Haydock House

Updated 26 February 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

Inspection team: This inspection was carried out by one inspector.

Service and service type:

Haydock House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates up to eight people in one adapted building. At the time of our visit there were six people using the service.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

This inspection was announced. We gave the service 48 hours’ notice of the inspection visit because the location was a small care home for younger adults who are often out during the day. We needed to be sure that they would be in.

The inspection site visit activity started on 5 December 2018 and ended on the 6 December 2018. We visited the service on the 5 December and looked at records, spoke with people and staff and completed a tour of the premises. On the 6 December 2018 we spoke with two relatives over the telephone.

What we did:

Before the 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. The provider returned the PIR and we took this into account when we made judgements in this report. We reviewed other information that we held about the service such as notifications. These are events that happen in the service that the provider is required to tell us about. We also considered the last inspection report and information that had been sent to us by other agencies. We also contacted commissioners who had a contract with the service.

During the inspection, we spoke with three people who used the service and two relatives. We also had discussions with six members of staff that included the area manager, registered manager and the deputy manager. We also had discussions with three care and support staff.

We looked at the care and medication records of two people who used the service, we undertook a tour of the premises and observed information on display around the service such as information about safeguarding and how to make a complaint. We also examined records in relation to the management of the service such as staff recruitment files, quality assurance checks, staff training and supervision records, safeguarding information and accidents and incident information.

Updated 26 February 2019

What life is like for people using this service:

¿ People were protected by strong and inclusive safety systems, with a focus on openness, transparency and learning. There were systems in place to make sure the service was safe, with very good staffing levels and highly skilled staff to deliver good quality care. Risks to people were fully assessed and exceptionally well managed. People were supported to take positive risks, to make sure they had greater choice and control of their lives. The positive risk-taking approach showed that staff respected people's right for independence and their right to take risks.

¿ People were fully involved and supported to safely recruit staff to work at the service. This ensured that successful applicants had the right values and skills to match the values that were at the heart of the service.

¿ The staff and the management team were passionate about providing people with support that was based on their individual needs, goals and aspirations. We saw that people were at the centre of their care and each person was treated as an individual. As a result, their care was tailored to meet their exact needs. The staff at Haydock House were committed to making sure people lived fulfilling lives and were protected from social isolation. People were well supported to make their own choices and staff were highly motivated with a 'can do' approach which meant they were able to achieve positive outcomes for people. People received care and treatment that was delivered in line with up to date best- practice guidelines in relation to Prada Willi Syndrome.

¿ Without exception, people spoke positively about their experience of the service and the successes they had been supported to achieve. It was clear the culture within the service valued the uniqueness of all individuals who lived there.

¿ There were excellent systems in place to monitor the quality of the care provided and to ensure the values; aims and objectives of the service were met. There was a high level of satisfaction with the service and people were well supported to express their views so improvements could be made. There was strong leadership that put people first and set high expectations for staff. We found an open ethos with a clear vision and values, which were put into practice by staff, who were proud to work for the service and felt valued for their work. A positive culture was demonstrated by the attitudes of staff and management when we talked with them about how they supported people.

¿ Staff were trained in infection control, and had the appropriate personal protective equipment to perform their roles safely. There were robust arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service

¿ People’s needs and choices were assessed and their care provided in line with their preferences. Staff received an induction process when they first commenced work at the service and received on-going training to ensure they could provide care based on current practice when supporting people. Each person's food intake was closely monitored to ensure they maintained a healthy weight in line with best practice guidance in relation to Prader-Willi syndrome. Staff supported people to access health appointments when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.

¿ 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. The principles of the Mental Capacity Act (MCA) were followed.

¿ Staff were caring and had built open and honest relationships with people. They were knowledgeable about how best to communicate with people and to advocate for them and ensure their views were heard. People spoke of the family atmosphere at the service and the genuine interest staff took in their wellbeing. There was a strong culture within the service of treating people with dignity and respect and staff spent time getting to know people and their specific needs before they provided them with care and support.

More information is in Detailed Findings below.

Rating at last inspection: Good (report published 20 August 2016).

About the service: Haydock House provides accommodation with personal care for up to eight people. There were six people using the service at the time of our inspection. This is a service that specialises in supporting adults with a range of complex needs and behaviours associated with Prader-Willi Syndrome (PWS). This is a genetic condition that means people with the condition will have an abnormal, insistent desire for food which can make the person eat excessively. This has the potential to result in life threatening obesity.

Why we inspected: This was a planned inspection based on the rating at the last inspection. At our last inspection we rated the service Good. At this inspection we found the service had improved to outstanding under safe and well-led domains. The overall rating for this service is Outstanding.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.