Hemmet House

Hemmet House is a residential care home providing personal care to up to eight people in one adapted building. The service provides support to people with physical disabilities. At the time of our inspection there were eight people using the service.

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

People were safe at the service. Staff knew how to safeguard people from abuse and keep them safe from identified risks to their safety and wellbeing. The service was clean and hygienic and staff followed current infection control and hygiene practices to reduce the risk of infection. The provider carried out health and safety checks of the premises and equipment to make sure these were safe. Medicines were managed safely. People were supported to take their medicines as prescribed.

There were enough staff to support people and meet their needs. Recruitment and criminal records checks were carried out on staff to make sure they were suitable to support people. Staff were provided training to help them meet people’s needs. Staff were well supported and encouraged to learn and improve in their role and to put people’s needs and wishes at the heart of everything they did.

People were involved in planning and making decisions about the care and support they required. People’s records set out their preferences for how their care and support needs should be provided. Staff understood how people’s needs should be met and provided the care and support which had been planned for people. The provider checked with people at regular intervals that their care and support continued to meet their needs and sought their views about how the service could be improved.

People were supported to stay healthy and well. Staff encouraged people to eat and drink enough to meet their needs. Staff supported people to manage their healthcare conditions and made sure people could access support from healthcare professionals when needed.

People were happy with the care and support they received from staff. Staff were kind and treated people well. They respected people’s right to privacy and to be treated with dignity. People were encouraged to be as independent as they could be with daily living tasks. 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 undertook a wide range of activities that reflected their interests and preferences. Relatives and friends were free to visit people without any unnecessary restrictions. The service had been designed and decorated to meet people’s needs and people had a choice of comfortable spaces to spend time in. The provider had plans to redecorate and refurbish the service as and when required.

The service was managed well by an experienced registered manager. They understood how people’s needs should be met and had oversight of the service. There were audits and checks at regular intervals, to monitor, review and improve the quality and safety of the service. There were systems in place to investigate accidents, incidents and complaints.

The service worked with healthcare professionals involved in people’s care and acted on their recommendations to deliver care and support that met people’s needs.

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 9 February 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Hemmet House accommodates eight people with a learning disability in one adapted building. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

This inspection took place on 10 January 2018. At the last inspection in November 2015 the service was rated Good. At this inspection we found the service remained Good.

People were safe at Hemmet House. Staff protected people from the risk of abuse and knew how to use the provider’s safeguarding policy and procedure for reporting any concerns they had about people to the appropriate person and authority. Risks to people's health, safety and wellbeing were assessed and reviewed and staff followed current guidance on how these should be minimised to keep people safe from injury or harm.

The provider continued to maintain a servicing programme of the premises and the equipment used by staff to ensure those areas of the service covered by these checks did not pose unnecessary risks to people. Some windows in the premises did not have appropriate restrictors in place to protect people from a fall from height and hot water from two outlets appeared to exceed a safe temperature to reduce the risk to people from scalding. Immediately after our inspection the provider fitted new window restrictors around the premises, undertook checks of all hot water outlets and adjusted these so hot water was maintained at a safe temperature. Daily checks had also been introduced to ensure this safe level was appropriately maintained.

The premises was kept clean and clear of slip and trip hazards so people could move freely and safely around. Staff followed good practice to ensure risks to people were minimised from poor hygiene and cleanliness when providing personal care, cleaning the premises and when preparing and storing food. Medicines were stored safely and securely and people received them as prescribed.

There were enough staff to keep people safe. The provider maintained recruitment checks to assure themselves of staff's suitability and fitness to support people. Staff had regular and relevant training to keep their knowledge and skills up to date with best practice. Staff were supported by the provider to meet the values and vision of the service which were focussed on people experiencing good quality care and support. Staff knew people well and understood people’s needs, preferences and choices. They were aware of people’s preferred communication methods and how people wished to express themselves.

