Haddon Court Limited

Haddon Court provides accommodation and personal care for 33 older people who may be living with a dementia. At the time of our inspection, the service was supporting 27 people. The home is situated close to the promenade and transport routes. Accommodation is provided on three levels and all bedrooms provide single occupancy.

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

The management team were in the process of further developing strategies and information to better guide staff to manage and maintain each person's safety.

We have made a recommendation about the assessment and monitoring of risks to people receiving care.

People felt safe and the provider had systems to protect them against the risk of abuse. There were enough staff deployed to meet people’s needs and staff continued to be recruited safely.

The new manager and provider are further developing a programme of continuous learning to better monitor the environment and care delivery. They are also looking to increase opportunities to gain feedback from people and their relatives.

We have made a recommendation about the auditing systems and engagement with people and their relatives.

The provider and manager had fostered a culture that was person-centred. A staff member told us, “It’s a lovely home. We are all like family.” We received positive feedback about the manager and how they were receptive to feedback. The service worked with outside agencies to maintain and enhance people’s health and wellbeing.

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.

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 (published 30 April October 2019).

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of choking. This inspection examined those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

We carried out a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

Recommendations

We have made a recommendation about the assessment and monitoring of risks to people receiving care.

We have made a recommendation about the auditing systems and engagement with people and their relatives.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The registered manager supported people to maintain their important relationships with family and friends. Relatives could visit regularly and were tested before entry to ensure everyone’s continued safety. Alternative arrangements included a large screen for virtual visits to assist those with visual impairment.

The provider ensured sufficient staffing levels throughout the pandemic. The workforce covered absence, without detriment to their effectiveness, so that people had consistency of staff who knew them.

Sufficient supplies of PPE supported staff to keep people safe. The registered manager underpinned this with regular training and circulated updated guidance. The management team completed records and spot checks to assure themselves of good infection control measures.

Haddon Court provides accommodation and personal care for 33 older people who live with dementia. At the time of our inspection the home had 32 people living there. The home is situated close to the promenade and transport routes. Accommodation is provided on three levels and all bedrooms provide single occupancy. There are three lounge areas and a large dining room.

People’s experience of using this service:

People and relatives consistently commented they felt safe and comfortable at Haddon Court. A relative commented, “It's a really good home, I would have no hesitation recommending it to anyone else.” Staff had training relevant to protecting people from abuse and poor practice and were able to describe their responsibilities.

The registered manager completed risk assessments aimed at minimising the risk of injury or unsafe care. They had a variety of systems intended to reduce accidents and regularly audited environmental and fire safety to maintain everyone’s welfare.

The provider assessed and monitored staffing levels to ensure they continued to meet people’s changing needs. A relative stated, “There seems to be enough staff.” The provider had a range of training to support staff in their roles.

The registered manager had multiple systems to ensure the safety of medication procedures. Staff demonstrated they understood their responsibilities and people said they received their medicines as prescribed.

Staff monitored and documented changes in people’s health and understood their responsibilities. People and relatives said staff were prompt in referring them to other healthcare professionals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. One person said, “They never try to force me into anything.”

Staff closely monitored how much each person ate and care records contained extensive information about their food likes/dislikes. People confirmed they enjoyed their meals. One person commented, “The meals are alright and I have a good appetite.”

We observed staff had a kind approach that focused on maintaining people’s dignity and valuing their individuality. One person commented, “The staff are smashing, they could not be any better.” The management team worked hard to ensure they valued people’s human rights.

Care records were personalised to the individual’s needs and support planning was aimed at assisting them to retain their self-determination. One person commented, “The staff here helped me become independent.”

People and relatives said the management team was approachable and visible at Haddon Court. One person stated, “Yes, I see the manager and the owner around the home.” The management team regularly completed a range of audits to assess the quality of care delivery. The registered manager told us the provider was ‘hands on’ in their approach and worked closely with staff. They added, “[The provider] is very involved in the home, the residents' wellbeing and making sure everyone is safe.”

Rating at last inspection: At the last inspection the service was rated good (published 16 November 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any issues or concerns are identified we may inspect sooner.

