Hays House Nursing Home

We found the following examples of good practice.

Clear focus was given to enabling relatives and friends to visit in a safe way. The service had introduced strict measures to prevent visitors from catching and spreading infections. Visitors were screened for symptoms of COVID-19 and were provided with personal protective equipment (PPE) to wear whilst in the home. A communal lounge on the ground floor had been designated in the early stages of the pandemic, as a safe space to enable visiting. A visiting pod had also been built with its own external access. The pod had an integral intercom system to enable effective communication. More phones, iPads and laptops were purchased to help people have regular contact with their family and friends.

Systems and routines had been reviewed to ensure safety was maximised. This included staggered times for staff breaks and working in designated areas, rather than across the whole home. Social distancing was promoted, and seating arrangements had been reduced within communal areas. Other aspects such as sourcing more clinical waste bins for the safe disposal of PPE, had taken place.

Robust cleaning regimes were in place and deemed an integral part of ensuring a safe environment. There were three domestic staff on duty and another who worked in the laundry. There were cleaning schedules for all areas of the home, and these were regularly reviewed to ensure maximum effectiveness. All areas seen were clean, with no unpleasant odours.

Staff had received regular infection prevention and control training, with additional elements related to the pandemic. Areas covered included how to put on and safely take off PPE, and good hand hygiene. Observation and monitoring were undertaken to ensure these practices were adhered to at all times. There was further auditing, to check the overall effectiveness of the infection prevention and control framework. Staff told us this enabled things to be identified and addressed, before becoming an issue.

The provider and registered manager kept up to date with government guidance. This was through general reading, management forums, other agencies and shared learning within the organisation. The information was regularly cascaded to staff, and practice was adjusted as required. The registered manager kept relatives and friends updated with any changes to guidance, both verbally and in writing.

Regular testing for COVID-19 was being carried out for people using the service and staff. Staff undertook their tests before they came to work, or in a completely separate part of the building. This ensured only staff who were safe to enter the home, could do so. The tests were recorded and registered in line with current guidance.

The registered manager and provider were appreciative of the staff team, and maintained morale well. They did this by gestures such as providing takeaways, and additional money for overtime working. Staff were paid if they were unwell, and unable to work. The registered manager and provider gave staff time and listened and communicated effectively. A whole team approach had been developed, which also enabled staff to be supportive of each other. Risks had been assessed for those staff who were deemed more vulnerable than others. Any concerns were addressed, with additional measures to maximise safety if required.

There were effective systems in place to check staff and professional visitors were vaccinated against COVID-19. All professional visitors were required to show their vaccination status before being allowed into the home. The registered manager and some registered nurses had completed training and an assessment of their competence, to enable them to administer vaccinations on site. This had been positive, and enabled vaccinations to take place in a timely manner. All staff were pleased to support the vaccination programme and were vaccinated as required, at that time.

At our last inspection in December 2015 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

This inspection took place on 6 and 7 March 2018 and was unannounced.

There was a registered manager in post at the service. 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 and associated Regulations about how the service is run.

People who use the service and their relatives were positive about the care they received and praised the quality of the staff and management. Staff respected people’s choices and privacy and responded to requests for assistance.

People told us they felt safe living at Hays House and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm and staff knew how to use them. Medicines were stored safely in the home and staff had received suitable training in medicines management and administration. People received the support they needed to take their medicines.

There were sufficient staff available to provide safe care. Staff understood the needs of the people they were providing care for and had the knowledge and skills to meet their needs.

Staff received a thorough induction when they started working at the home. They demonstrated a good understanding of their role and responsibilities. Staff had completed training to ensure the care and support provided to people was safe and effective to meet their needs.

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 support this practice.

The service was responsive to people’s needs and wishes. People had regular meetings to provide feedback about their care and there was an effective complaints procedure. People enjoyed the social activities that were arranged.

The registered manager regularly assessed and monitored the quality of care provided. Feedback from people and their relatives was encouraged and was used to make improvements to the service.

This inspection took place on 21 December 2015 and was unannounced. We returned on 22 December 2015 to complete the inspection.

There was a registered manager in post at the service. 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 and associated Regulations about how the service is run.

People who use the service and their relatives were positive about the care they received and praised the quality of the staff and management. Comments from people included, “ I’m very happy with the service”, “The staff are very pleasant” and “ I’m quite ill at the moment, but they are on top of things. They do their best for me ”. A visitor also told us, “They are all very nice staff, very attentive”.

People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm and staff knew how to use them. One person told us, “I feel safe here”.

Staff understood the needs of the people they were providing care for. People told us staff provided care with kindness and compassion.

Staff were appropriately trained and skilled. They received a thorough induction when they started working at the home. They demonstrated a good understanding of their role and responsibilities. Staff had completed training to ensure the care and support provided to people was safe and effective to meet their needs.

The service was responsive to people’s needs and wishes. People had regular group and individual meetings to provide feedback about their care and there was an effective complaints procedure. One person told us, “I don’t ever have any concerns, but if I did, the staff would sort it out”.

The provider regularly assessed and monitored the quality of care provided at Hays House. Feedback from people and their relatives was encouraged and was used to make improvements to the service.

Two people who lived at the home told us that they understood the care choices available to them, and could have their views taken into account in the way their care was delivered. A person said, 'They do ask if you are OK with things.'

We found that people's needs were assessed, and care was planned and delivered to meet people's needs. A person told us, "I know I have a care plan." People's care was regularly reviewed and their personal information was held securely.

We saw that the home was clean and well presented, and that people were protected from the risk of healthcare associated infections. A relative of a person who lived in the home told us, "It's always very clean, like you see it today."

We viewed a selection of staff records, and saw that relevant checks had been carried out when the home employed staff. Staff had opportunities to gain appropriate qualifications. A person who lived in the home told us, "Most staff are very kind and helpful." Another person told us, "They are a happy lot."

We saw that work was in progress to ensure that the home had appropriate systems in place to assess and monitor the quality of its services .

One person told us its 'very nice here'

A relative told us of their relative that they 'are very happy and staff are very caring'.

One person told us 'I like living here, very good food'.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We viewed six peoples' files, we found signed forms that people who had bed rails had or their next-of-kin had consented to their usage because they were unable to do so themselves.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

People were generally protected from unsafe or unsuitable equipment. We did find that one record did not have sufficient detail regarding the use of an air mattress and one bed that did not have bumpers fitted onto the bed rails.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

There was an effective complaints system available and complaints people made were responded to appropriately.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained. We saw that records were kept securely.