People remained actively involved in planning and making decisions about their care so that they received support that was responsive and tailored to their specific needs. Staff used information and guidance, based on best practice and current standards to plan and deliver care that would support people to experience good outcomes in relation to their healthcare needs. People’s care and support needs were discussed and reviewed with them regularly to ensure the support provided continued to meet these. People were encouraged to keep healthy and well, to eat and drink enough to meet their needs and helped to access healthcare services when needed.

People were encouraged to do as much as they could to retain their independence and control over their lives. The design and layout of the premises provided people with flexibility in terms of how they wished to spend their time when at home. People were supported to participate in activities and events to meet their social and physical needs and to build and maintain friendships and relationships with others. Staff were warm and welcoming towards people’s relatives and friends. They were kind and caring and treated people with dignity and respect. Staff ensured people's privacy was maintained when being supported with their care needs.

People were asked for their consent before care was provided and prompted to make choices. Staff were aware of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and supported people in the least restrictive way possible. The policies and systems in the service supported this practice.

People and their relatives had high levels of satisfaction with the quality of care and support provided. People, their relatives and staff were asked for their views about how the quality of care and support could be improved. They said senior staff demonstrated good leadership and were approachable and supportive. Senior staff monitored the quality of care and support provided. They undertook surveys and regular audits of the service and took appropriate action if any shortfalls or issues were identified through these. If people were unhappy and wished to make a complaint, the provider had arrangements in place to deal with their concerns appropriately.

The service had a registered manager in post who was aware of their registration responsibilities particularly with regards to submission of statutory notifications about key events that occurred at the service.

Further information is in the detailed findings below.

Hemmet House is a small care home which provides care, support and accommodation for people with learning disabilities and/or physical disabilities. There were eight people living at the home at the time of our inspection.

The service had a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People and relatives said people were safe at Hemmet House. Staff knew how to protect people if they suspected they were at risk of abuse or harm. They had received training in safeguarding adults at risk. They knew how and to whom they should report their concerns, if they suspected someone was at risk of abuse so that they could be sufficiently protected. They were also trained to support people in a way which protected them from harm that could arise from discrimination at home and in the community

There were appropriate plans in place to ensure identified risks to people were minimised. Staff had a good understanding of the specific risks to each person and what they should do to minimise these without restricting people’s rights to undertake activities or tasks. The provider ensured regular maintenance and service checks were carried out of the premises to ensure the environment and equipment was safe. Staff kept the home free of obstacles so that people could move freely and safely around.

There were enough suitable staff to care for and support people. Senior staff planned staffing levels to ensure there were enough staff to meet the needs of people using the service. The provider carried out appropriate checks on staff to ensure they were suitable and fit to work at the home. Staff received relevant training to help them in their roles. Staff felt well supported by senior staff and were provided with opportunities to share their views about how people’s experiences could be improved.

People and relatives were complimentary about the care and kindness shown by staff. We observed many instances of warm and caring interactions between people and staff. Staff knew people well. Their priorities were clearly focussed on ensuring that people's care and support needs were met and they had a good understanding and awareness of how to do this.

Staff treated people with respect. They knew how to ensure that people received care and support in a dignified way and which maintained their privacy at all times. Staff supported people to retain as much control and independence as they wanted. They did this by encouraging people to develop independent living skills which they were supported to use at home and in the community.

People were supported to keep healthy and well. Staff ensured people were able to access healthcare services when needed. Medicines were stored safely, and people received their medicines as prescribed. People were encouraged to drink and eat sufficient amounts to reduce the risk to them of malnutrition and dehydration.

Support plans had been developed for each person using the service which reflected their specific needs and preferences for how they were cared for and supported. They gave guidance and informed staff on how people’s needs should be met. People were appropriately supported by staff to make decisions about their care and support needs. These were discussed and reviewed with them regularly.

