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The Hall Residential Home Good

Reports


Inspection carried out on 7 October 2019

During a routine inspection

About the service

The Hall is a residential care home providing personal care to 47 people aged 65 and over who may be living with dementia in one adapted building. At the time of this inspection 39 people were living at the service.

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

People told us they were happy and felt staff had a good understanding of their care and support needs. Support was delivered in safe way by a consistent team of staff who had the skills, knowledge and relevant training to support people. Management encouraged staff to continuously develop their skills.

Medicine support was delivered in a safe way. Safeguarding concerns had been referred to the local authority when required. Risks to people were considered and any accidents and incidents were monitored and recorded.

People were treated with dignity and respect and their independence was promoted. Staff understood the importance of social interaction and this was encouraged. People had opportunities to take part in stimulating and enjoyable activities. Consideration was given to people’s specific interests and how participation within the local community could be encouraged.

Staff spent time getting to know people and their life histories. They understood the importance of this which stimulated meaningful conversations and activities. Care plans contained some person-centred, information. However, plans were in place for more information to be added to make sure they were completely person-centred.

Staff communicated with relevant professionals to ensure people received the healthcare support they required. People were provided with a variety of meals which they told us they enjoyed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were involved in decisions and their choices were respected. Information was presented in a way people could understand. Deprivation of liberty renewals had not always been submitted in a timely manner. This was addressed during the inspection.

People and staff spoke positively of the management team. The service was well-run by a registered manager who was passionate about ensuring people received the support they required and engaged with the community. Regular feedback on the service provided was requested from people and relatives.

Electronic systems meant the provider could regularly monitor the service provided. However some records could be developed further to drive improvements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (report published 26 April 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 28 February 2017

During a routine inspection

The Hall Residential Home is registered to provide accommodation and care to a maximum of 47 older people or people who may be living with dementia. The Hall Residential Home is situated in the village of Thornton Le Dale, close to village amenities. It is a large Grade II listed building with it's own grounds. The service provides residential support to people, and all bedrooms have en-suite bathrooms. There is on-site car parking for visitors and staff and disabled access into the building. There were 40 people who used the service at the time of this inspection, 23 people were living with dementia.

At the last inspection in October 2014, the service was rated ‘Good’. At this inspection, we found the service remained ‘Good’.

People told us they felt safe and were well cared for. The registered provider followed robust recruitment checks, to employ suitable staff, and there continued to be sufficient staff employed to assist people in a timely way. People’s medicines were managed safely.

Staff had continued to receive appropriate training to give them the knowledge and skills they required to carry out their roles. This included training on the administration of medicines and on how to protect people from the risk of harm. Staff received regular supervision to support them to fulfil their roles effectively, and had yearly appraisals to monitor their work performance.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People said they enjoyed good food. People's health needs were identified and staff worked with other professionals, to ensure these needs were met.

Staff were kind, caring, compassionate and patient. They respected people’s privacy and dignity and encouraged them to be as independent as possible. Health and social care professionals spoke positively about the quality of care provided.

Staff were knowledgeable about people’s individual care needs and care plans were person-centred and detailed. There was a range of social activities offered including meals to celebrate special events and festive holidays. Spiritual needs were met through in-house services and one-to-one pastoral care when requested.

People told us the service was well managed and organised. The registered manager assessed and monitored the quality of care provided to people. People and staff were asked for their views and their suggestions were used to continuously improve the service.

The service met all relevant fundamental standards we inspect against.

Further information is in the detailed findings below.

Inspection carried out on 7 October 2014

During a routine inspection

This inspection which took place on 7 October 2014 was unannounced. At our last visit to The Hall on 22 April 2013 we did not ask for any improvements to be made.

The Hall Residential Home provides accommodation and personal care for up to 47 older people, some of whom were living with dementia. There were 34 people living at The Hall on the day we inspected and seven of those were living with a dementia. The building is a converted hotel with a more recent extension. It is a large historic property with a large garden and car parking facilities.

There was a registered manager at this service who has been registered since April 2011. 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 service was safe and people who used the service confirmed to us that they felt safe. There were enough staff on duty to care for people appropriately. Medicines were managed safely.

