Hardwick View

Updated 31 March 2020

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

One inspector undertook this inspection.

Service and service type

Hardwick View is a ‘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 provider held the position of manager registered with the Care Quality Commission. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided. The provider had appointed a manager to support them to manage the home on a day to day basis.

Notice of inspection

The first day of the inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 14 people who used the service and seven relatives about their experience of the care provided. We spoke with seven members of staff including the provider/registered manager, manager and care workers. We also received feedback from two health care professionals and the local authority. We reviewed a range of records. This included three people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, meeting minutes and staff training were reviewed.

After the inspection

We continued to seek clarification from the manager to validate evidence found.

Updated 31 March 2020

About the service

Hardwick View is a residential care home providing personal care to younger and older people living with a learning disability, physical disability or a sensory impairment. The home can support up to 20 people; 19 people were living there at the time of the inspection. The home consists of a large family home and an adjacent bungalow where two people live independently.

The service has been developed and designed prior to the implementation of Registering the Right Support. However, we found the home adhered to the principles and values to ensure people 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.

The service was a large home, bigger than most domestic style properties. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People received a high level of person-centred care based around their abilities, preferences and interests. The manager and staff took time to get to know people and refused to see disability as a barrier to a full and inclusive life. A relative told us, “We chose Hardwick for its outstanding qualities of care, compassion and an open friendliness. These qualities have never changed and if anything, have grown, helping to give it the homely, warm atmosphere that the clients live in.” Another told us their loved one had a lifestyle that “exceeded their expectations.”

People told us they were happy and safe at Hardwick View. They were proud to show us around their home and tell us about their life. They told us of the friendships and relationships they had made and the various leisure activities they enjoyed.

Relatives and professionals told us of the support people were provided with to remain as healthy as possible to enable them to live comfortable and fulfilling lives. They gave us examples of where people’s health had improved as a result of the determination and dedication of staff to ensure everything possible had been done to support people to live their best life. One relative told us that without the support of the home, their loved one would not be alive to celebrate their birthday. People had the support of professionals to help them understand their health care needs and to work alongside staff to provide the best possible outcomes for people. The manager challenged healthcare professionals if people had not been given fair access to services and the same opportunities for support as people without disabilities. One person told us staff had helped them understand a newly diagnosed health condition and that they had the support of a specialist nurse. A professional told us, “Every individual is given the very best chance in life” and another described the home as “always excellent”.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were fully involved in making decisions about their care and treatment. Staff understood the importance and principles of supporting people to make their own decisions about their care. They always approached decision making from the view that with the right information, including advice and guidance from healthcare professionals, people could make their own decisions. A relative told us of the “amazing” support their loved one had received when deciding whether to have surgery. Staff were highly motivated and held a strong belief that people should be as independent as possible and live fulfilling lives.

What was important to people was very much respected and valued by staff, and staff did their utmost to support people’s preferences and interests. A relative told us about how positive the move to Hardwick View had been for their loved one; they said, “The day [name] moved in here her life started again, she’s hit the jackpot. She hasn’t stopped smiling since she has been here. It’s stunning here, she got a life.”

Social engagement was seen by the home as being important to people’s well-being and sense of self-worth. People enjoyed a wide range of social activities including clubs, sports and engaging with other organisations such as colleges, the Royal British Legion Club, churches and the local theatre. Staff recognised the importance of relationships with family and other people.

People received truly kind, caring and compassion support during their end of life care. The provider and manager saw Hardwick View as a home for life for people, should that be their wish. Staff had received training in end of life care and saw it as a privilege to care for people at this sensitive time. We were provided with examples where the home had gone ‘above and beyond’ what would have been expected of them to ensure people approaching the end of their lives were able to be with family and friends and enjoy special events. Feedback received from family members praised the home for their loving care. One considered themselves “blessed” to have found Hardwick View for their relation.

The home applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The provider, manager and staff, through their actions and how they spoke about the people living at Hardwick View, demonstrated they put their values of individuality, independence, inclusiveness, dignity and rights into practice. We received very positive feedback from people, relatives and professionals about how well the home was managed. One relative said, “[Manager] has done an outstanding job as manager. She has a wonderful kind and caring manner which she encourages the staff to follow. Hardwick stands out as a flagship to all other homes.”

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 good (published 29 June 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.