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Reports


Inspection carried out on 4 December 2019

During a routine inspection

About the service

Hambrook Meadows is a residential care home providing personal care and accommodation to 16 people. The service can support up to 20 people.

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

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.

There was a strong, visible caring culture of caring for people. People’s relatives spoke in glowing terms of how exceptionally compassionate and kind staff were. Staff cared for people in ways which demonstrated a real empathy for them and this caring attitude impacted very positively upon people’s lives. People expressed their views and were involved in making everyday decisions about their care. Staff respected people’s privacy and dignity and promoted independence.

The registered manager and staff worked closely with healthcare professionals to ensure people’s needs were met at the end of their lives. People had personalised care plans in place which detailed their physical and mental health needs, their personal preferences and social histories. People enjoyed a range of activities which had been designed to meet their individual needs.

The provider had policies and procedures in place designed to protect people from the risk of suffering harm and abuse. Risk assessments were in place which identified possible risks to people living at the home. People’s needs were met by suitable numbers of staff. People received their medicines as prescribed. The provider had processes in place to reduce the risk of the spread of infection.

People’s needs were assessed before they were offered a room in the home. People were supported by staff who had the appropriate training and skills. The registered manager had made changes to the home so that the environment met the needs of people living with dementia. People were supported to access healthcare professionals when necessary and staff sought consent to care in line with law and guidance. People were supported to eat and drink enough.

The provider had a complaints procedure in place. The registered manager and provider ensured there was a person-centred, open and inclusive environment for people to live and staff to work. There was a clear leadership structure in place which included the registered manager and senior staff. The registered manager sought the views of people using the service, their relatives and staff and had a system of auditing in place to monitor the quality of the service offered. The registered manager and staff valued working with other professionals to improve outcomes for people.

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 (report published 20 May 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Inspection carried out on 27 April 2017

During a routine inspection

Hambrook Meadows is a residential care home that can accommodate up to 20 older people who may be living with dementia. The home does not provide nursing care. If people require nursing care district nurses visit people at the home. At the time of this inspection there were 15 people living at the home and two who were in hospital.

The home is located in the village of Hambrook and is a large detached house that fits in with the local neighbourhood. Bedrooms are located on the ground and first floor of the home and 13 have individual toilet facilities. Bedrooms on the first floor are accessible by a stair lift. Communal areas include two lounges and a large conservatory.

At the last inspection on 29 October 2014, the service was rated good. At this inspection we found the service remained good.

The registered manager provided good leadership at the home. Everyone that we spoke with said that the registered manager was a good role model. Staff, people who lived at the home and their relatives said that the registered manager actively sought their views, listened and acted upon them.

Quality monitoring checks ensured people received a consistently good service. Records were well organised and up to date. Appropriate checks of the building and maintenance systems had taken place to ensure health and safety was maintained. A clear process for handling complaints was in place. As at the previous inspection, the service continued to meet all relevant fundamental standards.

People who lived at the home, relatives and professionals said that staff were extremely kind and caring and as a result positive relationships had been formed that enhanced peoples sense of wellbeing. People said that they were always treated with respect and dignity and that their rights were promoted. We observed interactions by staff that were genuine, warm, positive, respectful and friendly and people told us this was the norm.

People received care that reflected their individual needs and preferences. People said that they were happy with the choice of activities on offer and that they were supported to maintain relationships with people who were important to them. People were encouraged to give their views about the service they received; were involved in planning their care and their views were acted upon.

People’s healthcare needs were monitored effectively and medicines were managed safely. Staff worked co-operatively with other professionals to provide the care people needed. People enjoyed the food provided and were supported with their specific dietary requirements.

People received consistent care from staff who knew their needs well. Staff told us they enjoyed working at the home and were fully supported by the registered manager. Staff had access to appropriate support, supervision and training. 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 at the home support this practice.

People were protected from the risk of abuse and supported to take risks in a safe way. Staff understood their roles in keeping people safe. There were enough staff to keep people safe and meet their needs. People were protected by the provider’s recruitment procedures.

Further information is in the detailed findings below.

Inspection carried out on 29 October 2014

During a routine inspection

This inspection was unannounced and took place on 29 October 2014. As the service was newly registered this was the first inspection.

Hambrook Meadows is a service which is registered to provide accommodation for 20 older persons and who maybe living with dementia. This accommodation is provided over two floors. On the day of our inspection they were providing care for 17 people.

The service has a registered manager in place. 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 happy to be living at Hambrook Meadows. They said they felt safe with staff and relatives had no concerns about the safety of people. There were policies and procedures in place regarding the safeguarding of adults and staff knew what they should do if they thought people were at risk of potential harm.

People received support from staff to take their medicines as directed by their GP. There were appropriate and safe systems in place for the ordering, storage, administration and disposal of medicines. These systems were regularly monitored by the registered manager.

Care records contained an assessment of people’s needs. These were supported by risk assessments which protected people from any identified risks and helped keep them safe. There were also environmental risk assessments in place to minimise risk of harm within the home. Plans were in place to protect people in the event of an unforeseen emergency such as fire or flood.

Staff were aware of the needs of the people they supported. There was an effective care planning system in place which reflected the assessed needs of people. Staff involved people, where possible, in identifying how they wished to be supported and what was important to them. Staff delivered care with compassion and understanding. They took time to listen to people and ensure they understood them.

Appropriate recruitment checks were carried out for newly appointed staff to check they were suitable to work with older people. Staffing levels were adequately maintained to meet people’s needs. Activities and reminiscence sessions were available specifically designed to support people living with dementia.

Food at the home was both nutritious and appetising. People could choose their meals from a daily menu and alternatives were available if they did not like the choices available. Staff provided support to people at meal times and monitored food and drink intake as required.

The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made where this was in their best interests. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Whilst no-one living at the home was currently subject to DoLS, we found the registered manager understood when an application should be made and how to submit one. The provider had arrangements in place to meet the requirement of DoLS.

Each person had a plan of care which provided the information staff needed to deliver support to people. Staff received regular training to help them understand, implement and meet people’s needs especially around supporting people living with dementia. All staff received regular supervision which monitored staff’s performance. Staff had completed further professional training in working within social care to National Vocational Qualification (NVQ) Level two or equivalent.

People’s privacy and dignity were respected and staff had a caring attitude towards people. Staff were seen to be engaging positively with people. There appeared to be a good rapport between staff, people and their relatives.

The registered manager encouraged feedback from people, relatives, staff and visiting professionals. They responded to comments and involved people in making changes raised from these concerns through surveys, comment cards and regular meetings.

Quality assurance procedures were in place to check the quality of the service people received. Daily quality checks were carried out by the registered manager and senior staff. The provider carried out their own quality monitoring visit every month.

Staff knew what their roles and responsibilities were and what was expected of them. Staff said the registered manager was approachable and encouraged staff to voice their concerns or ideas on how to change the service delivery or aspects of care for individuals. Staff said the home’s ethos was about making sure the people were at the centre of their care they received and involved in decisions about their care.