Hailey House

Hailey House is a residential care home for up to 20 older people. On the day of our inspection, there were 15 people living at the service.

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

People’s care was not always delivered safely. Information relating to people's individual risks was not always recorded or did not provide enough assurance that people were safe.

Suitable arrangements were not in place to ensure the proper and safe use of medicines. The staffing levels and the deployment of staff was not suitable to meet people's care and support needs. Training was not always up to date. The premises did not meet everyone's needs.

Lessons were not learned, and improvements made when things went wrong. People were not protected by the prevention and control of infection. Staff did not always receive adequate training and supervision.

People and their relatives told us they were treated with care and kindness. However, the care provided was not always person-centred. People were not always treated with dignity and respect.

Not all care plans contained enough information to ensure staff knew how to deliver appropriate person-centred care. People were not supported or enabled to take part in regular social activities that met their needs.

The leadership, management and governance arrangements did not provide assurance the service was well-led, that people were safe, and their care and support needs could be met.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service were not in evidence.

Staff were recruited in line with requirements. People had enough food and drink to meet their nutritional needs. The service worked with other organisations to ensure they delivered joined-up care and support and people had access to healthcare services when needed.

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 4 July 2018).

Why we inspected

We received concerns in relation to the management of risk and medicines, staffing levels and the premises. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well led only.

We 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 COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hailey House on our website at www.cqc.org.uk.

Enforcement and recommendations

We have identified breaches in relation to risk and medicines management, staffing, care planning, person-centred care, the premises, and quality assurance at this inspection.

We have made a recommendation that the provider seek guidance in order to support people's communication and sensory needs.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures

We found the following examples of good practice.

People's wellbeing and mental health was being supported by good contact with family and friends.

There were clear arrangements at the entrance to the building and at other key areas to minimise the risk of infection.

Staff employed at the service had received training on infection prevention and the correct use of personal protective equipment (PPE). PPE was available and accessible throughout the building.

The service was visibly clean. Schedules were in place to show that regular cleaning was undertaken.

Audits were undertaken to check on infection control practices and make any improvements necessary.

The provider was following the government guidance on whole home testing for people and staff.

Hailey House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 20 older people. At the time of the inspection, there were 14 people living at the service.

Hailey House is a large detached house situated in a quiet residential area in Maldon, close to all amenities. The premises are set out on two floors and there are adequate communal facilities available for people to make use of within the service.

A registered manager was in post. 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.

People were protected from harm by staff who had been trained in how to safeguard people from the risk of abuse and understood their responsibilities to report any concerns.

Risks to people had been identified and assessed and management plans were in place to minimise risk whilst at the same time protecting people's rights and freedom. Staff demonstrated a good awareness of the risks to people and knew what to do to keep people safe.

Medicines were stored, administered and disposed of safely and were only administered by staff who had been trained and assessed as competent. Improvements were required in managing the stock control of people's medicines. Since our inspection these improvements have now been implemented.

Robust systems for the safe recruitment of staff were in place and there was sufficient staff deployed to safely meet people’s needs.

Staff had access to regular training to support them to develop the skills and knowledge to be competent in their role. Staff were supported through supervision, observations and appraisals to monitor their performance and identify gaps in knowledge and any training needs.

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.

The service supported people to have enough to eat and drink which met their needs and preferences. People were supported to access healthcare services promptly to help them maintain their health and wellbeing.

Staff were kind and caring, listened to people and treated them with courtesy. Communication between staff and people was warm, friendly and respectful. Visitors were made welcome at the service so that people could maintain relationships that were important to them.

The service included people in planning their care and support to ensure that care was provided the way people wanted. Staff had worked at the service for a long time and knew people well. Staff could describe people's routines and preferences and understood how to provide person-centred care.

Consideration had been given to people’s cultural and religious preferences.

We made a recommendation about greater consideration of equality and diversity.

People had access to activities both within the service and in the community which reflected their interests and preferences. The service had formed links with the local community groups and businesses to support people to feel socially included.

The service worked in partnership with health professionals to ensure that peoples end of life care needs were well met, including pain management. However, staff had not received any formal training in how to support people at the end of their life.

We made a recommendation about training for staff in end of life care.

There were systems in place to manage complaints and the service responded pro-actively to complaints. The provider listened and responded positively to feedback from people, relatives and staff.

There was a longstanding registered manager in post who worked in partnership with external agencies for the benefit of people who used the service. The registered manager and their deputy were hands-on and visible within the service which promoted a positive culture and strong sense of teamwork.

The new provider was investing in the service to ensure sustainability. Quality assurance systems were in place to assess and monitor the quality of service that people received and identify areas that required improvement.

Further information is in the detailed findings below.