The Old Hall

Updated 8 September 2020

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This was a targeted inspection looking at the infection control and prevention measures the provider has in place. As part of CQC’s response to the coronavirus pandemic we are conducting a thematic review of infection control and prevention measures in care homes.

This inspection took place on 20 August 2020 and was announced. The service was selected to take part in this thematic review which is seeking to identify examples of good practice in infection prevention and control.

Updated 8 September 2020

The Old Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation for up to 20 older people and people living with dementia. There were 20 people living in the home at the time of our inspection. The registered provider also offers day care support in the same building as the care home although this type of service is not regulated by CQC.

We inspected the home in the period 29 January to 5 February 2019. The first day of our inspection was unannounced.

At our last inspection we rated the home as Outstanding in four of the five key questions and overall. At this inspection we were pleased to find the registered provider had made many further improvements in pursuit of an ever more safe, effective, caring, responsive and well-led service. As a result, the home is now rated Outstanding in all five key questions and overall.

People were at the very heart of the service and everyone with we spoke with told us of the exceptional kindness they had experienced at The Old Hall, and how good this made them feel. One person said, “I have been here for four years now and have never regretted it. You feel as though you are not only cared for but really loved. I want to spend the rest of my days here as I couldn’t wish for anything more.” Staff promoted people’s right to make choices in every aspect of their lives and actively supported them to maintain their independence for as long as possible. People were treated with the utmost dignity and respect and end of life care was provided in an exceptionally person-centred and compassionate way.

There was a registered manager in post. A registered manager is a person who has registered with CQC to manage the service. Like registered providers (the ‘provider’) 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 registered manager was deeply involved in all aspects of the running of the home and provided her team with principled, person-centred leadership. She had created an exceptionally open and positive organisational culture and staff worked closely together, internally and externally, to provide people with highly personalised care and support. The registered manager gave a very high priority to the learning and development of both herself and her team. As a result, staff had all the skills and knowledge necessary to meet people’s individual needs and expectations. The provider had a highly selective approach to recruitment to ensure new staff were suitable to work in the home.

Under the registered manager’s research-led leadership a number of innovative changes had been made, all of which had proved extremely effective in maintaining and improving people’s physical and mental health. These included establishing a new team of well-being therapists; the introduction of Lady – an affectionate Cavalier King James Spaniel; the ongoing development of an internal ‘token economy’ and the creation of the Welcome Bar.

The provider had a meticulous and exceptionally person-centred approach to assessing and reviewing people’s individual needs and preferences. Staff had a deep and holistic understanding of each person living in the home, derived in part from the strong relationships they had forged with people’s relatives. People were actively involved in many aspects of the running of the home and had the opportunity to participate in a rich variety of one-to-one and communal activities and to maintain personal interests and hobbies.

The provider placed a very high emphasis on ensuring people were properly nourished and hydrated. People were completely satisfied with every aspect of the catering provision in the home and told us they could have anything they wanted to eat or drink, at any time of day or night. Staff worked in very close liaison with local health and social care services to ensure people had access to any specialist support they required. Systems were in place to ensure effective infection prevention and control and the management of people’s medicines was safe.

Staff knew how to recognise and report any concerns to keep people safe from harm and a sophisticated system was used to promote organisational learning from any significant incidents. Individual risk assessments were regularly reviewed and updated personally by the registered manager. Staff supported people in the least restrictive way possible and policies and systems supported this practice.

A range of audits was in place to monitor the quality and safety of service provision. Formal complaints were rare and any informal concerns were handled effectively. Since our last inspection, significant investment had been made to ensure the physical environment and facilities in the home remained suitable for people’s needs, in particular people living with dementia.