Hazel House

About the service

Hazel House is a residential care home providing personal care for up to 8 people with a learning disability and mental health conditions. At the time of the inspection there were 8 people living at the service.

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

Right Support

People received safe care and they were supported by staff who knew how to protect them from harm. Staff supported people to take their prescribed medicines and to access healthcare services.

Staff were aware of people's individual risks and plans were in place to minimise these while maintaining people’s independence.

Recruitment of staff was safe and robust. We saw that pre-employment checks had been completed before staff could commence work.

People could choose how they wanted to spend their time, whether they wanted to be with other people or in their own space and what and when they ate.

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.

Right Care

We found people were at risk of social isolation because the provider did not always ensure people had opportunities for social engagement. We have made a recommendation about this.

There was a relaxed atmosphere in the home where staff were respectful and supportive in their interactions with people.

Where people required support with personal care this was provided in a discreet way and promoted people’s dignity and privacy.

People were given choices about the way in which they were cared for. Staff listened to them and knew their needs well.

Right Culture

Staff demonstrated a positive person-centred attitude to their work and promoted people’s rights and independence.

Staff were proactive in ensuring people had equal access to services.

Staff told us they enjoyed working at the service and we saw they had formed good relationships with people they supported.

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 October 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

This inspection was a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of 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 Hazel House on our website at www.cqc.org.uk.

Follow up

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

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection, we found the service remained Good.

The service had a registered manager. At the time of the inspection, the registered manager was on maternity leave and the home was being managed on a day to day basis by a team leader with support from the providers management team. 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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.

People were safe living at Hazel House. Risks associated with people's care had been appropriately assessed. Medicines were managed and administered in a safe manner. There were sufficient staff available to ensure people received person centred care. Staff were safely recruited. Systems and processes were in place to ensure people were protected from abuse.

Staff had received regular training, supervision and an annual appraisal to support them to provide effective care. 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. People had choice around what they ate and were supported to maintain good health.

We observed kind and caring interaction between people and staff. People living in the home and their relatives praised the caring nature of the care staff and registered manager. People were involved in planning their care.

Care plans were person centred, detailed and updated as and when people's care needs changed. People were supported to lead active and fulfilling lives and went on regular daytrips. Systems were in place to manage complaints.

People and relatives told us they were happy with the overall service at Hazel House. Quality assurance processes were in place to monitor the quality of care delivered. The registered manager worked in partnership with external health and social care professionals to ensure people's health and social care needs were met.

Further information is in the detailed findings below.

Below is a summary of what we found. We used a number of different methods to help us understand the experiences of people using the service, because people using the service had complex needs which meant they were not able to tell us their experiences. We observed how staff were interacting with people who used the service, looked at care records that showed how people's needs were being met and a recent survey that the service had completed which reflected the views of people's relatives about the service.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

There were risk assessments in place to ensure that people's safety and well-being were maintained when receiving care and support. This meant that people's needs were identified and met in a manner that promoted their independence and safety. Guidance was available in people's care plans regarding their need for one-to-one support and where they had particular behavioural needs we saw that these were monitored regularly. We observed that people's changing behaviour was responded to sensitively in a manner that enhanced the individual's well-being. Sufficient staff were available to meet people's needs.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People's needs were assessed and support was delivered to meet their individual needs. We looked at three care plans. These provided information about people's needs and gave guidance for staff about how they should be met. We saw that care plans and risk assessments were complete and up to date. If someone had to move to another service, there would be no interruptions to their care and treatment. Health plans clearly identified people's health care needs and ongoing treatment. People had been involved in the preparation of their health plans. Staff spoken with understood the health care needs of the three people whose records we looked at. Care records showed the service had completed an assessment of people's needs prior to them being discharged to another service. This meant that the service worked with other providers to make sure that people's health and social care needs were addressed.

Is the service caring?

We observed that people were treated well by staff. We saw that staff understood their needs. People were spoken to in an appropriate manner. People's needs were assessed and support was delivered to meet their individual needs. We looked at three care plans. These provided information about people's needs and gave guidance for staff about how they should be met. Care records showed that people had been involved and consulted about their care. Care plans were person centred, written in an easy read and available in pictorial formats that reflected the needs, wishes and the likes and dislikes of people who used the service.

Is the service responsive?

Care plans identified the person's needs resulting from their cultural background. Daily notes showed that people who used the service had taken part in activities and were supported to access their local community. For example, people were supported to go to the attend day centres and clubs.

Staff knew how the people communicated and responded to their requests. People's views were recorded in one-to-one meetings, and when their care plan was reviewed. Staff explained that regular key worker discussions were used to help the person to be involved in decisions about their care. Staff listened to people and acted on their views. Care records showed that where professional guidance had been obtained this was recorded in people's care plans and was being followed by staff. People's care records that they had access to a range of health services and social care support.

Is the service well-led?

People who used the service, their representatives and staff were asked for their views about their care and treatment and these were acted on. An annual quality survey had been carried out. The manager explained that a report had been produced, and any suggestions to improve the service were addressed. Peoples' suggestions were used as the basis to improve the care provided by the home.

Six monthly audits had been carried out covering a range of areas such as medications management and care planning. These showed that the quality of service provision was assessed and monitored. We looked at the accident and incident records. This clearly showed that appropriate action had been taken to prevent accidents or incidents from happening. The manager showed us how they monitored accidents and incidents to look for any patterns and to record any preventative actions. Care was managed to make sure that people had their needs met safely. Where issues were identified improvements were made.

We observed that people who used the service appeared well cared for and were dressed appropriately. Staff were noted to be constantly supervising people to ensure that they were safe.

People who used the service stated that they had access to healthcare professionals and they had been given their medication. Assessments, including risk assessments had been carried out. The care provided had been reviewed regularly to ensure that the current needs of people were met. Staff were aware of the choices and preferences of people.

There were arrangements for staff support and supervision. Staff stated that they worked as a team. Essential training had been provided. This ensured that staff were able to meet the needs of people.

There were arrangements for quality assurance and audits. A recent satisfaction survey indicated that people who used the service and their representatives were satisfied with the services provided.

Appropriate checks were undertaken before staff began work. Staff told us that they had been through a thorough recruitment process. We observed that staff kept records relating to people who use the service securely. We saw that all records were up to date.