Herewards House

About the service

Herewards House is a residential care home and was providing personal and nursing care for 24 people aged 65 and over at the time of the inspection. The service can support up to 27 people.

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

Medicines were not managed and administered in line with good practice guidance. We observed medicine administration during our inspection and saw secondary dispensing took place. In addition, one person did not receive their medicines in line with the prescriber’s instructions. Self-administration of insulin did not follow safe practice and guidance.

Staff we spoke with confirmed they had received training in safeguarding and knew what action to take if they felt people were being abused. Recruitment files we viewed contained the relevant information to ensure staff were recruited safely.

Risks associated with people’s care and support needs had been identified and actions taken to minimise risks.

People we spoke with told us staff were kind and caring. They told us “Staff are kind and look after me well”, “I am very very lucky to be here.” We observed staff interacting with people in a positive way.

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.

People were supported to take part in activities. Activities were reliant on care staff and the service did not employ a specified member of staff for this.

There was a complaints procedure in place. People told us they knew how to make a complaint.

Some auditing took place, accidents and incidents were recorded and responded to effectively.

Staff and people told us the service was well run and they could always seek advice and support from the registered manager.

We have made a recommendation in relation to the providers auditing systems and reviewing consent agreements in relation to capacity.

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

Rating at last inspection

The previous rating for this service was good (published 30 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement:

We have identified a breach in relation to safe care and treatment at this inspection.

Please see the action we have told the provider to take at the end of this 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.

Herewards House provides accommodation for older adults and people, some of whom have dementia. The service provides ongoing care as well as respite stays. The service is located in a residential area of Maidenhead in Berkshire. The service is registered to accommodate a maximum of 27 people. On the day of our inspection there were 22 people who used the service.

The service must have a registered manager.

At the time of the inspection, there was a registered manager. 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 2008 and associated Regulations about how the service is run.

This was our first inspection of this service since the provider changed their registration, although the service has been operated for many years by the same people.

People were protected from abuse and neglect. We found staff knew about risks to people and how to avoid potential harm. Risks related to people’s care were assessed, recorded and mitigated. The management of risks from the building required some improvement. We found sufficient staff were deployed to meet people’s needs. Medicines management was safe, but improvements were needed in the premises to facilitate better preparation of medicines. We saw some refurbishment had been completed to modernise the building. We made recommendations about window restrictors and Legionella prevention.

Staff training and support was appropriate. Staff had the necessary knowledge, experience and skills to provide good care for people. The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People’s nutrition and hydration was satisfactory. Appropriate access to community healthcare professionals was available.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. We made a recommendation about DoLS applications.

There was a lot of complimentary feedback about Herewards House. People and others told us staff were kind and caring. People and relatives were able to participate in care planning and reviews, but some decisions were made by staff in people’s best interests. People’s privacy and dignity was respected. We made a recommendation regarding the Data Protection Act 1998.

Care plans were personalised and reviewed regularly. There was a satisfactory complaints system in place which included the ability for people and others to escalate complaints to external organisations. The service had no recorded complaints for a considerable period of time.

Staff demonstrated a positive workplace spirit and enjoyed their roles. People and others felt the service was well-led. A small number of audits were conducted to check the safety and quality of care. People who used the service and staff feedback was noted by the management team in the operation of the service. We made a recommendation about the statement of purpose and related statutory notifications.