Handford House Care Home

Updated 19 March 2025

We visited the service 15 April to 23 April 2025. Handford House Care Home is a residential care home service providing support to up to 52 adults of all ages living with dementia, nursing needs and physical disabilities. At the time of our assessment, there were 36 people using the service.

At our last assessment in July 2024, this service was rated inadequate overall. The key questions for safe and well-led were rated inadequate and the key questions effective, caring and responsive were rated requires improvement. At that assessment we found multiple breaches of regulation, relating to safe care and treatment, good governance, consent, person centred care and staffing. The local authority had suspended making placements in the service due to concerns about the care provided, this resulted in vacancies.

Prior to this assessment, the local authority told us they had noted improvements in the service. During this assessment, the management team told us they had agreed a plan with the local authority to start placing people in the service again. The management team assured us the systems to calculate the staffing numbers required would continue to be assessed to ensure safe staffing levels. The management team were now providing staff with appraisals and supervisions and training in how to meet people’s needs was in place to reduce the risks of unsafe and inappropriate care.

At this assessment we found the provider had made improvements, which were ongoing and they were no longer in breach of regulation. All of the improvements had not yet been fully implemented, plans were in place for these going forward, such as more social activity for people and improvements in the environment. The provider had learned lessons and put measures in place to reduce future risks. All of the improvements made needed to be embedded in practice and sustained to ensure continuous positive impact for people was achieved.

Since our last assessment there had been a change in manager, the new manager had worked in the service since October 2024 and was enthusiastic about the improvements being made and planned for. The care provision was being monitored, which assisted the management team to identify and address shortfalls.

Managers investigated incidents, including analysis and lessons learned. Improvements had been made in how risks were managed to reduce the risk of avoidable harm. However, we identified gaps in the monitoring of people’s blood sugars, the management team assured us this was being addressed. Improvements had been made in the infection prevention and control processes. The facilities and equipment met people’s needs and were clean and well-maintained. There was an ongoing programme of refurbishment and redecoration. Staff managed medicines safely. The administration of creams, repositioning and the provision of fluids was kept under review daily and any shortfalls were identified and addressed.

People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. People had enough to eat and drink to stay healthy and people’s health was monitored to support healthy living. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff involved those important to people and took decisions in people’s best interests where they did not have capacity.

People were treated with kindness and compassion. People had choice in their care and were encouraged to maintain relationships with family and friends. There were systems in place to support staff wellbeing, however, we received mixed views from staff about how they were being listened to and the morale in the service.

Staff provided information people could understand. There was a complaints procedure in place and complaints were managed in line with the provider’s procedure. People’s end of life decisions were now sought and documented. Improvements had been made in how people’s person centred care was being assessed, planned for and delivered, including how people and their representatives, where appropriate, were involved in decisions about their care. Ongoing improvements were being made in the provision of social activity.

During our assessment visits, we spoke with 13 staff members including the regional manager, service development and regulation director, manager, deputy manager, and care, nursing, activities, domestic, and catering staff. We received electronic feedback from 6 staff members and spoke with 1 on the telephone. We reviewed the care plans of 4 people who used the service and several medicines records. We reviewed 3 staff recruitment files. We also reviewed records relating to the management of the service including monitoring systems, complaints, staff training and the staff rota.

This service has been in Special Measures since our last assessment report of July 2024 which was published in December 2024. The provider demonstrated improvements that have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Updated 19 March 2025

During our assessment visits, we spoke with 6 people who used the service and 5 relatives. We also received electronic feedback from 7 relatives and spoke with 3 on the telephone. People and relatives knew who the manager was and recognised the improvements being made, which were ongoing. Some relatives told us they understood all improvements could not be made overnight, but were confident the manager was working to implement positive changes.

People told us they felt safe living in the service and the manager was approachable and listened to their concerns. One relative said, “Since the new manager came there is not so much to pick up [concerns], generally [manager] is accessible, we can email and [manager] responds quickly, that is a positive.” People and relatives told us how improvements had been made in how they were being consulted about the individual care being planned for and provided.

People and relatives told us how improvements had been made in the cleanliness of the service. One person told us, “The cleanliness of the home is very good, laundry is better than it was and now it is fairly good.” However, we received feedback from 3 relatives that their family members were seen to be wearing clothing which did not belong to them.

Improvements had been noted in the staffing levels, however, some people said staff were not always available when needed. One person told us they had to wait for the nurse, when there was 1 nurse on shift, to finish their medicine round at night before they were provided with the support they required. Another person said, “There is never enough time, it is not the care staff, it is the amount of work they have to do… some staff give time to chat, but it needs another 2 carers on this floor.”

People and relatives told us a new activities staff member was working in the service and improvements were ongoing with access to social activity.

People told us they got enough to eat and drink and the staff had listened to their suggestions about the menu. We received mixed views about the quality of the meals provided. For example, a person told us the food was served cold. We did sample the lunch meal and found it to be hot, and other people told us the food was hot enough. One person said, “The food is great.” Another said the menu was, “Repetitive.”

People and relatives told us the staff were respectful in their interactions. A person told us, “Staff are quite good, cheerful.” A relative said, “Staff are very good, they are courteous and lovely.” However, a person raised that there were times when called at night, staff walked into their bedroom and left, “It happens time to time but more often with the night staff… sometimes they come in and just walk away, occasionally happens in the day as well, I need the toilet I ring they come then go away and don’t come back… happens on average twice a week, I have not complained.”

People told us how they felt their independence and choice was promoted and respected. A person said, “[Staff] don’t tell you to do this or that, they work with you.” Another person told us, “I wake myself up, sometimes they come I am already dressed, I can lay in if I want, they just say you having a sleep in, see you later, they have a good attitude.” Another person commented, “It is good that I am independent, they just let me be what I am.”