Safeguarding alerts had been made by the service to the local authority when necessary but none had been substantiated. Staff had been trained and knew what to do in situations where people may be at risk of harm.

This service was not always effective. There were some features of a dementia friendly environment but more needed to be done to develop the environment in order to make this a truly enabling service.

We recommend that the provider looks into good practice guidance relating to dementia friendly environments.

The registered manager followed the principles of the Mental Capacity Act (MCA) 2005.

Activities were organised to enhance people’s lives. People were given plenty to eat and drink at mealtimes  and were supported by staff where necessary.

Staff were kind and caring and we saw them knocking on people’s doors showing respect for them.

The service was responsive and people who used the service were asked about their likes, dislikes and preferences.

There was a complaints policy and procedure in place and people told us they would approach staff if they had needed to complain.

The service was well led by a registered manager and directors who led by example and who had completed training in order to be able to develop the service. There was an effective quality management system in place.

Inspection carried out on 23 April 2013

During a routine inspection

We carried out an inspection on the 23rd of April at The Hall following a compliance action from the previous inspection regarding involvement of people who used the service. During this inspection we also looked at further areas of compliance.

We found that the service was now involving people and their families in their own planning as well as other parts of the service. We looked at revised care planning documentation and found this to be very person centred and personalised to the individual. We observed the support given was of a high standard and people told us they were happy living in the home. One person told us “Everything I need is here”. Another told us “The quality of care is great”.

We looked at the environment within the home and found this to be well maintained and very well appointed. We looked at the newer areas of the home and found these had been installed to a very high standard.

We saw that staff recruitment checks were thorough and complete. Staffing levels were appropriate and were monitored closely. We looked at the audit systems to assess the quality of care given and the ways in which feedback was gathered and found this to be robust and inclusive.

Inspection carried out on 27 November 2012

During a routine inspection

During our inspection of The Hall we looked at the involvement of people in care planning and life in the home and whether people were treated with respect and dignity. We found that there was a high standard of care being provided and staff knowledge of privacy and dignity was good. However, there was a lack of involvement in planning and reviews and under utilisation of activity staff in providing stimulating activities that suited all residents.

One person who used the service told us “I really like it here. The food is good, the view is good and the staff are good”. Another person told us “They respect me and listen to me. I don’t think there is anything I would improve”. A relative told us “I am happy with the care and I have no worries about them being here”.

The care plan files we looked at were detailed and accurate and were up to date. The care we observed was person centred and adapted to suit individual people’s needs.

Staff were well trained, including around safeguarding vulnerable adults and the people said they felt safe at all times. Staff understood what they needed to do if they suspected any abuse. We looked at the amount of staff working in the home and found it to be appropriate and we looked at training and supervision of staff and found this to be robust and supportive.

The complaints system being used in the home was appropriate, and staff made good efforts to ensure people had a chance to give their opinion or raise any concerns.

Inspection carried out on 11 July 2011

During an inspection in response to concerns

People said that there was food available at any time of the day or night. One person said ‘The food is good’. Another person said ‘I can choose where I want to eat’. A third person said ‘The food portions are adequate over a twenty four hour period. Some portion sizes are small but balance this with the quality, and the food has been above and beyond my expectations. The bacon was so nice the other day I would have liked two pieces’.

People said they were happy with the arrangements in place for dealing with medications. One person said ‘Staff dealt with my tablets professionally’. Another said ‘The doctor prescribes my medication for me. The staff have received training to be able to deal with medications so they know what they are doing’.

We spoke to people about the home environment all were very happy with the recent refurbishment that had been undertaken. One person said ‘It’s like a hotel; you cannot fault the attention to detail that has been undertaken when some of our historic rooms have been redecorated. It is beautiful here’.

People were asked if they were asked for their opinions about the service they received. One person said ‘I have been to a residents meeting’. Another said ‘I speak with the manager to give her my views, regularly’.

People we spoke to told us they felt the staff were wonderful. However, one person said ‘I feel the staff are pressured. If I ring for help sometimes during the day staff have to say I am just dealing with someone else. I will come back to you’. Another person said ‘I did not have my shower last night as staff came to me a bit too late’.