Haddon House Care Home

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.

Haddon House Care Home provides accommodation in one adapted building; nursing and personal care for up to 30 older people living with dementia. At this inspection there were 26 people receiving nursing care, living at the service

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

People’s dementia care was not always organised or delivered in a timely, individualised manner; to optimise their choice, independence or engagement in relation to their mealtime experience and occupational daily living activities.

The provider’s staffing, risk management and medicines arrangements helped to ensure people’s safety at the service and protected from the risk of harm or abuse. The provider took action when things went wrong at the service and referred to relevant authorities involved with people’s care when required to do so.

People’s care and diverse needs for their health and nutrition, were effectively assessed and accounted for. Staff supported people to maintain or improve their health and nutrition as agreed with them and any external health professionals involved in their care. People were supported to have maximum control of their lives and staff supported them in the least restrictive way possible. The provider’s related policies and systems supported this practice.

Staff were trained and supported to provide people’s care. Relevant information sharing was followed for people’s care when needed, to help ensure they received consistently informed care as agreed with them.

People received care from kind, caring staff who ensured their dignity, equality and rights in their care. Staff had good relationships with people and their representatives; they knew how to communicate with people and understood what was important to them for their care. People or their appropriate representative were informed, involved and supported to understand, agree and make ongoing decisions about their care.

Daily social or recreational activities were regularly offered for people to join. People were supported to maintain contacts with family and friends who were important to them engage in spiritual worship as they chose.

Staff were trained and understood nationally recognised standards for people’s end of life care. This, along with related consultation and partnership working with relevant external health professional leads, helped to ensure people’s dignity, comfort and choice for their end of life care.

People and their relatives were informed and confident to make a complaint or raise any concerns about the service, if they needed to. People’s views and feedback were regularly sought. Findings from complaints and feedback were used to help inform service planning and improvement.

The service was well managed and led. The provider governance and oversight arrangements were effectively operated to help ensure the quality and safety of people’s care and any related service improvements when needed.

The service was well managed and led. The provider operated effective governance arrangements to ensure the quality and safety of people care and related service improvements. The registered manager and staff understood their role and responsibilities for people’s care. Effective arrangements were established for communication, record keeping and information handling at the service; along with relevant engagement and partnership working for people’s care and safety. This helped to ensure regulatory requirements were met.

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. (Report published July 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.

Haddon House is a residential and nursing care home for 30 people with dementia. The home is situated in the small town of Ilkeston, an area in Derbyshire. At the last inspection, the service was rated Good. This inspection was unannounced and we found 27 people were using the service. At this inspection we found the service remained Good.

People continued to receive safe care. People were consistently protected from the risk of harm and received their prescribed medicines safely. Staffs were appropriately recruited and there were enough staff to provide care and support to people to meet their needs.

The care that people received continued to be kind and considerate. People were supported to maintain good health and nutrition Training was made accessible to support staff with their ongoing professional development. We saw supervisions were provided to give staff guidance in their roles.

There was an open culture at the home and people had developed positive relationships with the staff. Care plans provided detailed personalised information to enable staff to provide consistent care and support in line with people’s personal preferences. People knew how to raise a concern or make a complaint and the provider had responded to any complaints in line with their policy.

The registered manager understood their role and ensured we received appropriate information in a timely manner about events at the service. Audits had been completed to identify measures to maintain people’s safety and to drive improvements within the home. The home participated in new initiatives which provided opportunities to the staff and the development of ideas.

Further information is in the detailed findings below

We found that provider had in place processes to ensure that staff at the home were recruited safely.

We found that the provider had put systems in place to monitor the administration of medicines but that people were not protected from the risk associated with the unsafe storage of medicines and nutritional supplements.

We found that people or their relatives understood the care and treatment they received. People able to express their views and their relatives told us they were satisfied with the care and treatment they received.

We found that staff asked people or their relatives for consent before they received any care or treatment and the provider acted in accordance with their wishes.

People we spoke to and their relatives told us that staff were caring and thoughtful in their approach and we found that there were enough qualified and skilled staff available to meet peoples needs.

Although the provider had safe systems in place for the storage of medication we found that that people were not always protected against the risks associated with medicines because the provider did not have appropriate arrangements in place for the safe administration of medicines.

We found that care and staff records were kept securely.