Archived: Hazelford Residential Home

Hazelford Residential Home is a residential care home providing personal care to 15 people aged 65 and over at the time of the inspection. The service can support up to 36 people across two floors.

People’s experience of using this service and what we found

Since the last inspection lots of improvements had been made to ensure the safety of people living in the home. Infection control processes had improved. Medicines were being managed safely. Measures in place to ensure safe recruitment practices were carried out and staff had been fully trained. Staff were provided with clear guidance on how to support people safely.

Management, leadership and governance of the home had improved. The home had a dedicated and passionate registered manager who had worked hard to make the necessary improvements. There was systems and processes in place to monitor the quality of care delivered and the safety of people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was inadequate (published 15 December 2020) and there were multiple breaches of regulation. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 15 December 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hazelford Residential Home on our website at www.cqc.org.uk.

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.

Hazelford Residential Home is a residential care home providing personal care to 17 people aged 65 and over at the time of the inspection, some of whom were living with dementia. The service can support up to 36 people across two floors.

People’s experience of using this service and what we found

People living in the service were not safe and were placed at risk of harm. Risk management and poor infection control process at the service put people at increased risk. Medicines management and administration were not safe. Records relating to people's care did not always contain sufficient information and guidance to enable staff to provide the safe care and support people required.

The service lacked oversight and leadership which led to poor outcomes for people using the service. There were very limited quality monitoring and auditing processes in place which left people at risk.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 6 July 2019).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practices were safe and the service was compliant with IPC measures. A targeted inspection looking at the IPC practices the provider had in place took place on 4 November 2020 and was unannounced.

During this targeted inspection a number of concerns were found around infection control and governance which prompted a focussed inspection to take place on 5 November 2020 and 11 November 2020.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report. The provider has taken action to mitigate some of the risks identified.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to infection control, risk management and leadership at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Hazelford Residential Home is a residential care home which was providing personal care to 30 people aged 65 and over at the time of the inspection. The service can support up to 36 people.

People’s experience of using this service and what we found

Work was needed to make personal and environmental risk assessments more robust. Fire drills and practice evacuations techniques were not taking place. Although medicines were administered safely medicines to be taken when required had no protocols in place to support staff. Accidents and incidents were recorded, however there was no analysis of these. We have made a recommendation about analysing accidents and incidents. With regard to infection prevention and control work was needed in some areas of the home.

Work was needed to bring all staff training up to date. The registered manager had recognised this and arranged for a new training company to support them with this. People were happy with the food provided. 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.

Engagement between staff and people using the service was caring and respectful. People and their relatives spoke positively about the care staff provided. We have made a recommendation about supporting people’s independence.

Systems of governance and oversight were not sufficiently robust to identify the concerns we raised during the inspection. There was no provider oversight into the service and the registered manager needed more support. Staff we spoke with felt supported by the registered manager.

Care plans were person centred and detailed people’s wishes and preferences. People had access to a range of activities, outings and continued to follow hobbies and interests. People and their relatives knew how to make a complaint if needed. There were enough staff on duty and staff were recruited safely.

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 3 December 2016.)

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence the provider needed to make improvements. Please see the safe, effective and well led sections of this full report. We found no evidence during this inspection that people were at risk of harm from this concern.

We found breaches in the relation to people's safety and the management of the service. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This inspection took place on 31 August 2016 and was unannounced.

Hazelford Residential Home Residential Home is owned and managed by A N I Health Care Services Limited. It is situated in the village of Bleasby in Nottinghamshire and offers accommodation for to up to 36 older men or woman. At the time of inspection 24 people were using the service.

The service had 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

People who used the service and staff at Hazelford Residential Home knew who to report any concerns to if they felt they or others had been the victim of abuse. People’s care records showed that any risk to their safety had been identified and measures were put in place to reduce these risks. There were enough staff with the right skills and experience to meet people’s needs. Medicines were stored, administered and handled safely.

People were supported by staff who had received the training they needed to support people effectively. People had consented to the care that they received. People’s rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly.

People spoke positively about the food they received. They were able to have choice in what they ate at each meal and received support to eat if required. People had regular access to their GP and also other health care professionals when required.

People were supported by staff who were caring and treated them with kindness, respect and dignity. Staff encouraged people to remain independent wherever possible and where people showed signs of distress or discomfort, staff responded to them quickly. There were no restrictions on friends and relatives visiting their family members.

Staff were always on hand to respond to people’s needs and a range of activities were available to those that wished to join in. Care plans were written with the involvement of each person and their family. They were reviewed regularly to ensure staff responded appropriately to any change in need a person may have. A complaints procedure was in place and people felt comfortable in making a complaint if needed.

The atmosphere within the home was warm and friendly. People living in the home were asked for their opinions with regard to the service that they received, which meant that their views informed decisions to improve the service. Staff understood the values and aims of the service and spoke highly of the registered manager. The registered manager had clear processes in place to check on the quality of the service and to ensure that any improvements identified were made and sustained

We carried out a responsive inspection following the receipt of some concerning information from an anonymous source. Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

We found systems designed to keep people safe were not followed. One person who had recently sustained an injury following a fall had a risk assessment and care plan associated with preventing falls. These had not been reviewed or updated following this recent fall.

Is the service effective?

We found staff were not effective at meeting the care and welfare needs of people who used the service. Documentation did not accurately show what support people had received.

Is the service caring?

We found staff spoke with people in a sensitive and caring manner. A person who used the service told us, 'They look after me fine.'

Is the service responsive?

We found records made did not show staff responded appropriately to the care and welfare needs of people who used the service.

Is the service well-led

There was no evidence to show that monitoring forms used were checked or reviewed to ensure people were receiving the care they required.

We found people were supported to make decisions about their care. People's individual characteristics were respected and their privacy and dignity were promoted. A member of staff told us, 'We don't do things the fastest way, we encourage people to do things themselves, like wash their own face and put their deodorant on.'

We found people were encouraged to have sufficient food and drink to promote their well-being. A person told us, 'We get more than enough, we had fresh salmon the other day and we always have a pudding.' Another person told us how staff took the time to help people to eat their meals when they had difficulty doing so themselves.

We found people had their medication when they needed it and this was administered safely. A person told us, 'They have never run out of my medicine. I always have it.'

We found the provider had taken the appropriate steps to safeguard the health, safety and welfare of people when concerns were raised at the number of staff on duty. A person who used the service told us, 'I thought they had been a little bit short staffed recently, but things are better now.'

We found the provider assessed and monitored the quality of the service. A person who used the service told us, 'I think the home is very well run, everything they do for you is for your own good. I don't think I would get better attention anywhere else.'

We found the provider had complied with the actions we set.