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Inspection carried out on 6 August 2018

During a routine inspection

This inspection was unannounced. This was the first comprehensive inspection carried out of this service which was re-registered with the Care Quality Commission (CQC) in December 2017 under the same owners.

Hickling 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 29 people in one building. At the time of our inspection 28 people were living in the home. Hickling House provided accommodation and care to older adults, some of whom were living with dementia. People were accommodated in rooms with ensuite toilets, and there were other communal bathrooms available, as well as two communal lounges and a conservatory with ample seating, and a dining room. One room was shared between two people.

There was a registered manager working in the service. 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.

The service was safe, as staff had a good knowledge of safeguarding, and there were risk assessments meeting people’s needs. The environment was maintained and kept safe for people, and there were enough staff to keep people safe. There were recruitment practices in place which contributed to suitable staff being employed. Medicines were administered as prescribed, and any errors were identified and acted upon in a timely manner.

Staff had training relevant to their roles and people were confident in their ability. People received a choice of home cooked meals, and enough to eat and drink. Staff supported people to have specialist diets, and to access healthcare services when needed.

People’s needs were pre-assessed to ensure the service could meet these needs before they moved in. To ensure people received consistent care, staff communicated with healthcare professionals involved in people’s care arrangements so obtain relevant information.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff understood people’s mental capacity, and supported people to make decisions in their best interests if needed.

Staff were caring towards people and respected their privacy and dignity, and encouraged independence.

Care plans were in place to guide staff on how to meet people’s needs and these were reviewed regularly. These also included information about people’s life histories and their day to day preferences. People were supported in a sensitive and responsive manner towards the end of their lives.

There were meaningful activities on offer throughout the week in the home and people were supported to access the community and go out on trips. There was equipment to support people living with dementia to engage with, which enhanced their wellbeing and allowed them to practise movement.

People and relatives felt comfortable to speak with staff or raise any concerns. Staff sought feedback regularly from people and there were meetings for people living in the home and their families, as well as surveys. Action was taken where any areas for improvement were identified.

There was good leadership in place, and the registered manager was known to everybody. The staff team worked well together. There were effective quality assurance systems in place to monitor and improve the service.

The staff and the management team had a strong sense of accountability and were aware of their responsibilities. This included working with external agencies and organisations and sharing information where needed.