Archived: Hunters Moon

Hunters Moon is a care home providing accommodation and personal care for up to seven people with a learning disability. The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People said they were happy with the support they received. Staff knew what to do to keep people safe and were confident any concerns would be taken seriously.

Risks to people’s well-being and safety were assessed, recorded and kept up to date. Staff supported people to manage these risks effectively. People received support to take their medicines safely.

The home was clean, and the provider had taken additional infection prevention and control measures as a result of the COVID-19 pandemic.

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 26 April 2019).

Why we inspected

We undertook this targeted inspection to check on a specific concern we had received about keeping people safe. An overall rating for the service has not been given following this targeted inspection.

We also 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 coronavirus and other infection outbreaks effectively.

CQC have introduced targeted inspections to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

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.

• The service was safe and people were protected from avoidable harm. Risks people faced were well managed and staff had clear information on how to support people safely.

• Staff treated people in ways that maintained their dignity and privacy.

• Staff were well trained and there were enough of them to provide the support people needed. Staff were thoroughly checked before they worked at the service.

• The service worked well with other health and social care professionals to ensure they could meet people’s needs.

• Relatives were confident any complaints would be investigated and action taken to resolve them.

• The service was well-led. The registered manager had systems in place to assess the quality of the service provided and plan improvements where needed.

More information is in Detailed Findings below.

Rating at last inspection:

Good (report published 19 May 2017).

About the service:

Hunters Moon is a care home for people with a learning disability. Seven people were living in the home at the time of the inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will monitor all intelligence we receive about the service to inform when the next inspection should take place.

There was a registered manager in post at the service. 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 and associated Regulations about how the service is run. The registered manager was available during this inspection.

We previously carried out a comprehensive inspection of this service in March and April 2016. A breach of legal requirements was found. The service was rated Good overall and Requires Improvement in the 'Responsive' domain. After the comprehensive inspection, the provider wrote to us to say what actions they would take to meet legal requirements in relation to the breach of Regulation 17 of the Health and Social Care Act Regulated Activities Regulations 2014. Good Governance.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met the legal requirements. This report only covers our findings in relation to those requirements and the Responsive domain. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Hunters Moon on our website at www.cqc.org.uk.

We found on this inspection the provider had taken steps to make the necessary improvements.

The recording of the care and support people received was more detailed and enabled an audit to ensure people received support as required. Systems were in place to monitor the standard of record keeping.

People took part in a range of activities of their choice.

People were supported to raise any concerns they may have and there was a complaints policy and process in place.

Care was co-ordinated when people transitioned between Hunters Moon and other services.

At the last comprehensive inspection in June 2015, we identified the service was not meeting a number of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the service was not safe and well led. The registered manager at the time did not ensure people were supported against the risk of abuse. An investigation into an allegation of abuse was substantiated by the local authority safeguarding team. We found that staff did not come forward or whistle blow and the culture within the home did not evidence an open and transparent culture where abuse was not tolerated and where staff felt able to raise concerns without fear of recrimination. The registered manager did not follow the provider's disciplinary procedures as required. We served a notice of decision to cancel the registered manager’s registration.

In addition, we found that medicines were not being administered in a safe and competent manner. Agency staff did not have the required level of skills and experience to be able to support people safely and not all staff received timely supervision and support.

During this inspection we found the provider had made substantial improvements. Further work was required around record keeping which the provider had already identified as part of their continuing improvement plan. Activity and daily records did not contain sufficient information to be able to evidence that people were receiving appropriate stimulation with regards to activities, meaningful occupation and interventions.

We met with the manager who was now in place. Following this inspection they became registered with the CQC to manage Hunters Moon. People and staff told us they thought the service was well led. People told us they felt safe living at Hunter’s Moon and with the staff who supported them. Staff were confident the registered manager would take their concerns seriously around keeping people safe. The culture in the home was positive and safeguarding people was discussed openly and transparently. Staff told us 'it's a different team' and 'having the right staff makes all the difference, we respect each other and the people who live here'. Staff told us they would have no hesitation in whistleblowing to provider or the local safeguarding team if they had any concerns around people's safety and welfare including reporting inappropriate staff practice. The registered manager, deputy manager and staff were aware of their responsibilities in all areas of safeguarding people.

Staffing levels were safe. The registered provider continued to monitor staffing levels to ensure people received a personalised service. People received one to one support and some people received two to one support.

Staff were available to assist people when needed, including support for people to eat, drink and move around the home safely. Staff responded to requests for assistance from people. We observed staff interacting with people in a way that demonstrated a good understanding of their needs and showed warmth towards them.

Medicines were being managed safely and people received their medicines on time.

Staff understood their responsibilities under the Mental Capacity Act 2005 and the action they needed to take if people did not have capacity to consent to their care.

Staff received supervision and support and told us they felt well supported by the manager.

A programme of mandatory and more specific training was in place and all staff had the required skills and knowledge to be able to support people effectively.

People's records contained care plans relating to their specific needs and there was evidence the plans were updated when people's needs changed. Some people told us they were involved in developing and reviewing their plans. Where people were not able to tell staff what care they needed, there was a record of who had been involved in making decisions. The provider had identified that further improvements were required to the level of detail which was recorded and an action plan was in place for this.

We spent time in the communal lounge and kitchen area with people who lived at the home so that we could observe the direct care, attention and support that they received. We observed there was constant interaction between staff and people in the home. People were relaxed, happy and comfortable in each other's company.

We saw that confidential personal information about people was stored securely. The provider had policies relating to record keeping, data protection and confidentiality of records.

It was a positive visit and we found that the provider was compliant in all five outcomes that we looked at.

Consent was obtained before staff assisted people. Their needs were assessed and comprehensive care plans were devised that supported people in all aspects of daily living. There was careful monitoring of people's well being to enable staff to review people's needs and update the care plans appropriately.

There were good arrangements in place to protect people from abuse. Staff attended training in safeguarding vulnerable people and when abuse was suspected appropriate responses were made.

Medicines were managed appropriately with good systems in place for the storage, administration and recording. Staff were required to be deemed competent to administer medicines before they were permitted to do so.

People were supported by sufficient staff, we observed them too work well together to support people. One member of staff we spoke with told us how they had previously worked at the home as an agency carer and applied for a permanent position because they liked the home.

When complaints were received they were handled appropriately.