• Care Home
  • Care home

Hay House Nursing Home

Overall: Good read more about inspection ratings

Broadclyst, Exeter, Devon, EX5 3JL (01392) 461779

Provided and run by:
Chartbeech Ltd

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Background to this inspection

Updated 23 March 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 26 February 2021 and was announced.

Overall inspection

Good

Updated 23 March 2021

Hay House Nursing Home is nursing and residential home for 35 people, the majority of people living with dementia or a cognitive impairment. The service is a large, older style building with a secure garden and well maintained grounds in a rural setting.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

We carried out an unannounced inspection of Hay House Nursing Home on 19 February 2018. At the time of the inspection 32 people were living at Hay House Nursing Home.

There was a registered manager employed at the home who were clearly passionate about providing a high quality, individualised service. They had worked at the service for many years. 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 provider, Chartbeech Ltd had recently been bought by new owners who owned another service in the South East.

At this inspection we found the service was meeting all regulatory requirements and we did not identify any concerns with the care provided to people living at the home. Most people were not able to comment directly on their experiences due to living with dementia. One relative said, "They’re amazing! Mum is seen as an individual and since she has been here we have seen her [personality] coming through again. They care deeply. She had the best care here.” Another relative told us, “They are brilliant. It’s such a nice home, relaxed. They know [person’s name]’s habits, people do their own thing.”

On the day of the inspection there was a calm and relaxed atmosphere in the home and we saw staff interacted with people in a friendly and respectful way. People were able to choose what they wanted to do and also enjoyed spending time with the staff who were visible and attentive. There was a lot of staff interaction and engagement with people. They looked comfortable and happy to spend time in the lounges, their rooms or the conservatory and diner.

People were encouraged and supported to maintain their independence. There was a sense of purpose as people engaged with staff, watched what was going on, played games and pottered around the home or watched television. The majority of people were living with dementia and were independently mobile or required some assistance from one care worker. Staff engaged with them in ways which reflected people's individual needs and understanding, ensuring people mobilised safely from a discreet distance or were engaged with sensory activities.

People were provided with good opportunities for activities, engagement and trips out. These were well thought out in an individual way. People could choose to take part if they wished and when some people preferred to stay in their rooms, staff checked them regularly spending one to one time with them.

People and relatives said the home was a safe place for them to live. One relative said, “It’s such a relief. I can have a break and not worry about coming in.” Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns. Staff were confident that any allegations made would be fully investigated to ensure people were protected. Any safeguarding concerns had been managed well with provider involvement and the service worked with the local authority safeguarding team.

Relatives said they would speak with staff if they had any concerns and issues would be addressed and people seemed happy to go over to staff and indicate if they needed any assistance. Staff were vigilant about protecting each person from possible negative interactions with other people living at the home, recognising frustrations and misunderstandings between people due to them living with dementia. They used chatting and distraction techniques as they knew people well, showing patience and understanding. Behaviours were monitored if necessary to keep people safe and appropriate referrals made to external health professionals.

People and relatives knew how to make a formal complaint if they needed to but felt that issues would usually be resolved informally. There had been few complaints. One relative had mentioned some windows needed cleaning and this was done immediately.

People were well cared for and relatives were involved in planning and reviewing their care as most people were not able to be involved due to living with dementia. Care plans showed that people were enabled to make smaller day to day choices such as what drink they would like or what clothes to choose. Where people had short term memory loss or anxiety staff were patient in repeating choices each time and explaining what was going on and listening to people's repeated stories.

There were regular reviews of people's health, and staff responded promptly to changes in need. For example, care records showed many examples of staff identifying changes in need and appropriate and timely referrals to health professionals. One person had been referred to the older persons mental health team and there was a GP round every week. People were assisted to attend appointments with appropriate health and social care professionals to ensure they received treatment and support for their specific needs.

Medicines were well managed and stored in line with national guidance.

Staff had good knowledge of people, including their needs and preferences. Care plans were individualised and comprehensive ensuring staff had up to date information in order to meet people's individual needs effectively. Handover and communication between staff shifts was good so there was consistent care. The service rarely used agency staff but were able to fill vacancies if they could not cover shifts within the staff team.

Staff were well trained and there were good opportunities for on-going training and obtaining additional qualifications. The staff team was very stable and many care staff had worked at the home for some years. A newer care worker told us, “I love it here. The manager is very nice too.”

People's privacy was respected. Staff ensured people kept in touch with family and friends, inviting friends and family to outings and events regularly. Four relatives told us they were always made welcome, updated on their loved ones care and were able to visit at any time.

The registered manager and showed great enthusiasm in wanting to provide the best level of care possible and valued their staff team. For example, they arranged their shift so they were available at early evening when people living with dementia could become more anxious. Staff had clearly adopted the same ethos and enthusiasm and this showed in the way they cared for people in individualised ways. We spoke to the registered manager about the accessible information standard. This ensures people’s communication needs are identified and met. Care plans provided good information and the registered manager already included the standard in their assessments, hospital passports and information sharing within the wider staff team.

People’s equality and diversity was respected and people were supported in the way they wanted to be. Care plans were person centred and held full details on how people’s needs were to be met, taking into account people preferences and wishes. For example, some people liked to live with strict routines to help them remain well and staff knew and respected those. Information included people’s previous history, including any cultural, religious and spiritual needs.

Meal times were a positive experience, with people being supported to eat a meal of their choice where they chose to eat it. Staff engaged in conversation with people and encouraged them throughout the meal, noting who liked to sit with whom. Nutritional assessments were in place and special dietary needs were catered for as well as specialist crockery and cutlery and finger foods to aid independence for people living with dementia.

There were effective quality assurance processes in place to monitor care and plan on-going improvements overseen by regular provider visits. There were systems in place to share information and seek people's views about the running of the home, including relatives and stakeholders. All responses were positive from the recent quality assurance questionnaire. People's views were acted upon where possible and practical, and included those living with dementia. Their views were valued and they were able to have meaningful input into the running of the home, such as activities they would like to do, which mattered to them.

A monthly newsletter and notice board kept people up to date and organised events such as BBQs and fetes encouraged families and children to attend. This showed that people and their families mattered to the staff, who also shared their lives, families and pets.

Further information is in the detailed findings below.