Hazelhurst Nursing Home

Updated 25 February 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Hazelhurst Nursing Home is a ‘care home’. People in care homes receive accommodation and 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 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 unannounced.

What we did before the inspection

Before the inspection we reviewed information we had received about the service. This information included ‘notifications’ the provider had sent to CQC. A notification is information about important events, which the service is required to send us by law.

During the inspection

We spoke with seven people who lived at the service and they told us about their life at Hazelhurst Nursing Home. We were also able to speak with three relatives who were visiting their family member. We spent a period of time observing how people were looked after, how they spent their time and the interactions between them and the staff team. We spoke with 10 members of staff, the registered manager, the deputy manager and the registered owner. We were able to speak with one healthcare professional who was visiting the service at the time of the inspection.

We looked at four people's care records, training records, policies and procedures, complaints, audits and quality assurance reports.

After the inspection we contacted two healthcare professionals who were regular visitors to the service after our inspection and their comments have been included in the main body of the report. We used the information the provider had included in their provider information return (PIR). The PIR was used during analysis of evidence during report writing. This is information we require providers to send to give us some key information about the service, what the service does well and improvements they plan to make.

Updated 25 February 2020

About the service

Hazelhurst Nursing Home is registered to provide personal and nursing care for up to 44 people living with conditions such as dementia and physical disabilities. The property dates from the 19th century and has been extended to provide additional bedrooms and living space. Hazelhurst Nursing Home is set in approximately 14 acres of grounds, close to Ross on Wye. Some of the bedrooms were registered as shared bedrooms but only occupied by one person, thereby reducing the maximum capacity. At the time of the inspection, 35 people were in residence.

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

Staff received safeguarding training and understood their responsibility to keep people safe. They knew how to report any safeguarding concerns to the local authority or CQC. Any risks to people’s health and welfare were assessed and appropriate management plans put in place to reduce or eliminate the risk. Staffing levels for each shift were appropriate, determined based upon each person’s care and support needs and kept under continual review. The service employed staff who would look after people well. Pre-recruitment checks ensured new staff were suitable. Checks included written references and a Disclosure and Barring Service check. Medicines were well managed and administered by those staff who had been trained and were competent. People received their medicines as prescribed.

The assessment and care planning arrangements ensured each person’s care and support needs were met. Staff received the training they needed to enable them to do their job well. New staff completed an induction training programme at the start of their employment. Staff were also encouraged to complete health and social care qualifications as well as the provider’s mandatory training programme. Staff were well supported to do their job and received a regular supervision session with a senior member of staff.

People were able to access the healthcare support they needed with the staff team making any arrangements as required. People received the food and drink they needed to maintain a healthy, balanced diet. Any preferences they had regarding food and drink were accommodated.

People were encouraged to retain as much choice and control of their daily lives and staff supported them in their best interests. The service was meeting the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards.

People and relatives all stated that the staff who looked after them were extremely kind, very caring and friendly and listened to what they had to say. People received person-centred care and made their own decisions about their daily life and the way they were looked after. The staff team were fully aware of each person’s specific needs and ensured they had good trusting relationships with people.

People were well cared for. The care and support they received took account of their specific needs, including their gender, faith and culture.”

People received a person-centred service. Each person was involved in drawing up their care plan and having a say in how they wanted to be looked after. Care plans were reviewed each month and adjusted as necessary. Changes in people’s care and support needs were identified promptly and taken account of. This meant people continued to be looked after in the way they required and wanted. The service provided end of life care well and were signed up to the Gold Standards Framework. When a person’s end of life care wishes were difficult to achieve, the staff sought solutions to address these.

Meeting people’s social and emotional needs was seen as a paramount human need. Great emphasis was placed on providing person-centred activities for each person. Person-centred profiles were developed for each person and used to plan activities. The staff were able to share examples of extraordinary one-to-one activities they had arranged for people. There was a range of planned activities each day and people were continually asked what they would like to do. There were no restrictions on visitors and visitors were as well cared for as the people who lived at Hazelhurst.

The registered manager and deputy provided good leadership for the staff team. There was a real commitment by all to provide a quality service and there a continual improvement plan in place. Governance systems and regular visits by the provider and quality manager ensured standards were always maintained at the highest level. People were very much at the centre of all decision making in the home and their views and opinions were listened to and acted upon. The service worked in partnership with other health and social care services and ensured they always followed best 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 31 July 2017).

Why we inspected

This was a planned inspection based upon 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.