People were encouraged to maintain relationships that were important to them. People were also supported to undertake activities and outings of their choosing. There were no restrictions on visitors to the home. Relatives told us they were made to feel welcome by staff when the visited the home. People said they felt comfortable raising any issues or concerns directly with senior staff. There were arrangements in place to deal with people's complaints, appropriately.

The senior staff team demonstrated good leadership. They sought people’s views about how the care and support they received could be improved. They ensured staff were clear about their duties and responsibilities to the people they cared for.

Staff carried out regular checks of key aspects of the service to monitor and assess standards. They took appropriate action to make changes and improvements when this was needed. They also used learning from incidents and events to drive improvements within the service.

Staff had sufficient training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) to understand when an application should be made and in how to submit one. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service and the staff supporting them and from looking at records.

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

Is the service safe?

People using the service told us they felt safe. We saw from recent satisfaction surveys the relatives of people using the service thought people were well cared for. One relative had noted, 'Hemmet House provides a safe home environment.' Another stated, 'The residents all appear well cared for and come across very happy at Hemmet House.'

Senior staff assessed potential risks to people's safety, health and welfare both within the home and in the community. There was appropriate guidance for staff on how to prevent or minimise these risks, which meant people were protected from the risk of harm when they received care and support. There were enough staff to meet the needs of people using the service.

People were cared for in an environment that was kept clean and hygienic. Staff knew how to maintain good standards of cleanliness and personal hygiene to reduce the risk of cross infection. The home was free from clutter and obstacles which meant people were able to move freely around the home.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The home had proper 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 in how to submit one. This meant people would be safeguarded as required.

Is the service effective?

Staff encouraged and supported people to make choices and decisions about how they lived their lives. People's wishes were respected and consent was sought before staff carried out any care and support. This meant people did not receive care or support they did not want or ask for.

People using the service and their relatives were involved in planning their care and support. People's specific needs were taken into account and there was guidance and instructions for staff on how these needs should be met. People's care plans were reviewed regularly and any changes to these were updated promptly. This meant staff had up to date, accurate information about the care and support people needed.

Is the service caring?

People were supported by kind and caring staff. We observed staff were patient and gave positive encouragement when supporting people. These interactions were warm, kind and respectful. People were clearly comfortable with the staff that supported them.

A relative had commented in the recent satisfaction surveys, 'Hemmet House provides the residents with a very comfortable, caring and happy place to live.'

Is the service responsive?

Staff were responsive to any changes and deterioration in people's general health and well-being. They took appropriate action to ensure relevant healthcare professionals were kept informed about any changes so that people got the appropriate medical care and attention they needed.

People told us they were comfortable speaking to staff if they had any issues or concerns. One of the people using the service had commented in the recent satisfaction survey, 'I feel complaints I make are dealt with quickly.' A relative had noted, 'I appreciate being able to approach staff with any concerns.'

Is the service well-led?

The service used the views and experiences of people using the service, their relatives and staff to assess and monitor the quality of service provided. They sought people's ideas and suggestions for improvements and made changes that people wanted or needed. They took appropriate action to address any issues or concerns about service quality.

Senior staff demonstrated a good understanding and awareness of how regular audits and checks improved the service that people experienced.

A relative told us, "They've done everything they can to make them happy and keep them safe. This is the first place they have been really happy." People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The provider had taken steps to provide care in an environment that was safe, suitably designed and well maintained.

We saw evidence that there were effective recruitment and selection processes in place and appropriate checks were carried out before staff were allowed to work with people using the service. We found that people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

People were supported in promoting their independence and community involvement. People told us they were given opportunities to express their choices and to make decisions in their daily lives. We observed that staff were aware of people's preferences and routines so they could support people in their daily lives. For example they knew at what time people preferred to eat and what time they went to bed or got up.

We saw the satisfaction surveys that had been completed by representatives of people using the service and they were happy with the care being provided in the home. The provider had a system to assess the feedback provided in the satisfaction questionnaires and to take action where required to address areas where improvement had been identified.