Archived: Horncliffe House

There was a registered manager. 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.

At the last inspection in November 2015, the service was rated ‘Good’. At this inspection we found the service remained Good.

At the last inspection we recommended water temperatures were checked regularly so that people were not at risk of scalding themselves. At this inspection they had addressed the issue.

Horncliffe House is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

We spoke with people who lived at the home and comments were positive in relation to care and support provided by the staff team. One person said, “The staff are fantastic nothing is too much trouble we get along like a house on fire.”

We found staff were aware of treating people as individuals with importance placed on promoting dignity and respect. People who lived at the home confirmed staff treated them as individuals and delivered person centred care.

The service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during their daily routines and delivery of their care. These had been kept under review and were currently being updated.

Staff had been appropriately trained and supported. They had the skills, knowledge and experience required to support people with their care and social needs.

People told us they received their medicines as prescribed and when needed. We found appropriate arrangements were in place for the safe storage of medicines.

We looked around the building and found it was clean and a safe place for people to live. We found equipment had been serviced and maintained as required. However some areas of the home were in need of updating. The registered manager acknowledged areas of the building required upgrading to improve standards throughout the home. Comments from relatives, staff and people who lived at the home spoke about the need for refurbishment of the home.

People had been 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.

Staff had been appropriately trained and supported. They had the skills, knowledge and experience required to support people with their care and social needs.

People told us the standard of food at Horncliffe House was good and they were able to have a choice of meals. One person said, “The food is really good and I enjoy it.”

There was a complaints procedure which was made available to people on their admission to the home and their relatives. People we spoke with told us they were happy and had no complaints.

People who lived at the home told us they enjoyed a variety of activities which were organised for their entertainment.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits, staff meetings and daily discussions with people who lived at the home to seek their views about the service provided.

A registered manager was in place. 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.

At the last inspection on 13 May 2014 we found the provider was meeting all the requirements of the regulations inspected.

During the inspection visit to Horncliffe House all relatives and people who lived at the home we spoke with told us they felt their relative was safe and cared for. The registered manager had systems in place to check people’s safety, including the safe management of accidents and incidents. Staff demonstrated they had a good understanding of protecting individuals from potential harm or abuse.

Some radiators were delivering heat at very high temperatures. This put people at risk of scalding or burning themselves.

We have made a recommendation the service seeks advice to ensure heat is delivered at safe temperatures from radiators.

We observed people’s medicines administered at breakfast time and at lunch time. They were dispensed in a safe manner and people received their medicines on time. Staff had received related training to ensure medicines were administered correctly by knowledgeable staff. The registered manager and local pharmacy had carried out checks to ensure processes were completed safely.

The registered manager had completed an assessment of people’s support needs. This was before they moved into the home. A relative we spoke with had been consulted and involved in the assessment and support plan. We found evidence of this in records we looked at. People who lived at the home said they were happy with their care and support provided to them by caring staff.

People who lived at the home were happy with the variety and choice of meals available to them. The service employed cooks who prepared homemade meals and comments were positive about the quality of food. One person said, “The food is great”. Regular snacks and drinks were available between meals to ensure they received adequate nutrition and hydration.

The registered manager understood the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who lacked capacity to make their own decisions.

Staff we spoke with had a good understanding of how people should be treated in terms of respect and supporting people with dignity. For example we observed good examples of staff being respectful and patient towards people during our inspection visit.

The service had a complaints procedure which was made available to people on their admission to the home. People we spoke with told us they were comfortable with complaining to staff or management when necessary.

The registered manager and owner used a variety of methods to assess and monitor the quality of the service. We looked at a number of audits that were undertaken by the registered manager and owner. This ensured the service continued to be monitored and improvements made when they were identified. People were supported to feed back about the quality of their care through surveys and meetings.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, staff supporting them and from looking at records. We also had responses from external agencies including social services .This helped us to gain a balanced overview of what people experienced living at Horncliffe House.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

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

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. The manager had been trained to understand when an application should be made and how to submit one. This meant that people would be safeguarded as required. The manager said, 'We will be looking for more staff to undertake this training in the future.'

