Handsworth

Handsworth is a residential care home located in the borough of Trafford, Greater Manchester. The home is registered with the Care Quality Commission (CQC) to provide care and accommodation to a maximum of 43 people, aged over 65 years. At the time of this inspection the home had two vacancies.

People’s experience of using this service:

¿ People living Handsworth received outstanding care which was responsive to their needs.

¿ We received excellent feedback from people and their relatives regarding the quality of care provided to people living at the home.

¿ Staff consistently demonstrated the values of the home and put people at the heart of everything they did.

¿ Staff were clear they worked as a team and for the benefit of people living at Handsworth.

¿ Equality, diversity and protecting human rights was a golden thread that ran through every aspect of the home. People were valued as individuals and diversity was celebrated.

¿ Activities were meaningful and reflected people’s interests and personal preferences

¿ People's support plans were tailored to them and had been developed with involvement of their families.

¿ Food was home cooked with a varied menu and people were given lots of choice

¿ The management team was highly effective and led by example. There was a strong culture of continuous learning, openness and transparency.

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

Rating at last inspection

‘Requires Improvement’ (report published on 14 February 2018).

Why we inspected

This was a planned follow-up inspection based on the rating at the last inspection. At this inspection, the key questions of safe, effective and well-led have improved to good. The key question of caring has improved from good to outstanding. The overall rating is now 'Good.'

Follow up

We will continue to monitor this service and plan to inspect in line with our inspection schedule for those services rated ‘Good.’

Handsworth is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home is registered for up to 43 people and is located in a residential area of Bowdon in Greater Manchester. Accommodation is across three floors. There is an accessible garden to the rear of the premises and parking for several cars is available at the front of the home. All rooms have their own toilet and some rooms have ensuite shower rooms. At the time of our inspection there were 39 people living at the service.

There was a manager in post who had been registered with CQC since October 2010. 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.

We found two breaches of the Health and Social Care Act regulations in relation to adequate recording and communication of risks. You can see what action we told the provider to take at the back of the full version of the report.

We made two recommendations about enhancing the current emergency evacuation system and strengthening how the Mental Capacity Act was applied with the service.

The service was not consistently safe as risk assessments did not contain sufficient details to ensure staff supported people safely. Recruitment processes helped to ensure suitable staff including volunteers were employed and staffing levels were sufficient to support people appropriately. There were systems in place to protect people from risk of abuse, accidents and incidents.

Appropriate maintenance and checks took place to ensure equipment and the environment were safe for people living at the care home and staff supporting them. The building was in need of refurbishment. However the registered manager could not tell us when this work would start.

Staff’s knowledge and awareness of mental capacity and deprivation of liberty safeguards was satisfactory. People’s care records contained capacity assessments and appropriate applications for deprivation of liberty had been made. However, requirements of the mental capacity act were not always applied effectively. For example, consent to care was not always consistently recorded in people’s care records.

People told us the food was of acceptable quality and meals took into consideration people’s preferences. This helped to maintain people’s good health and wellbeing. We identified concerns regarding how information about special dietary needs such as fork-mashable foods was communicated to staff. We asked the registered manager to address these concerns.

The provider ensured new staff completed an induction and received mandatory and on-going training. Staff had regular supervision and yearly appraisals. This helped to ensure staff were equipped and supported to carry out their role.

The provider had proactive systems in place to ensure people’s healthcare needs were met as and when required. The local GP operated a weekly surgery from the care home and people were supported by staff to attend hospital appointments.

The service was caring and compassionate. People’s dignity and privacy were treated respectfully. We saw that there was good rapport and friendly interactions between people and staff. Staff demonstrated that they knew people well and were able to describe people’s personalities, their preferences and their interests.

Relatives gave us examples of how they were involved in making decisions about the care provided. Care records we looked at confirmed that relatives, where applicable, had been consulted in the care planning process.

We saw examples of how people were encouraged to develop and maintain their independence. This helped to ensure people maintained a good quality of life and wellbeing.

The service was responsive to people’s needs. Support plans contained personal histories, equality and diversity information and people’s interests and hobbies. The service had assessed all relevant needs such as physical and emotional needs. An activities coordinator with the support of volunteers arranged a wide range of activities and outings to help ensure people’s mental health and physical wellbeing was catered for.

People’s end of life needs were reviewed and updated as required and family members, where appropriate, were involved in this process.

