Haddon House Care Home

Updated 19 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and a specialist nurse advisor. We visited the service on the first day. On the second day we made phone calls to gather feedback from staff and relatives.

Service and service type

Haddon House Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Haddon House Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people who lived in the service and spent time observing people who may not be able to share their views verbally with us. We received feedback from 4 relatives. We spoke with 12 staff which included the registered manager, regional support manager, deputy manager, nurse, care staff, domestic and housekeeping staff, chef and administrator.

We reviewed aspects of 9 people’s care records and multiple medicine records. We looked at 2 staff files in relation to recruitment. We looked at a range of other records including quality assurance checks, meeting minutes and training records.

Updated 19 November 2022

About the service

Haddon House Care Home is a nursing care home providing personal and nursing care to up to 23 people, in one adapted building. The service provides support to older people, many of whom are living with dementia. At the time of our inspection there were 23 people using the service.

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

Improvements were needed to ensure people's care and risk support records were up to date and gave sufficient guidance to staff so they could provide safe care. Monitoring of some risks associated with people's care required strengthening. Some areas of supporting people who may show distress required improvement.

The registered manager worked openly and transparently. They were working at pace with the management and staff team to prioritise, embed and sustain a range of improvements. This included improvements to quality assurance processes, care records and documentation, the environment, staff training and support to the team. The majority of staff felt well supported and also thought the team worked well together.

People's care and specialist health needs were met and timely referrals were made to health professionals when needed. People were protected from harm and the risk of abuse.

Staff were recruited safely. Staffing levels were calculated using a dependency tool and were sufficient on the day of inspection. Mixed feedback was received about staffing levels. Ongoing recruitment was taking place and use of agency staff had reduced, which provided better consistency for people's care.

Medicines practices were safe and people received their prescribed medicines in the way they preferred. Checks and audits ensured any issues were identified and prompt action taken. Good infection prevention and control practices were followed. This was supported by ongoing improvements to the environment such as flooring and furniture.

Lessons were learned when things went wrong. Accidents, incidents and falls were recorded and followed up appropriately.

The majority of feedback from relatives and people was positive about the care and support people received, and the friendliness of the staff team. People and their representatives, where appropriate, were involved in people's care and decision making.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 18 March 2020).

Why we inspected

We received some concerns in relation to nursing practices in the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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.

We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Haddon House Care Home on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.