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

Haddon Court provides care and support for a maximum of 33 people who live with dementia. At the time of our inspection there were 33 people living at the home. Haddon Court is situated in a residential area of Blackpool close to the promenade. All bedrooms offer single room accommodation and there are communal lounges, dining areas and gardens for people’s use. Accommodation is provided over three floors with lift access for individuals with limited mobility.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 the last inspection on 29 August 2015, we rated the service as Requires Improvement. We made recommendations for the provider to improve people’s safety and welfare. These related to recruitment documentation and employee background checks, varied meals and menu options, the provision of dementia-friendly mealtimes and medication recordkeeping.

During this inspection, we found the provider had completed the necessary improvements and people who lived at Haddon Court experienced a good service. For example, they implemented new recruitment procedures to protect people from unsuitable personnel. A staff member told us, “My recruitment was very good. It was very professional.”

Additionally, we saw the management team had improved their medication procedures. For instance, we reviewed a sample of medication charts and associated risk assessments and found staff completed them correctly. Enhanced audits checked processes to safeguard people from unsafe management of their medicines.

Furthermore, the provider had enhanced people’s experiences at mealtimes. For example, they encouraged people who were friends with others who lived at the home to sit together. The provider used an external agency to implement a ‘scent delivery system’ that produced pleasant food aromas to increase people’s appetite. Those who lived at the home and their relatives told us they enjoyed their meals and had a varied diet.

The new ‘scent delivery system’ also provided a relaxation scent in another part of the home to reduce people’s anxiety. This was an excellent way of enhancing people’s experiences of living at Haddon Court. Additionally, people and their relatives told us staff were kind and courteous in the provision of good standards of care. A relative said, “The staff and [the registered manager] treat people as their own, like their grandfather. I love that.”

The registered manager ensured staff had information about reporting concerns and had training to protect individuals from abuse or harm. They had suitable arrangements to reduce the risk of inappropriate or unsafe care. People told us they felt safe and comfortable whilst living at Haddon Court. A relative said, “We feel relieved because [our relative] is in a safe place.”

The provider utilised a staffing model to check enough staff were consistently available to meet people’s complex requirements. They additionally provided a range of training, including refresher guidance, to underpin staff understanding and experience. One person told us, “I find the carers here understand me. That’s a help in itself because I feel confident in their abilities.”

We discussed the Mental Capacity Act (MCA) and associated Deprivation of Liberty Safeguards (DoLS) with staff who demonstrated a good awareness of related principles. Care files we looked at held evidence people or their representatives had signed their consent to care and support.

Staff agreed care planning with individuals who lived at the home and involved them in every aspect of their support at Haddon court. One person stated, “They talk with me frequently about my care, what I need and how they can support me.” Records we looked at were person-centred and customised to people’s preferences and requirements in relation to their support.

We observed the provider was caring towards people and their relatives and understood their needs. They confirmed Haddon Court had good leadership. One person said, “I would recommend the home to everyone. From the owners to the managers and staff, everyone cares and are interested in us as people.” Staff told us the management team supported them in their roles. The registered manager undertook a variety of audits to check quality assurance.

Some people had limited verbal communication and understanding and were unable to hold a conversation with us because of their dementia condition. To help us understand their experiences of living in the home we observed the care they received and the interaction by staff.

During our inspection we used a method called Short Observational Framework for Inspection (SOFI). This involved observing staff interactions with the people in their care. SOFI helps us assess and understand whether people who use services were receiving good quality care that meets their individual needs. We observed staff being responsive and attentive. This confirmed people who required support with their personal care or meals were being treated with respect and dignity.

We looked at care planning, meal arrangements and recruitment of staff records. We also talked with residents about the home. Comments were positive and included, 'The staff are all wonderful.' Also, 'I cannot fault anyone who works here the food is good and the care excellent.'

There were a range of audits and systems in place to monitor the quality of the service being provided.

During our inspection we spoke with some people and observed staff delivering personal care support. We saw people were treated with respect and dignity. We were told the staff team provided sensitive and flexible personal care support and they felt well cared for. The people we spoke with said they had no concerns about their relatives care.

We reviewed records and observed practices, which included those related to medication, meals and general care. We saw sufficient numbers of staff were on duty to be responsive to the needs of the people in their care.

People told us that the home was "A safe place, with a good atmosphere. The staff are very caring and patient".

"There are lots of activities and it's very family orientated".

"I am the final decision-maker in my husband's care. They fully involve me and will contact me to update me to changes".