Complaints and concerns raised were well managed and in line with the legal requirements.

The provider had systems in place to help ensure people’s communication needs and impairments were recorded and staff were aware of these. Appropriate consents were in place to share this information with the relevant health authorities.

The service was not consistently well led. Quality assurance processes in place did not effectively identify concerns identified at this inspection such as gaps in risk assessments, mental capacity requirements and consent, and clear communication to staff about people’s dietary needs.

The registered manager was well-liked and respected. People and their relatives told us the registered manager and staff were helpful. There was an open and transparent culture at the service. The registered manager valued the contribution of their staff and there was good communication amongst the staff team. This helped to ensure people were supported effectively.

Staff were adequately supported in their caring roles. This support included regular staff meetings and policies and procedures.

Handsworth is a well presented home in a residential area of Bowden close to Manchester. It is registered for up to 43 people. The provider is Methodist Homes (MH). It benefits from an accessible garden to the rear with raised planters. Parking for several cars is available to the front of the home. All rooms have their own toilet and some rooms benefit from ensuite shower rooms.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People had assessments and care plans that identified areas of risk associated with their care and support, however there was limited guidance in place to show staff how to minimise risk and some actions identified were not always followed effectively. For example we saw in one care plan the person’s weight was to be measured weekly, however records showed this was done at irregular intervals.

The provider ensured staff were knowledgeable about the risks of abuse and had policies, practices and training in place to ensure staff understood their responsibilities under safeguarding.

Appropriate background checks were carried out before new staff began working in the service.

The registered manager and staff did not fully understand the principles and responsibilities in accordance with the Mental Capacity Act (MCA) 2005. We found staff did not fully understand capacity, which meant people may not receive appropriate support to make decisions.

Appropriate arrangements were in place to manage the medicines of the people who used the service.

Staff received a thorough induction which included checks on their competencies. We saw there was a programme of training in place which included mandatory training and regular refresher courses. A programme of regular supervision meetings and annual appraisals was in place.

We observed the lunchtime service and saw it was relaxed, with people assisted to make choices

in a patient and caring way. People were supported to eat their meal and we saw the staff

members provided this support when needed.

We saw the provider had robust systems in place to ensure any complaints or concerns were recorded and investigated. We saw accidents and incidents were reported. We were able to see what actions had been taken in response to these reports.

We received consistently positive feedback about the registered manager. The audits were detailed and we saw evidence which showed any actions resulting from the audits were acted upon in a timely manner.

We have identified breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection. You can see what action we told the provider to take at the back of the full version of the report.

The home was warm, clean and welcoming. Appropriate policies and procedures were in place and up to date and staff members were aware of how to access them and the of correct procedures to follow.

We looked at five care records which contained up to date health and medical information, monitoring charts, risk assessments and personal profiles. Wishes and preferences were recorded and people who used the service and their relatives were included in discussions about their care.

We spoke with a visitor and several people who used the service. The visitor said, 'I have seen a great improvement in my X's mobility and general well-being which I feel is down to good care and good food. I wish I had brought X here sooner'. One person who used the service told us, 'I am very well looked after and the staff go out of their way to help'. Another said, 'I don't think you could find anywhere better'.

We spoke with two members of staff who demonstrated an awareness of safeguarding and mental capacity issues. Staff felt they were well supported. Staff meetings were held regularly, and training was comprehensive and on-going.

Complaints were taken seriously and followed up appropriately. Regular audits were undertaken and the results analysed. Improvements were made to the service as appropriate.

We were told that they had a volunteer that attended twice a month to play the piano. They had a prayer meeting each Friday and a church service on Thursday.

We spoke with one relative who told us that their relative 'did things here and got stimulation' and that they had a 'quality of life when they came here'.

We spoke with 2 people who used the service who told us that they were 'happy here'.

Staff told us that people who used the service had access to a hairdresser who visited twice a week and there was a hairdresser's room available.

We were told that there was an activity co-ordinator on daily. Activities were on display in the hall and there was evidence of different activities throughout the day. The registered manager told us that they used memory boxes for some activities.

We saw that people who used the service and their relatives had access to a library and leaflets. We saw a file for information leaflets on medications on display.

Arrangements were in place to ensure that medicines, including controlled drugs, were securely stored. A safe system was in place for the ordering and returning of medicines.