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Hammonds Requires improvement

Reports


Inspection carried out on 20 August 2019

During a routine inspection

About the service

Hammonds is a residential care home providing personal care to 14 people who live with a learning disability and/or other health conditions. The service can support up to 20 people.

Hammonds accommodates 14 people across three separate buildings, each of which has separate adapted facilities. One of the buildings had four rooms catered for people who stay at the home for short breaks on a respite basis.

The principles and values of Registering the Right Support (RSS) and other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. The provider had not always consistently applied these values.

The service was a large home and was registered for the support of up to 20 people. 14 people were using the service, two of which were staying for a short break. The numbers accommodated are not in line with 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.

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

Hammonds requires further development to be able to deliver support for people that is consistent with the values that underpin RRS. For example, people did not always identify, review or develop individual support outcomes and aspirations or take part in meaningful activities. People's communication needs were not fully supported to enable them to have maximum control of their lives. There were limited opportunities for independence and community inclusion.

People were not always receiving respectful or dignified support. However, people and relatives spoke fondly about the staff and we observed some positive interactions between staff and people.

People received care and support that was safe. One person said, "I feel safe. Staff help me stay safe. The staff are perfect, I like [registered manager]. If I needed help I would talk to him.” One relative said, “I think [person] is very safe. They have been here over 20 years. I think they (staff) are absolutely wonderful with him. He likes the men especially. I am very, very happy that [person] is there.”

Improvements had been made to the management of medicines and risk assessments around people’s health needs. People were supported by staff who received training and were able to identify and respond appropriately to abuse. There were sufficient staff to meet people's needs.

Training and observation of staff practice ensured staff were competent in their roles. People were supported to have 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 enjoyed a healthy, balanced and nutritious diet based on their preferences and health needs. One relative said, “It looks nice. No complaints. It’s food he can eat and digest. He’s put on weight and looks good.”

Many staff had worked at the service for a long time. Staff told us they felt they were overall well supported by the management and worked together effectively as a team.

A system of audits monitored and measured aspects of the service and were used to drive improvement. The management team worked proactively with the NHS and Social Services to proactively meet peoples care needs.

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 requires improvement (published 22 August 2018) and there was one breach of regulation. The provider completed an action plan after the last inspection to show what

Inspection carried out on 9 April 2018

During a routine inspection

An unannounced inspection took place on 9 April 2018.

Hammonds is registered to provide residential care for up to 20 people who live with a learning disability and/or other health conditions. Accommodation is provided for 16 people on a permanent basis; four rooms cater for people who stay at the home for short breaks on a respite basis. At the time of the inspection, there were 14 permanent residents and two people staying on a respite basis. The home provides accommodation in three separate units which are linked by a courtyard and external walkways. A unit called The Lodge accommodates people for short breaks, each room has en-suite facilities and overhead tracking for safe moving and handling. Each unit has a lounge and dining area and kitchen facilities. There is a small sensory room. Some people have lived at Hammonds for many years.

The service had a registered manager 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 and associated Regulations about how the service is run.

Hammonds is a service for people with a learning disability including autism. The care service has not been developed and designed in line with the values that underpin the Registering the Right Support CQC Policy and other best practice guidance. It is very difficult for large services to meet these standards. However at Hammonds we observed that the service had a good understanding of person-centred care and how this was provided for people living at the home. We have made a recommendation for the home to familiarise themselves with the Registering the Right Support CQC Policy. You can see what action we told the provider to take at the back of the full version of the report.

During the inspection, we saw that CQC had not been notified of some incidents and of DoLS authorisations. Following the inspection the registered manager acted swiftly to submit the DoLS authorisations to the CQC. This is a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.

During our visit the registered manager told us that risk assessments are going to be improved. We told the registered manager we saw an overstock of medicines and identified medicines records need to be better. Although we saw improvements were needed to be made to risk assessments and medicines we did not see this having an impact for people living at Hammonds. We have made recommendations about the management of medicines and risk assessments. You can see what action we told the provider to take at the back of the full version of the report.

During the inspection the service was found to be very caring and staff knew people very well. Staff knew how to support people and encouraged people to pursue activities and interests. The premises were adapted to keep people safe and personalised to reflect their interests and likes such as decoration of people’s rooms. Staff told us they felt supported by management however supervision was not done regularly in accordance with their policy. We have made a recommendation for the home to follow their supervision policy. You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 13 October2015

During a routine inspection

Hammonds is a residential care home which is registered to provide accommodation for up to 20 people with a learning disability. There are 16 permanet places and four places available for respite care. The home provides accommodation in three separate units which are linked by a courtyard. On the day of our visit 18 people were living at the home.

