We carried out a review of the data available to us about Hazelwood Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hazelwood Care Home, you can give feedback on this service.
Hazelwood Nursing Home is a nursing home providing support and accommodation for up to 50 older people, some of whom were living with dementia. At this inspection, there were 35 people living in the service.
We found the following examples of good practice;
There was clear information for visitors on arrival. The home had an audio and visual display which outlined procedures for visitors. Visitors were asked to complete a screening questionnaire and had their temperature checked by a thermal scanner on arrival. Visitors were asked to wear face masks, undertake a lateral flow test and sanitise their hands.
There were sufficient stocks of personal protective equipment (PPE) which staff were using appropriately. Staff had undertaken training on putting on and taking off PPE and effective hand washing. Staff competency was checked to ensure this was completed correctly.
The premises was clean. Enhanced cleaning took place and cleaning schedules were adapted to ensure high traffic areas were regularly sanitised. Domestic staff had hand held devices to log when areas were cleaned. This supported management to audit cleaning effectiveness.
Admissions to the home followed current guidance. The home had adapted a wing of the building to enable people to be safely admitted and isolate prior to entering the rest of the home. This minimised the risk of transmission when a person was admitted.
Staff undertook regular testing including lateral flow tests prior to entering the home. Therefore, staff who had tested positive on a lateral flow test were able to leave the site to isolate and had not come in to contact with people and other staff.
Hazelwood Nursing Home is a nursing home providing support and accommodation for up to 50 older people, some of whom may have dementia. At this inspection, there were 45 people living in the service.
People’s experience of using this service and what we found
People were positive in their feedback. Comments included; “Yes I feel safe here. The staff are generally good people”; “The staff have a good knowledge of what I need” and “It is very homely here. I sleep very well here. It is very quiet. I do as much as I can for myself.”
Our observation showed people were safe at Hazelwood. Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. The provider followed safe recruitment practices.
People received the support they needed to stay healthy and to access healthcare services. Each person had an up to date care plan, which set out how their care and support needs should be met by staff. These were reviewed regularly. The GP said, “When I visit, I always find the staff friendly and helpful, and I find them very caring towards the patients. I have not been concerned about safety on my visits.”
Medicines continued to be stored and managed safely by staff. There were policies and procedures in place for the safe administration of medicines, which staff followed. Staff training records confirmed staff had been trained in medicine administration.
People continued to receive care from staff who were well supported with induction and training. Registered nurses’ renew their registration with the Nursing and Midwifery Council [NMC] every three years. Staff received one to one supervision and annual appraisals. A member of staff said, “The manager had supported me a lot in the past and they continue to do so.”
Staff understood the importance of promoting people’s choices and provided the support people required while assisting and maintaining independence. This enabled people to achieve positive outcomes and promoted a good quality of life. One person said, “I am encouraged to look after myself, I am as independent as I can be.”
The staff were caring and knew people, their preferences, likes and dislikes well. We received good feedback from people, relatives and healthcare professionals about the quality of care provided by staff.
We observed people’s rights, their dignity and privacy were respected. Staff supported people with their lunch at a gentle pace whilst engaging with them. People continued to be supported to maintain a balanced diet and staff monitored their nutritional health.
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. We saw that people participated in activities, pursued their interests and maintained relationships with people that mattered to them.
The service continued to be well led. Effective quality audits continued to be in place and continuous improvement and learning were embedded in the service. We observed that the registered manager was proactive in ensuring people received good care. One relative said, “The manager is a brilliant leader.”
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 on 12 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
There was a registered manager in post who was registered with the CQC. 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.
At our last inspection on 16 November 2015, we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches were in relation to medicines not being effectively managed, there not being sufficient staff deployed to ensure people’s safety and wellbeing, people not receiving personalised care with activities that were designed to stimulate or interest them and poor quality auditing systems. The provider sent us an action plan stating that they would address all of these concerns by 30 January 2016.
At this inspection, we found that the provider had taken action on all these areas and was fully meeting the regulations where breaches were found.
The provider had systems in place to protect people against abuse and harm. The registered provider had effective policies and procedures that gave staff guidance on how to report abuse. The registered manager had robust systems in place to record and investigate any concerns.
Risks to people's safety had been assessed and actions taken to protect people from the risk of harm. The environment was clean and appropriate measures had been taken to reduce the risk of infection. However, there was no recent fire risk assessment in place that was carried out by a trained competent person. This was brought to the attention of the registered manager who took immediate action.
Medicines were managed safely and people had access to their medicines when they needed them.
Staff were well trained with the right skills and knowledge to provide people with the care and assistance they needed. Staff met together regularly and felt supported by the manager. Staff were able to meet their line manager on a one to one basis regularly. However, there were no robust records to identify when people were having supervisions or when they were due. We have made a recommendation about this in our report.
There was sufficient staff to provide care to people throughout the day and night. When staff were recruited, they were subject to checks to ensure they were safe to work in the care sector.
The staff were kind and caring and treated people with dignity and respect. Good interactions were seen throughout the days of our inspection. Staff knew the people they cared for well and treated them with kindness, compassion, dignity and respect.
The principles of the Mental Capacity Act 2005 (MCA) were adhered to. People’s mental capacity was being assessed appropriately and meetings took place to make decisions on people’s behalf and in their best interests, when they were unable to do so.. Staff had training on MCA and had good relevant knowledge.
The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people’s freedom had been submitted and the least restrictive options were considered as per the Mental Capacity Act 2005.
