Hagan Hall

Hagan Hall is an extra care and support service for people who are tenants. The service has 24 self-contained flats. There were 18 people using the service at the time of our inspection.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance the Care Quality Commission (CQC) follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support

Staff supported people to follow their interests, such as going to the local shops, film nights, meeting friends and going to events.

People were supported to access health and social care support by staff who valued and understood them well.

Staff worked positively with people to achieve their aims. They had a good understanding of what was a good and bad day for people. The mood at the service was calm and welcoming.

Staff ensured people took their medicines safely and had the right risk assessments in place.

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.

Right Care

There were sufficient staff to meet people’s needs safely and to ensure they felt safe.

Staff communicated with people well, understanding how they liked to be spoken with and what made them feel more at home.

Staff upheld people’s dignity. They respected and promoted people’s independence and the things that mattered to them.

Staff had recent refresher training on safeguarding and knew how to keep people safe. Where safeguarding protocols were not followed in line with local arrangements, the provider took immediate and robust action.

Right Culture

The ethos, values, attitudes and behaviours of the service were followed by staff. These were in line with the key principles of guidance such as Right Support, Right Care, Right Culture. Staff felt well supported and there was a permanent core to the team. Staff understood their roles and responsibilities.

There were regular audits of key areas of the service. The provider had already identified these needed to improve to ensure incidents could be fully reflected on and lessons truly learned.

Some areas of service oversight required improvement, such as the regularity of supervision and competence checks.

We have made a recommendation about this.

Staff felt supported, there was good morale and no reliance on agency staff.

People and those close to them had been involved in care planning. The provider had identified the need to improve the person-centred nature of some care documentation and this work was nearly complete at the time of inspection.

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 1 November 2017).

Why we inspected

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

The service was last inspected in June 2015, at which time the service was compliant with all CQC regulations. At the previous inspection we rated the service good. At this inspection the service remained good.

Hagan Hall is an on-site domiciliary care and support service for people who are tenants within the Hagan Hall sheltered housing scheme. The service has twenty four self-contained flats. There were 15 people using the service at the time of our inspection.

The service had a registered manager in place. 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.

We found care was delivered safely by staff who were appropriately trained. There were sufficient numbers of staff to meet the needs of people who used the service.

New staff underwent pre-employment Disclosure and Barring Service (DBS) and other checks to ensure they were suitable to work with people who may be vulnerable.

Risks were managed through pre-assessment and ongoing assessment. Staff displayed a good knowledge of the risks people faced and how to help them reduce these risks.

There were no medicines errors on the Medication Administration Records (MAR) we viewed and staff had received medicines administration training. Their competence was assessed annually. The registered manager undertook medicines audits and we found no concerns in this regard.

New staff received an induction and all staff completed mandatory training, including safeguarding, health and safety, fire safety, infection control and food hygiene. Not all staff had received training in dementia awareness – the registered manager agreed to address this to ensure the service was better prepared to meet the needs of people who may develop dementias.

Staff told us they were well supported and we saw supervisions and appraisals were in place, as well as regular meetings. Team morale was strong and staff told us they felt confident in raising and questions or concerns openly.

People consistently told us they were happy with how staff supported them with their choice of meals although we noted the service could do more to promote people choosing and preparing healthier alternatives.

External professionals we spoke with agreed the care they had observed was to a good standard and that people were treated in a dignified way that respected their individualities.

People contributed to their own care planning and were involved in reviews, with family members also involved. Where people’s needs changed, external professionals told us that staff worked with them to ensure people’s needs were met.

Care plans contained sufficient person-centred information for staff to have a good knowledge of people’s backgrounds, whilst the keyworker system meant staff were generally able to speak in detail about people’s individual likes, dislikes and histories.

The service had a complaints policy in place and people who used the service knew how to complain and who to, should the need arise. People had been supported to make complaints about matters important to them.

People who used the service and staff told us the registered manager was fair, approachable and supportive. We found them and the service manager to have a clear vision about how the service could continue to improve and focus on supporting people to achieve specific outcomes in the future.

We found people's privacy, dignity and independence were respected and people experienced care and support that met their needs and protected their rights.

We found people were cared for by staff who were supported to deliver care and treatment safely.

The provider had an effective complaints system available

People were protected from the risks of unsafe or inappropriate care because accurate and appropriate records were maintained.

We found people experienced care, treatment and support that met their needs and protected their rights.

There were sufficient staff on duty to support people for their care needs. We looked at how the service recruited staff by checking five staff files. These showed that the appropriate checks and procedures were being followed.

During our visit, all interactions we observed between the staff and the people living at the

home were open, respectful and courteous. They addressed people by their names and spoke respectfully.

We saw that staff provided whatever was wanted in a way that demonstrated a good knowledge of each individual person. Where appropriate, we saw staff providing support and encouragement to the people to do things as independently as possible.

People using the service and realtives spoke positively about care workers and the service they provided.

Comments from person using the service included "I like living here, staff are always available and they are friendly", "I get supported as much as I need and encouraged to do things for myself like tidying my house", "The manager is always avialble for a chat if I need it."

Comments from relatives included, "I am very happy, the staff are execellent", "staff are always busy but are always available for a chat if I need to speak to them", I am always kept informed about my xxxx either by telephone or when I pop in."