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.