From our observations during the day, we found people were treated with respect and dignity by staff. People living at the home told us they felt safe. Comments from people who lived at the home included, 'I had to move here from another home, my room is lovely, the staff are excellent and I feel safe and secure. I would not want to go through moving again.'

Is the service effective?

People's health and care needs were assessed with them, and they were involved in developing their plans of care where possible. The manager had introduced 'personal history profiles' so that more information could be obtained. They provided an individual picture of each person and would support staff to develop relationships and know people better. 'These are being completed as soon as possible with residents and families.' Specialist dietary, mobility and equipment needs had been identified in care plans where required.

Is the service caring?

We spent part of the day in the lounge and dining areas observing staff interaction with residents. People were supported by kind and attentive staff. We saw staff showed patience and gave encouragement when supporting people. One resident we spoke with said, 'The staff are so lovely and caring.'

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

Is the service responsive?

We saw evidence of daily activities planned and going on in the home. These were planned in response to people's wishes and individual interests. One resident said, 'The organ player is very good I do like it.'

We saw evidence of the complaints procedure around the home for people to see. Residents we spoke with said they knew how to make a complaint if they were not satisfied. The manager and staff we spoke with told us a recording system was in place to investigate record and reach outcomes for any complaints they received. People can therefore be assured complaints would be investigated and action taken as necessary.

Is the service well-led?

We had responses from external agencies including social services .They told us they had a good working relationship with the manager and staff to make sure people received their care and support they required.

There were a range of audits and systems put in place in by the manager and provider to monitor the quality of the service being provided. However the manager might like to note more formal ways of seeking views of people who lived and work at the home would ensure the continuing development for providing quality care and support for people.

Submitted fire records show that a fire drill and regular fire alarm tests had been undertaken. These had been signed and dated as completed. This meant Horncliffe House's required fire safety checks were up-to-date.

We received recorded minutes from a recent meeting held between service users and the manager. The record showed that quality of care was discussed along with suggestions about activities and menus. We further received recorded minutes from a recent team meeting. Areas that were discussed included confidentiality, medication, food safety and activities. This meant the registered provider involved people in the quality monitoring of service provision.

Additionally, we received several satisfaction questionnaires that had been completed by service users or their relatives. A relative commented that their family member, 'Always speaks highly of the staff and the attention she is given'. Another person stated, 'The home is kept clean and fresh and the staff give exceptional attention to the residents'.

We observed staff interacting with people in a supportive and respectful manner. This matched their related care plans. Care records were person-centred and reviewed regularly. One person told us 'I'm very independent and the staff help me to keep my independence'. A relative told us, 'I'm happy that mum's in this home. The care is very good ' the staff really care for mum'.

The home worked with other providers effectively and recorded these events. People felt they received medical attention in a timely and confidential manner. We found during our inspection that medication procedures were undertaken by using a safe approach. People expressed that they were aware of the home's complaints process.

The Horncliffe had undertaken a range of audits to monitor the quality of its service. However, fire safety, service user surveys and team meeting records could not be fully checked. This was because the manager, who was on leave, was the only person to have access to them. This meant that we could not fully carry out our regulatory duties with regard to quality assurance.

We were also told that the meals were good and that the staff team were patient and kind. People also told us that they felt safe living at the home. One person said, 'I have never had anything to complain about, they have a lot of patience, staff do very well'.

We observed the interaction between the staff and the people who used the service. We observed that staff were respectful of people and treated them with dignity. For example, we saw staff knocking on people's bedroom doors before entering. We also saw staff offer assistance with personal care needs in a discreet and dignified manner.

People were able to furnish their bedrooms with personal items. One person told us, "I hate a soft bed, I have a hard one'. This same person described how she was able to take some of her own furniture from home, to make her bedroom more personal. This enabled the person to have her familiar and precious things around her to make her bedroom more homely.

Staff spoke in a friendly way and there was a relaxed, comfortable and homely atmosphere. One person said, 'The staff are all very nice and helpful, like having servants. They are kind and caring, I find them alright'.