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The Hazelwell Requires improvement

Reports


Inspection carried out on 23 October 2019

During a routine inspection

About the service

The Hazelwell is a purpose-built care home that is registered to provide personal and nursing care to older people. The care home accommodates up to 55 people across three separate floors. One of the floors provides support to people who requiring nursing care. On the day of inspection 36 people (three of which were receiving respite care) were using the service.

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

In most cases, risks to people had been identified and assessed with guidance in place for staff to follow to ensure people did not come to harm. However one person’s risks assessments had not identified factors that could result in them falling. This meant measures had not been put in place to prevent them coming to harm.

Overall, medicines were safely managed and administered to people at the right times. However, one person had not received medication that was required to help manage their condition effectively. Some people’s records had not been completed to show when and where medicines such as creams and ointments had been applied.

Whilst systems were in place to check the quality and safety of the service, they had not always identified issues that we found during the inspection, especially those related to medicine records.

Most people’s needs and choices had been thoroughly assessed both prior to and after moving into the home. However, one person’s needs had not been fully assessed prior to them moving into the home which resulted in care plans not being in place to guide staff in providing effective care and support.

We made a recommendation regarding this.

On the whole people were supported to access other health and social care professionals and staff sought advice from external agencies in a timely manner. However, for one person staff had not sough important medical advice in a timely way. We found no evidence that this person had come to any harm.

We made a recommendation regarding this.

Enough staff were on duty at the time of our inspection. However, at times it was noted that staff were not always deployed effectively across the three floors which left other staff feeling rushed during busy times. This was discussed with the registered manager and staff during the inspection.

People told us they felt safe living at the home and explained that staff were quick to respond when they needed support. Family members and friends also told us they felt confident people were safe and treated well. Staff showed a good level of understanding around how to identify safeguarding incidents and were confident in reporting concerns to the relevant people.

People were provided with support to maintain a healthy balanced diet. Both care and kitchen staff had good knowledge of people’s dietary requirements and any risks associated with poor food and drink intake or difficulties with swallowing. Staff were observed to provide support at meal times in a sensitive and patient way and the overall mealtime experience was positive. People told us they enjoyed the food which had been compared to “5 star restaurant standards”.

Staff were knowledgeable and showed they knew people well and how to support them. Staff had received a range of training appropriate to their role and people’s needs and told us they felt supported in their role. Two ‘home trainers’ had been recruited to help address issues regarding records and to provide regular consistent training support to staff.

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 spoke highly of the caring approach of all staff describing them as “Marvellous,” “Truly brilliant” and “Superb.” It was clear that positive relationships had been developed between staff and people. Family members and friends told us they were always made to feel welcome and descri

Inspection carried out on 11 April 2017

During a routine inspection

The inspection took place on 11 and 12 April 2017 and was unannounced on the first day. This was the first inspection of a new service that was registered by CQC in June 2016. The service is registered to provide accommodation and nursing or personal care for up to 55 people and 25 people were living there, or having a short stay there, at the time of the inspection.

The home is a converted and extended four-storey property set in its own grounds in a residential area overlooking the Dee Estuary in Heswall, Wirral. There were bedrooms on the ground, first and second floors, however the second floor was unoccupied at the time of the inspection. Communal areas were provided on each of these floors, with staff and service areas on the third floor.

The home had a manager who was registered with the Care Quality Commission. 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.

There were enough qualified and experienced staff to meet people’s needs and keep them safe. The required checks had been carried out when new staff were recruited and all staff had received induction training before they commenced employment.

We found that the home was clean and well maintained and records we looked at showed that regular health and safety checks were carried out. All areas were furnished and decorated to a very high standard and people had a choice of comfortable sitting areas both indoors and outdoors.

Medicines were managed safely and records confirmed that people always received the medication prescribed by their doctor.

Where appropriate, applications had been made to the local authority for Deprivation of Liberty Safeguards. People were very happy with their meals and told us that choices were always available.

The members of staff we spoke with had good knowledge of the support needs of the people who lived at the home. The staff we met had a cheerful and caring manner and they treated people with respect. People who lived at the home and visitors who we spoke with expressed their satisfaction with the care provided and with the staff.

The care plans we looked at gave information about people’s care needs and how their needs were met. They also gave detailed information about people’s individual choices and preferences.

There was a friendly, open and inclusive culture in the home and people we met during our visits spoke highly of the home manager. Quality audits were completed and identified where improvements were needed.