Henley House

At the time of the inspection there were strict rules in place throughout England relating to social restrictions and shielding practices. The ones that applied to the area this home was located were commonly known as 'Tier Four Rules'. This meant the Covid-19 alert level was high and there were tighter restrictions in place affecting the whole community.

We found the following examples of good practice:

Staff, management and visitors were using personal protective equipment (PPE) correctly and there were procedures in place around the use of PPE. We noted good practices around the disposal of PPE and other waste.

The provider had processes to minimise the risk to people, staff and visitors from catching and spreading infection. These included weekly testing of staff and at least every 28 days for people living in the home. Hand sanitiser and PPE were available throughout the home. There were signs to remind staff, visitors and people about the use of PPE, the importance of washing hands and regular use of hand sanitisers.

Processes when visitors entered the home were quite robust. Temperatures were taken and recorded to see if the visitor was showing signs of infection. Entry was prevented if the reading was out of range. In addition, the registered manager agreed to raise a brief questionnaire at the front door so that additional checks were made to be completely sure visitors were safe to enter.

Where appropriate, ‘socially-distanced' visits had been taking place. At the inspection however, and consistent with enhanced restrictions, these visits had been restricted and were only allowed in exceptional circumstances. There was a visiting pod that had been created outside of the home where people could see their loved ones in an isolated way. The registered manager said it was hoped these visits could be resumed when restrictions were lifted.

Visiting rules and process were communicated effectively to people using the service and their relatives. People's mental wellbeing had been promoted by innovative use of social media and electronic tablets so people could contact their relatives and friends. At the time of inspection, the home's activities coordinator was away from the home but the registered manager said a programme of activities was to be introduced shortly with reminders to staff to encourage people to participate.

The provider also insisted people were tested before admission to the home. Overall we were satisfied the service, staff, people and visitors were following the rules to try and prevent infection from entering the home.

The infection control policy and people's risk assessments had been considered and revised following the pandemic so that people were protected in the event of becoming unwell or in the event of a Covid-19 outbreak in the home.

Staff had knowledge of good practice guidance and had attended Covid-19 specialist training. There were sufficient staff to provide continuity of support and ensure safeguards were in place should there be a staff shortage.

The home was clean and hygienic. A designated full-time cleaner was in post and additional staff could be used if this was required.

Staff had received Covid-19 related supervision and all had access to appropriate support to manage their wellbeing should it be required.

Further information is in the detailed findings below.

Henley House is a residential care home that was providing personal care to 21 people at the time of the inspection. The service can support up to 23 people. Henley House accommodates people across two floors, each of which has separate adapted facilities and a lift. Some of the people living in the home had a diagnosis of early stage dementia. The home is situated in Accrington, Lancashire.

People's experience of using this service and what we found:

People were supported to be safe and said that they felt safe. Staff received safeguarding training and had a good understanding of the principles involved in acting when abuse was suspected.

Medicines were managed safely. This meant people received their medicines as prescribed by healthcare professionals.

People's needs were met through assessments and support planning. The service worked with health and social care professionals to achieve positive outcomes for people. Staff had good knowledge and skills and this ensured people's needs were well met. We saw good examples of when people had been supported to maintain a healthy and balanced diet.

The provider had a robust recruitment process. This meant that staff were recruited safely. Any issues with staff were dealt with promptly using a fair and thorough disciplinary process.

People told us staff were compassionate and kind and during the inspection, we observed this to be the case. Management and staff knew people well. People were 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.

People received care and support that was person-centred. We saw examples of how the care and support people received enriched their lives through meaningful activities. The service had a robust complaints policy.

The values and culture embedded in the service ensured people were safe and at the heart of the care and support they received. The registered manager and assistant managers planned and promoted holistic, person-centred, high-quality care resulting in good outcomes for people. People knew how to feedback their experiences and this was considered and acted upon by the registered manager and assistant managers. Staff told us they received good support from management.

There was an end of life policy in place that could be used if appropriate. Staff had been trained around this and the home were involved with local organisations to ensure best practice was applied during times when people were at the end of life. Relatives were complimentary about the support that was provided at this sensitive time.

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 25 July 2017).

Why we inspected:

We carried out this inspection based on the previous rating of the service.

Follow up:

We will continue to review information we receive about the service until we return to visit as part of our re-inspection programme. If any concerning information is received we may inspect sooner.

At the last inspection on 17 March 2015, the service was rated ‘Good’. At this inspection we found the service remained Good.

The service had a registered manager who was also the provider. 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.

People’s medicines were administered safely, as prescribed. Medicines were also managed and stored securely to ensure they were safe. There were risk assessments which identified risks to people and management plans put in place to ensure people’s health and well-being were maintained.

People consented to the care and support they received. The service complied with the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and understood their responsibilities in relation to MCA and DoLS.

People were safeguarded from the risks of abuse and improper treatment. Staff had received training on safeguarding and they were knowledgeable on the procedure to follow if they had any concerns. There were sufficient staff available to safely meet people’s needs.

People told us staff were kind and caring. We observed that staff treated people with respect and promoted their dignity. People were supported to communicate their views about how they wanted to be cared for.

People’s nutritional needs were met. People told us they enjoyed the choice of food that was available to them. People had access to food and drinks throughout the day. People were kept occupied and encouraged to participate in activities.

Staff were trained on various areas to ensure they had the relevant skills, knowledge and experience to provide good care to the people they supported. Staff received regular support and supervision to carry out their duties effectively.

The service liaised with various healthcare professionals to meet the needs of people. People at the final stages of their lives were supported in line with their wishes and were cared for in a dignified way.

People had their individual needs assessed and their care planned in a way that met their needs. People received care that reflected their preferences and choices. Reviews were held with people and their relatives to ensure people’s support reflected their current needs.

People and their relatives had opportunities to share their views and give feedback about the service and these were acted upon. The service was subjected to regular quality checks to ensure the service was of good quality and met people’s needs.

We found that the home was clean, tidy and free from offensive odours. Training for all members of staff was in place for the prevention and control of infection.

We saw that members of staff were attentive to people's needs and responded promptly when people required assistance. One person said, 'They come right away when I buzz.'

We found improvements to the system for monitoring the quality of the service provided had been made. The manager regularly checked most aspects of the care and facilities provided at the home.

We saw that improvements to care planning had been made. All sections of people's care plans were accessible to all care workers.

We found that members of staff had a good understanding of safeguarding procedures and told us they would report any concerns immediately.

We noted that recruitment procedures and members of staff received the training they needed in order to provide safe and appropriate care for people using the service.

We found that some improvements to the monitoring of the quality of the service had been made. However, the system did not cover all aspects of the care and facilities provided at the home.

We saw that people's individual care plans lacked clear guidance for staff to follow in order to ensure that identified risks were effectively managed. Care records stored electronically were inaccessible to care workers.