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Inspection Summary


Overall summary & rating

Good

Updated 20 December 2017

The inspection took place on 15 November 2017 and was unannounced. Haunton Hall is a care home that provides accommodation with personal and nursing care and is registered to accommodate 90 people. Some areas of the home are unused and awaiting refurbishment; at the time of this inspection accommodation was available for up to 47 people and 46 people were using the service. Haunton Hall accommodates people in one building across four separate units, each of which has separate adapted facilities. One of the units specialises in providing care to people living with dementia; two units provide nursing care and there is residential accommodation. The home is in a rural location and there are extensive grounds and garden areas. There is no public transport to the village of Haunton.

The service had a registered manager 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.

When we completed our previous inspection on 4 January 2017 we found concerns relating to how people received medicines that were on an ‘as required’ basis. This was because there was no information available to ensure all staff knew when these were needed. Prompt action was not always taken to ensure medicines were administered in a form that people could take. Capacity assessments had not always been completed where needed and it had not always been identified that some people were subject to restrictions. The fire safety systems also needed further improvements and evidence that action had been taken was not available. The provider was rated as requires improvement overall. At this inspection we found improvements had been made, however further improvements are needed to recognise where applications to lawfully restrict people’s liberty need to be made.

On this inspection we found people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were able to make decisions about their care and staff knew how to respond if people no longer had capacity to make some specific decisions. However, where people were assessed as having capacity, authorisations to deprive them of their liberty had been applied for. Restrictions on liberty can only apply where people lack capacity to make certain decisions. We have made a recommendation about staff training on this subject.

Medicines were now managed to ensure people were protected from the risks associated to them. The number of staff on duty had been reviewed to enable people to receive support when they needed this. Recruitment procedures were in place to check that staff were suitable to work with people.

Risks to people were managed in a safe way and staff knew how to recognise and report potential abuse. Safeguarding procedures were in place and where concerns were identified these had been reported to ensure people’s safety. Accidents were reviewed and improvements were made to prevent further incidents and keep people safe. Infection control procedures were in place and the home was clean.

People felt the staff had the right skills to provide the care they wanted. People had access to health professionals and where advice was given, this was followed. People enjoyed the food and were offered a choice of what to eat and drink. Adapted cutlery and crockery was provided to support people to retain their independence. There were large pictorial signs in the home to help people to recognise different areas and rooms. The communal areas enabled people to have a choice of where to sit and there were hand rails fitted in corridors.

Staff knew people well and people were happy with the care they received. People’s privacy and dignity was promot

Inspection areas

Safe

Good

Updated 20 December 2017

The service was safe.

There were sufficient staff working in the service and people felt safe when they received care. Risks to people had been assessed and there was information about action to be taken to minimise the chance of harm occurring to people and staff. People received their medicines as prescribed and systems were in place to recruit staff that were suitable to work with people.

Effective

Requires improvement

Updated 20 December 2017

The service was not always effective.

People were supported to make decisions for themselves and helped to make best interest decisions were made where they lacked capacity. Where restrictions had been identified, applications to make these lawful had been submitted; however, these applications had also been made for people who had capacity. Staff knew how to support people and ensured that their health and wellbeing was maintained. People were involved in ensuring that they had their nutritional needs met.

Caring

Good

Updated 20 December 2017

The service was caring.

People received support from staff that were kind and caring. Staff knew how people wanted to be supported and provided care in line with their preferences and wishes. People were treated with dignity and respect and were supported to express their views about their care; their views were listened to and acted upon.

Responsive

Good

Updated 20 December 2017

The service was responsive.

People were supported to engage in activities that interested them. Information was available to ensure people received personalised care and support; this was reviewed to reflect their current support needs. People knew how to raise concerns and complaints.

Well-led

Good

Updated 20 December 2017

The service was well-led.

Systems were in place to assess and monitor the quality of care and to identify where improvements could be made. Staff were supported in their role and felt able to comment on the quality of service and raise any concerns. The quality of service people received was regularly monitored through feedback from people. The future of the home was reviewed to ensure quality could be improved and the service could be sustained.