Hardwick Dene

Updated 26 February 2022

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 COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. We had received information of concern about visiting arrangements at this service. This was a targeted inspection looking at the infection prevention and control measures and visiting arrangements the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 26 January 2022 and was announced. We gave the service 24 hours’ notice of the inspection.

Updated 26 February 2022

This inspection took place on the 5 December 2017 and was unannounced. At the last comprehensive inspection on 15 November 2016 we rated the service as requires improvement. This was because we found two breaches of the Health and Social Care Act (Regulated Activities) 2014. The breaches were:

• People who used the services were not protected against the risks associated with unsafe management of their medication.

• The provider failed to maintain accurate and complete records in respect of each person’s care and treatment.

We carried out a focussed inspection on 24 May 2017 and found that the provider had made enough improvement for them to no longer be in breach of the regulations. However the service remained rated as requires improvement.

At this inspection on 5 December 2017 we found the service had made further improvements and is now rated good.

Hardwick Dene is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Hardwick Dene accommodates 50 people in one adapted building. At the time of our unannounced inspection there were 39 older people and people living with dementia living at the service.

The Care Quality Commission (CQC) records showed that the service had a registered manager. However, they were not in post during this inspection. They had left the service and needed to cancel their registration. There was an acting manager in place to carry out the day-to-day running of this service. They had started their application with the CQC to become the 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.

Staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Staff were knowledgeable about how to report poor care practice and suspicions of harm. Information and guidance about how to report concerns, together with relevant contact telephone numbers was displayed as a prompt to staff, people who used the service, and their visitors to refer to. Pre-employment checks were in place to make sure that new staff were considered suitable to work with the people they were supporting.

People were assisted to take their medication as prescribed.

Processes were in place and followed to make sure that infection control was promoted and the risk of cross contamination was reduced as far as practicable.

The service had adaptations in place to help people with limited mobility such as handrails, sloping floors instead of steps, a stair lift and a passenger lift.

Staff were available to support people’s individual needs in a caring, patient and respectful manner. People’s privacy and dignity was maintained and promoted by the staff supporting them.

People and their relatives were given the opportunity to be involved in the setting up and review of their individual support and care plans. Staff encouraged people to take part in activities and trips out into the local community. People’s friends and family were encouraged by staff to visit the service and were made to feel welcome.

People were supported by staff and external health care professionals, when required, at the end of their life to have a comfortable and dignified death.

People had individualised care and support plans in place which recorded their needs. These plans informed staff on how a person would like care and support to be given, in line with external health care professional input. Individual risks to people were identified and assessed by staff. Plans were put into place to minimise these risks as far as practicable to enable people to live as independent and safe a life as possible.

People’s health and nutritional needs were met. People were assisted to access a range of external health care professionals and were supported to maintain their health and well-being.

Staff were trained to provide effective care which met people’s individual needs. The standard of staff members’ work performance was reviewed by the manager through supervisions, spot checks and appraisals.

Compliments about the care provided were received and complaints were investigated and action taken to make any necessary improvements. However, complaints records did not demonstrate that the manager always followed the provider’s policy around how all complainants should receive a formal acknowledgement of their complaint and a formal response following the investigation.

The manager sought feedback about the quality of the service provided from people, their relatives, and staff. There was an on-going quality monitoring process in place to identify areas of improvement required within the service. Where improvements had been identified, actions were taken to make the required improvement. Learning from incidents took place to reduce the risk, as far as practically possible, of recurrence.

Records showed that the CQC was informed of incidents that the provider was legally obliged to notify us of.

Further information is in the detailed findings below.