Hunters Down Care Home

The service is a two storey premises located on the outskirts of Huntingdon. The service has communal lounges and dining areas on each floor and all bedrooms are single rooms with an en-suite shower room. The service is divided into five separate units called communities. People are cared for in a community according to their needs and levels of independence.

We found the following examples of good practice.

Visitors, one or two people only, could visit their family member, friend by appointment only. This would be a socially distanced garden visit wearing a face mask. Gaps in-between each visit were 45 minutes. This was to allow staff to clean. On arrival into the building, a visitor must wait to enter, sign in and have their temperature checked. They also must answer a health declaration around COVID-19. The manager confirmed that people’s relatives were communicated to re COVID-19 restrictions when booking their visit, by telephone, via email, letters and the locations Facebook page.

Staff were asked to socially distance when on their break and the manager and care manager told us that staff breaks were staggered to promote this. Additional smoking areas outside of the building had been set up to also reduce the risk of staff congregating together.

The manager and care manager told us that staff were cohorted into the different communities (units) each shift and remained there, to reduce the risk of cross contamination. This was particularly important in the dementia communities where people struggled to socially distance. This was because they may not have the mental capacity to maintain this information.

There was an infection control policy that included a decontamination section re COVID-19 and fluids spillage. There was also a stand-alone COVID-19 policy for staff to refer to for updated guidance. This included a COVID-19 care after death policy. For anyone on end of life a named relative /friend was at an agreed time able to sit with the person in the room whilst wearing full PPE.

Within the providers organisation a COVID-19 team had been set up to triage information and government guidance to support care home managers and staff as and when it changed.

Hunters Down Care Home is registered to provide accommodation and nursing care for up to 102 people. At the time of our inspection there were 91 people living at the service.

The service is a two storey premises located on the outskirts of Huntingdon. The service has communal lounges and dining areas on each floor and all bedrooms are single rooms with an en-suite toilet and washbasin. The service is divided into five separate units. People are cared for in a unit according to their needs and levels of independence.

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

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 felt safe and were happy living in at Hunters Down. There were enough staff employed to ensure people needs were met in a timely way. Staff were knowledgeable about people’s needs and how to support them safely. Staff received appropriate training and knew how to report their concerns internally and externally to local safeguarding authorities.

People and relatives told us staff were kind, caring and respectful towards them. Relatives confirmed they felt welcome at the home. People were involved in their care and where appropriate their relatives as well.

Staff received regular training, supervision and appraisals to develop further. Their skills and knowledge were regularly reviewed through competency assessments.

Activities were delivered and encouraged by staff. The variety of activities offered meant that every person found something of interest and could participate in group or individual engagement opportunities.

The registered manager had quality assurance systems to ensure the monitoring and improvement of the service, action plans were in place to drive improvement. Staff understood their roles and responsibilities. People, relatives and staff felt the registered manager was approachable. The registered manager had an open-door policy.

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 27 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

This unannounced comprehensive inspection was undertaken by two inspectors and an expert by experience and took place on 5 June 2017. At the previous inspection on 23 June 2015 the service was rated as ‘Good’. At this inspection we found the service remained 'Good'.

A registered manager was in post at the time of the inspection. 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 2008 and associated Regulations about how the service is run.

Staff had a good understanding of how to protect people from harm. This was as well as being knowledgeable about those organisations they could report any potential concerns to.

Accidents and incidents such as falls, were identified and acted upon when required.

Risks of harm to people such as choking, malnutrition and skin integrity had been assessed and were managed well.

There were enough competent staff to provide people with support when they needed it.

Staff had received appropriate training, support and development to carry out their role effectively.

People received appropriate support to maintain healthy nutrition and hydration. Staff enabled people to access support from external health care professionals as soon as this was required.

Shortfalls in staff practice around medicines administration had been successfully implemented to address the accurate recording of medicines.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). 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 we observed were treated with kindness by staff. However, not all staff were consistent in their approach to respecting people's privacy and dignity. Not all people's needs were responded to in a person centred way.

People were given the opportunity to feed back on the service and their views were acted on.

People received personal and nursing care by staff who provided this care with compassion and kindness.

People were offered and took an active part in the varied hobbies, interests and pastimes that were provided.

The registered manager and their team worked hard to create an open, transparent and inclusive atmosphere within the service. People, staff and external health professionals were invited to take part in discussions around shaping the future of the service.

There was a robust quality assurance system in place and shortfalls identified were promptly acted on to improve the service.

Further information is in the detailed findings below.

One member of staff said: 'I can't fault the home. The procedures work better and the information is recorded'.

We saw that the units we visited and the bathrooms and toilets we inspected were clean and fresh. There were no malodours. Some carpets were stained in the lounge areas of some units. One person said: 'It's a very good place. They come and clean (the bedroom and en suite) every day'.

We noted that some people had ill-fitting shoes which could cause them to fall. We spoke with the manager and staff who said they requested that family members provide appropriate footwear but this was sometimes not provided. The manager stated she would check that all shoes and slippers were suitable.

Some people said they thought there was a shortage of staff and two people said they felt hurried when staff assisted them with their personal care that morning. The manager stated there were no staff vacancies at the time of the inspection. We found that staff were busy in the home but people were assisted in a calm atmosphere. We noted that people were clean and well dressed.

Staff we spoke with knew the people they were caring for and how to ensure the care provided was personalised to enable people remained as independent as possible. We saw different communication methods used when people had difficulties understanding speech.

Overall the home was clean with no offensive odour. There was one unit that was malodorous but later in the day this had been dealt with. Some units had carpets that were in need of cleaning, although spot cleaning was undertaken during the inspection. Generally the decor was good and each unit had different pictures for example. People had their own possessions in their rooms, having things such as a TV, pictures, radio and telephone.