by staff who understood the
principles of the Mental Capacity Act 2005. However, improvements were required to the recording of decisions relating to mental capacity.
A complaints process was in place and people and relatives felt confident to complain if they needed to.
Systems and processes had not always been effective in driving continuous improvement at the service
Knowledge of meeting the regulations was limited. For example, notifications the provider is required by law to send us about events that happen within the service had not always been sent to us in a timely way.
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 requires improvement (published 16 June 2018). Improvements had been made and the service is now rated good overall. However, the service was not consistently well-led and this key question remains requires improvement.
Why we inspected
This was a planned inspection based on the previous rating. We have found evidence that the provider still needs to make some improvements. Please see the well led section of this full report.
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.