The registered manager had started to implement a dementia friendly environment but this had not been completed. We have made a recommendation about this in our report.
People had freedom of choice at the service. People could decorate their rooms to their own tastes and choose if they wished to participate in any activity. Staff respected people's decisions.
People told us they were very satisfied with the care staff and the support they provided. Relatives told us they were happy with the service their loved ones received. Staff communicated with people in ways that were understood when giving support. Staff and the registered manager had got to know people well. Staff could build positive relationships with people to fully understand their needs.
Staff respected people’s privacy and dignity at all the times. The provider had ensured that people’s personal information was stored securely and access only given to those that needed it.
People at the service had access to a wide range of activities that were designed for their individual needs. People, relatives and staff told us they were very happy with the improvements made by the registered manager about the provision of activities.
The provider had ensured that there were effective processes in place to fully investigate any complaints. Outcomes of the investigations were communicated to relevant people.
The registered manager was approachable and took an active role in the day to day running of the service. Staff were able to discuss concerns with the registered manager at any time and felt they would be addressed appropriately. The registered manager was open, transparent and responded positively to any concerns or suggestions made about the service. Audits were carried out in all aspects of the service to identify how the service could improve and action was taken as a result.
We inspected Hazelwood Nursing Home on 16 and 17 September 2015 and the inspection was unannounced. Hazelwood Nursing Home is located in Longfield near Gravesend and provides accommodation, personal care and nursing for up to 50 older people. The home is set over two floors and has a lift to bedrooms and communal areas between both floors. At the time of our inspection there were 47 people living at the home, with 18 people on the ground floor and 29 people on the upper floor. Everyone at the home was living with dementia, some people had mobility difficulties and sensory impairments and some people displayed behaviours that challenged others. Many people were receiving care in bed.
The service did not have a registered manager. 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. The previous registered manager had left at the end of August and interim management arrangements were in place to cover the service whilst recruitment to the post was in progress.
We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
Relatives said they felt people were safe living in the home, however we found that staffing levels were not based on people’s support needs and there were insufficient numbers of staff to provide the support and supervision people required.
People received their prescribed medicines, however medicines were not effectively audited and guidance was not always robust enough to ensure people received their medicines when they required them and in a way that ensured their efficacy.
People who required the most care and support were not always given the support they needed to ensure they had meaningful occupation during the day and were not socially isolated.
Although there were some systems to assess quality and safety of the services provided, not all were effective in identifying concerns and ensuring improvement.
Staff were confident in how to protect people from abuse and harm. They were aware of the procedures to follow and were clear about their responsibilities.
Risk assessments were person centred and gave staff clear concise guidance regarding people’s individual needs. They included both measures to reduce identified risks and guidance for staff to follow to ensure people were protected from harm.
Staff knew people well and provided effective care that was based on detailed guidelines written in people’s individual care plans. Staff had completed the training they needed to supportpeople in a safe way.
We observed that staff sought people’s consent before providing care and support. Staff and management understood the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and their responsibilities.
People were provided with adequate nutrition and staff were knowledgeable about people’s dietary requirements.
People were referred to health care professionals when needed and there were strong links with a wide range of health professionals including the local GP surgery.
People were treated with respect and dignity by staff who demonstrated kindness and compassion.
People’s individual assessments and care plans were regularly reviewed to ensure they remained appropriate in meeting their needs.
People were supported to maintain their relationships and relatives told us that they felt most welcome.
Relatives knew how to make a complaint and were given opportunities to give their views.
We observed people using the Short Observational Framework Inspection methodology (SOFI). We saw that people were relaxed and well cared for.
We spoke to relatives of people living at the home and staff. People told us that they were happy with the care and support being delivered at the home. One person told us 'Staff are like an extended family to me' another said, 'My Mum's room is always immaculately clean and staff in the home are always smiling.'
We found that the premises and grounds were well maintained and clean.
Staff told us they felt supported in their roles and that they have supervision and regular opportunities for training. The manager of the home told us they were planning on introducing appraisals for staff and formalising continuing professional development for nursing staff.
We looked at the provider's quality assurance system and found that there was a range of monitoring processes in place that enabled the provider to respond to issues of quality.
People who used the service said, 'I am ok here', 'The staff are nice', 'They look after me well' and the home is well run.'
We also spoke with three relatives of people who used the service who said that they were happy with the care provided. They said staff are wonderful and the care is second to none.' 'My relative lights up when staff come into the room.' 'He gets physical affection {hugs}.' One person told us that 'I feel my relative is safe here, there are enough staff.' We were also told, 'The food's always good, the owner and staff are always accessible and the staff deal with any issues immediately.' 'We were kept involved in the initial assessments. We were asked about what my relative liked and disliked and we signed and agreed care plans.'
One person said 'I have sometimes been worried about the levels of staffing but I have spoken to the manager about this and I feel that I can talk with the manager if I do have any worries and these are acted on.'
We were told that the 'Staff always say hello and are always very friendly, I have had no complaints at all.'
Comments from people included (written with their permission):
'My health has improved dramatically since I have been here. I was very ill, but now I am much better and can walk again. This place cannot be faulted. The staff are excellent, and the home is run very well. Staff come instantly if I ring my buzzer.'
'All the staff have got time for us'.
'It is wonderful here, excellent. We couldn't have picked a better home'.
A relative said:
'I am very happy with the care that is given here. Nothing seems to be too much trouble for the staff. I am pleased I am allowed to help my relative in some small ways'.