Archived: Hazelmere Nursing Home

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. There were 18 people living in the home on the day of our inspection. We spoke with eight people who lived at the home, one relative and five members of staff.

Is the service safe?

People were treated with respect and dignity by the staff. People who used the service told us they felt safe. A relative told us, "I'm really pleased with the care my relative receives.'

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

The manager compiled the staff rotas, they took people's care needs into account when they made decisions about the numbers, qualifications, skills and experience required. This helped ensure that people's needs were always safely met.

Policies and procedures were in place to make sure that unsafe practices were identified and people were protected.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant that people were safeguarded as required.

Is the service effective?

People's health and care needs were assessed with them, and, as far as practicable, they were involved in developing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

People's needs were taken into account with the accessible layout of the service, enabling people to move around freely and safely.

Visitors confirmed that they were able to see people in private and that visiting times were flexible.

The home had systems in place to assess and manage risks and to provide safe and effective care. The staff were appropriately trained and training was refreshed and updated regularly. Staff could also take the opportunities provided to study for additional qualifications and to develop their understanding of caring for people with conditions such as Parkinson's disease and diabetes. We also found evidence of staff seeking advice, where appropriate, from the GP or social services.

Is the service caring?

People were supported by kind and attentive staff. We saw that all staff that had contact with the people who used the service showed patience and empathy.

We spoke with relatives who said they were always made to feel very welcome. They told us 'Whenever I visit there are always staff around and they are kind, friendly and keep me informed of things.' We saw that the staff took time with people over lunch and when they were moving about within the home. We observed that people were treated sensitively with consideration and dignity.

People who used the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People's needs were assessed before they moved into the home and care plans and risk assessments were maintained and reviewed regularly. This ensured that the care and support provided reflected any identified changes in people's individual care needs. We saw that the staff monitored weight, nutrition and hydration and handover sessions were helpful and informative. However we did find that the care documentation did not reflect the care delivery in respect of monitoring fluid and food intake, safe moving and handling and continence needs. We also found inaccuracies in documentation about external health examinations that caused confusion with staff when discussing peoples care needs. This could impact negatively on people's needs if staff do not respond to poor intake of food and fluids and move people safely. A compliance action has been set in relation to people's records and the provider must tell us how they plan to improve.

As well as satisfaction questionnaires, staff told us they operated an 'open door policy' so people who used the service and visitors to the home could discuss any issues they may have. This was confirmed by the relatives we spoke with.

People told us they were asked for their feedback on the service and their feedback was heard and changes were made as a result. People and their relatives, who we spoke with, also knew how to make a complaint or raise any issue or concern that they might have. They were also confident that their concerns would be listened to and acted upon.

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 and consistent way.

The service did not have a robust quality assurance system in place and records seen by us showed that identified shortfalls had not been identified or addressed. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Staff told us they were clear about their roles and responsibilities. The lack of staff meetings and staff feedback however meant that the provider had not sought the views of staff to gain their views of the standard of care and treatment delivered to the people who used the service.

When we inspected this service on 9 July 2013 we found that people were not always treated with dignity and respect. We found that the planning and delivery of care did not meet people's individual needs. We found there were not effective systems in place to assess and monitor the quality of the service that people received.

The manager wrote to us with an action plan which told us how these shortfalls would be addressed. This inspection was carried out to follow up on the progress made by the home in relation to these essential standards.

At this inspection we found that steps had been taken which demonstrated improvement in the three areas.

People were seen to be involved in their care and were shown dignity and respect. Care plans we looked at reflected the care that people received. Care plans were seen to be up-to-date and personalised with specific guidance for staff. The home had taken steps to put systems in place to assess and monitor the quality of the home's service.

We looked at five care plans. We found the care plans we looked at contained limited evidence of people being involved in their care.

We found that care was delivered in a task orientated way and did not always reflect the needs of the people.

We found the home to be clean and tidy. There were cleaning schedules in place. One person told us, 'I like my room here, nice, bright and airy.'

We found that staff were provided with appropriate training. One staff member told us, 'We get a lot of training, both from one of the nurses here and from an external provider.'

We found that the home did not have effective systems in place to monitor the quality of care.