Hendra House Residential Home

Updated 22 December 2017

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 20 October 2017 and was unannounced. The inspection team consisted of one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to our inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We took this information into account during our inspection of the service.

As part of our inspection, we reviewed the information we held about the service. We contacted representatives from the local authority and Healthwatch for their views about the service and looked at the statutory notifications the provider had sent us. Healthwatch are an independent national champion for people who use health and social care services. A statutory notification is information about important events, which the provider is required to send to us by law.

As part of the inspection, we spent time with people in the communal areas of the home and spoke with 10 people who used the service and 11 visiting relatives and friends. Two people we spoke with were living with dementia and therefore conversations were not in-depth. We spent time observing interaction between staff and people. We also used the Short Observational Framework for Inspections (SOFI) to help us understand the experiences of people living with dementia. We also spoke with two visiting health care professionals and a visiting hairdresser. In addition, we also contacted two local GPs and another health care professional for their views on the service.

We reviewed a range of records about people’s care and how the home was managed. These included two electronic care records, six electronic medicine administration records (MAR), staff training records, quality assurance audits and minutes from resident and staff meetings.

As part of the inspection, we spoke with the registered manager, a care manager, one team leader, five care assistants, the cook, one kitchen assistant and two domestic staff.

Updated 22 December 2017

This unannounced inspection was carried out on the 20 October 2017.

Hendra House Residential Home is a care home that provides accommodation and personal care for up to 28 older people. The home is situated in a residential area of Ludlow. There are car parking facilities to the front of the building. At this inspection, there were 28 people living at the home, a number of whom were living with dementia.

At the last inspection in July 2015, the service was rated Outstanding. At this inspection, we found the service remained Outstanding.

There was a registered manager in post at the time of our inspection. 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 continued to receive outstanding care at Hendra House Residential Home. People, their relatives and health care professionals told us staff adopted a compassionate and caring approach towards their work. We saw very positive interaction between staff and people throughout our inspection. People’s rights to privacy and dignity were understood and promoted by staff. People were also provided with a keyworker, who the provider matched to the interests and personality of the person. Staff told us they took pride in knowing each person and knowing and understanding their needs. People were encouraged to be independent, express their views and make choices about the care and support they received. People told us they were listened to by staff and felt able to voice their opinions. They also felt actively involved in decision-making about their care and support needs. The provider and staff supported people’s involvement in decisions that affected them. People continued to be supported when considering their end of life care needs, such as future wishes and cultural needs. Staff had received training in end of life care and the home had a nominated end of life champion. The provider worked closely with local funeral directors to advise or assist with the provision of services.

Leadership at the home continued to be 'outstanding.' People told us the registered manager and the management team continued to lead by example. They regularly met with people and were always available when people wanted to speak with them. People described an open and inclusive culture, where their views and opinions were welcomed and acted upon by the provider. The provider had continued to deliver high standards of performance, especially around encouraging self-development and the provision of training opportunities for staff. This meant people consistently received high standards of care. Consistent leadership at the home provided for continual improvements, which were for the benefit of people who lived at the home. The provider told us that their approach to providing high quality care and support had gained national recognition, where staff had received national and regional nominations and awards. The provider had continued to develop lasting relationships within the local community, which included local churches, schools, and voluntary organisations. The provider was actively involved working with care organisations across the sector both locally and nationally, which involved sharing good practice and expertise.

People consistently told us they felt safe living at the home. There continued to be systems in place to protect people from abuse by ensuring appropriate referrals were made and action taken to keep people safe. Risks to people were managed in a way that protected them and kept them safe from harm. People were supported safely and their needs were met by sufficient numbers of staff. People continued to receive their medicines safely.

We found people continued to receive care and support from staff who had the skills and knowledge to meet their needs. People, their relatives and health care professionals told us they had confidence in the knowledge and skills of the staff, and their ability to meet people’s individual care and support need. Staff told us they received regular supervision in the form of one-to-one meetings with the management team to receive feedback on their performance, and discuss any additional support they may need. We saw staff seeking people’s consent before providing any care. When people lacked mental capacity to take particular decisions, staff took the required action to protect people's rights and ensure people received the care and support they needed. People’s dietary requirements continued to be assessed and people were provided with sufficient food and drink.

People received care and support that reflected their individual needs and requirements. They were supported to spend time in ways they found enjoyable and stimulating. The provider continued to routinely listen to people’s experience, concerns and complaints. People told us that if they had any concerns they would approach staff or the management team and were confident issues would be resolved. People were supported when considering their 'end of life' requirements, such as future wishes and cultural needs. Staff and managers had received training in 'end of life care' and the home had a nominated end of life champion.

Further information is in the detailed findings below.