The service had a registered manager 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 and associated Regulations about how the service is run.

People felt safe with the home’s staff. Relatives had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm. Risks to people’s safety had been assessed and care records contained risk assessments to manage identified risks.

People were supported to take their medicines as directed by their GP. Records showed that medicines were obtained, stored, administered and disposed of safely. The provider’s medicines policy was currently being updated. There were appropriate arrangements for obtaining, storing and disposing of medicines.

Thorough recruitment processes were in place for newly appointed staff to check they were suitable to work with people. Staffing numbers were maintained at a level to meet people’s needs safely. People and relatives told us there were enough staff on duty and staff also confirmed this.

Food at the home was good. There was a four week rolling menu displayed in the kitchen and in each accommodation unit. Staff went round each morning to check people’s choices for the main meal of the day which was provided each evening. Breakfast and lunch was provided by staff in each individual unit and people were able to make their own choices for breakfast and lunch.

Staff were aware of people’s health needs and knew how to respond if they observed a change in their well-being. Staff were kept up to date about people in their care by attending regular handover meetings at the beginning of each shift. The home was well supported by a range of health professionals.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood when an application should be made and how to submit one. The provider had suitable arrangements in place to establish, and act in accordance with the Mental Capacity Act 2005 (MCA). Staff had a basic understanding of the Mental Capacity Act (MCA) 2005

Each person had a care plan which informed staff of the support people needed. Staff received training to help them meet people’s needs. Staff received an induction and there was regular supervision including monitoring of staff performance. Staff were supported to develop their skills by means of additional training such as the National Vocational Qualification (NVQ) or care diplomas. These are work based awards that are achieved through assessment and training. To achieve these awards candidates must prove that they have the ability to carry out their job to the required standard. All staff completed an induction before working unsupervised. People said they were well supported and relatives said staff were knowledgeable about their family member’s care needs.

People’s privacy and dignity was respected. Staff had a caring attitude towards people. We observed staff smiling and laughing with people and offering support. There was a good rapport between people and staff.

The registered manager operated an open door policy and welcomed feedback on any aspect of the service. There was a stable staff team who said that communication in the home was good and they always felt able to make suggestions. They confirmed management were open and approachable.

There was a clear complaints policy and people knew how to make a complaint if necessary.

The provider had a policy and procedure for quality assurance. The registered manager worked alongside staff and this enabled him to monitor staff performance. A group manager employed by the provider visited the home regularly to carry out quality audits.

Weekly and monthly checks were carried out to monitor the quality of the service provided. There were regular staff meetings and feedback was sought on the quality of the service provided. People and staff were able to influence the running of the service and make comments and suggestions about any changes. Regular one to one meetings with staff and people took place. These meetings enabled the registered manager and provider to monitor if people’s needs were being met.

Inspection carried out on 23 September 2013

During a routine inspection

At the time of inspection, there were 19 people living at Hammonds. We spoke with one person living at the home, two visitors, the home manager and four staff members. The person we spoke with was happy living there and told us, "I like it. It's my home". A visitor said, "It's magnificent here. I can't praise it enough". We noted that the home offered a wide range of social and educational activities.

We saw that people's consent was sought, wherever possible, before offering care and support. We observed that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and preferences were taken into account.

People were protected from the risks associated with poor medication management. We saw that medicines were properly handled and administered in line with the providers policy. We noted that there were enough skilled and experienced staff to do this and to deliver effective care. We also found that systems were in place to make a complaint about the service if people needed to.

Inspection carried out on 19 March 2013

During a routine inspection

The people we spoke to told us they liked living at the home and liked the staff. One person told us “It’s good here, I like cooking cakes and the staff always help me, they also help me clean my room every day, I feel respected”.

A Health Professional we spoke with told us “staff are very empowering I really like this home “.

We saw that people's privacy and independence were respected, people experienced safe and effective care based on detailed care plans and risk assessments that documented people’s preferences and met individual needs.

People using the service were protected from abuse as they were supported by a staff team who had appropriate knowledge and training on safeguarding adults. We saw policies on whistle blowing and safeguarding.

We saw evidence that staff received ongoing training and supervision which provided them with the skills and knowledge to meet the needs of the people they were supporting.

The Provider had effective systems in place to monitor quality assurance and compliance.

Inspection carried out on 23 November 2011

During a routine inspection

People accommodated at the time of the visit were not able to tell us about their experiences.

We spoke to one relative on the telephone and she told us that she never had any cause to question the care in the home and that she and all of her family were very happy with the care.

We spoke with a health professional who told us the home worked and communicated well with them. We were also told the home carried out advice and suggestions for support for individual people as directed. We were told they were well prepared and organised when professionals visit.