We carried out a review of the data available to us about Halsdown Nursing 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 Halsdown Nursing Home, you can give feedback on this service.
We found the following examples of good practice.
• The premises were clean and well maintained. Additional cleaning schedules had been introduced since the beginning of the coronavirus pandemic. Care staff were managing the cleaning effectively ensuring each room, en-suite and equipment were clean and implementing a regular deep clean programme. High touch areas such as door handles, technical equipment and light switches were cleaned throughout the day. Hand sanitiser was readily available throughout the premises.
• There were trollies stocked with personal protective equipment (PPE) stationed around the home and each person had their own clinical waste bin to support the safe disposal of PPE worn by staff. Laundry was washed separately on a hot wash.
• There was a clear procedure for staff to follow, when arriving and leaving and at break times. For example, staff recorded their temperatures as soon as they came into the building. They donned and doffed their uniform in a separate changing room and did not wear their uniform outside the service.
• Staff accessed weekly testing. People who used the service were also supported to access regular testing.
• Staff supported people to remain in contact with their families in line with government guidance. Increased staffing supported this. A new garden gazebo and screened area had been made with a booking system to enable thorough cleaning. There was lots of staff engagement with people to ensure they did not feel isolated, with allocated time for ‘something to make people’s lives better’. Gifts were encouraged and managed safely.
• All staff had received recent training in infection control and prevention (IPC) and were seen to be following correct IPC practices at all times, including social distancing.
• The registered manager and providers were visible and supported staff. They promoted a positive support network ensuring staff felt valued and cared for. They had arranged a treat for when it was safe so staff had something to look forward to. All updates to UK Government guidance were shared with staff and family members.
• The registered manager sought support and advice from external agencies and was open to all advice and guidance offered. There was a contingency plan informing staff how to manage Covid-19 and a robust admission policy.
Halsdown Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Halsdown Nursing Home provides nursing care for older people, some of whom are living with dementia. It is a two storey adapted building with 14 rooms, three of which can accommodate couples who wish to share a room.
The registered provider is also the registered manager of the service. A registered manager is a person who has registered with 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 this inspection we found the service remained Good.
Why the service is rated Good.
Staff developed exceptionally positive caring and compassionate relationships with people. The ethos of the home was that of an extended family. Staff were highly motivated and found ways to value each person’s contribution and treat them with the utmost dignity and respect. The home was organised around people’s needs, by staff who knew what was important to each person.
People were supported at the end of their life to have a comfortable, dignified and pain-free death. The service worked with hospice staff to improve end of life care for people. Staff followed national best practice guidance such as 'One chance to get it right' and NICE guidelines for end of life care (2015) and were working towards The Gold Standards Framework (GSF). This helped staff have the skills and confidence to help people have a good death.
Staff undertook 'Dementia Friends' training to understand various types of dementia affected people, they encouraged and supported people living with dementia to live well. Dignity training was provided in innovative ways to promote best practice. Staff sought out opportunities to praise and value people.
Staff demonstrated a good awareness of each person's safety and how to minimise risks for them. People's risk assessments were comprehensive with actions taken to reduce the risks as much as possible. We found the hot water supply to hand wash basins in people’s rooms and in bathrooms was too hot. We made the deputy manager aware of this risk. They took immediate action to address and arranged for thermostatically controlled valves to be fitted in all rooms the next day. This meant hot water temperatures were reduced to within safe recommended limits.
Staff understood the signs of abuse and knew how to report concerns, including reporting to external agencies. A detailed recruitment process was in place to ensure people were cared for by suitable staff. People received their medicines safely and on time from staff that were trained and assessed to manage medicines safely. People received their prescribed medicines on time and in a safe way.
There were sufficient numbers of suitable staff to keep people safe and meet their needs. People were supported by staff who were trained and had the skills and knowledge to meet their needs. Staff had received a full induction and were knowledgeable about the signs of abuse and how to report concerns.
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 CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provide legal protection for those vulnerable people who are, or may become, deprived of their liberty. The service had made appropriate applications to the local authority DoLS team for people they had assessed as needing to be deprived of their liberty.
People's health and wellbeing was improved by staff who worked with a range of professionals to support them to lead a healthy lifestyle and access healthcare services. Staff promoted people’s health through good nutrition and hydration.
People received personalised care that responded to their changing needs. People’s care records were detailed about their individual needs. A variety of group and personalised activities were provided which supported people with mental alertness, self-esteem and social inclusion. People concerns were listened to and responded to and no complaints had been received since the last inspection.
People, relatives, staff and professionals consistently praised the consistently high standard of care at Halsdown. The service was well led by the registered manager and deputy manager, who led by example. Staff used evidence of what works best to continually review and improve their practice. People, relatives and staff were regularly consulted and involved in developing the service.
The inspection took place on the 5 and 11 August 2015 and was unannounced. We last inspected the service in January 2013 and did not identify any concerns or breaches of regulations.
Halsdown Nursing Home provides accommodation for up to 17 older people who may require nursing or personal care. The home has a registered manager, referred to as ‘Matron'. 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, relatives and health and social care professionals were overwhelmingly positive about their experiences of the home. They spoke about how friendly and welcoming staff were, the homely atmosphere and said the home was well organised and run.
Staff were kind and compassionate towards people, and had warm and caring relationships with them. They were highly motivated and used innovative ways to respect each person’s dignity and maintain their privacy. The home was organised around people’s needs, and they were supported by staff who knew what mattered to them.
People were actively involved in making decisions about their care. They were offered day to day choices and staff sought people’s consent for care and treatment. Where people lacked capacity, staff demonstrated a good understanding of their responsibilities under the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty safeguards (DoLs). Mental capacity assessments were undertaken for people who lacked capacity, relatives and health and social care professionals were consulted and involved in decision making in people’s ‘best interest’.
People were supported to receive ongoing health care support. Staff were knowledgeable about people’s care needs, and any risks. Detailed care plans showed each person's care and treatment needs. Care records were up to date and showed accurate records were kept about each person, which were regularly reviewed and updated as people’s needs changed.
People were supported to remain active, and be as independent as possible. They were encouraged to mobilise and a regular exercise class was provided. People were assisted to maintain their interests and hobbies and to try new things, and accessed the community regularly.
People and relatives felt safe at the home, although some minor health and safety risks related to the premises were identified. The registered manager addressed most of these during our visit.
The culture of the home was open and friendly. There was clear leadership from the registered manager, and staff had clear roles and responsibilities. The provider had a range of quality monitoring systems in place which were used to continually review and improve the service.
The provider participated in a number of good practice initiatives to encourage high standards of care and keep staff up to date with practice. This included schemes such as Dignity in Care, the Social Care Commitment and the Alzheimer's society’s 'Dementia Friends'. There was evidence of continuous improvements being made in response to these initiatives and from people’s feedback.
Risks to people's health and welfare were identified and their needs were met in a way that was personalised to each person. Health promotion was encouraged through referrals to specialists and through the use of regular dentistry and chiropody services. People told us they felt safe and well cared for.
We saw people had a choice of suitable and nutritious food and drink available in sufficient quantities. People said the food was good. People were cared for in an environment that was suitably designed and well maintained.The home was clean and comfortable.
There were enough qualified, skilled and experienced staff on duty to meet people's needs. Systems were in place to monitor the quality of the service. We found that the provider was responsive when issues were raised and lessons were learnt from incidents.