Archived: Hyman Fine House

We found the following examples of good practice.

At the beginning of the pandemic, the registered manager and the maintenance person drove and picked staff up that would otherwise have used public transport to travel to work. The provider had supplied staff with face masks to be used outside of work in addition to the Personal Protective Equipment to be used within the home.

Agency staff worked exclusively at this home. The registered manager supplied agency staff with their own uniforms upon entry to the home, these were then washed and kept on site.

Staff had taken residents out for the day on the home’s mini-bus on to ensure people were still able to leave the home. People sat socially distanced on the mini-bus and remained in the vehicle throughout. People were supported to attend online synagogue services and exercise classes.

Hyman Fine House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

This comprehensive inspection took place on 16 October 2018 and was unannounced.

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.

Hyman Fine House had a registered manager who had been working for Jewish Care since 1999 and in post as registered manager at this home since January 2011. 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.

People’s risks around food and nutrition were not always recognised and understood by all staff. Other risks to people and the environment had been identified and staff understood people well and how to manage risks to help ensure people were safe. People continued to be supported to receive their medicines safely by staff that were trained in administering medicines. People continued to feel safe. One person told us, “I feel safe here, the staff look after me well.”

People remained protected from avoidable harm. There was a safeguarding policy and staff received training. Staff knew how to recognise the potential signs of abuse and knew what action to take to keep people safe.

People continued to be supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff understood best interest decision making where people lacked capacity in line with the principles of the Mental Capacity Act 2005. Staff sought people’s consent before giving personal or nursing care.

People were supported to maintain their health and had assistance to access health care services when they needed to. The home had a weekly GP’s surgery. People were supported to attend other healthcare appointments. We saw people had access to services such speech and language therapists (SALT), diabetic team, chiropodists, opticians, dentists and physiotherapists. One person told us, “They’re really on the ball, I see the doctor when I’ve needed to and they look after my health really well.”

People continued to have access to an extensive and wide variety of activities and were involved in planning activities. People received compassionate and dignified end of life care that respected their wishes. People were proactively supported to maintain relationships with people who were important to them. One person said, “The best thing about the home is that they really care about the people.” Concerns and complaints remained well managed and were responded to.

People continued to receive kind and compassionate care. People told us the staff were kind and caring and they were happy with the service they received. One person said, “The staff commitment to care is 24/7, you can’t beat it.” We saw positive interactions between people and the staff caring for them. Staff said they enjoyed working at the home and felt supported by the registered manager. A relative told us, “It feels like a home.”

The home continued to be well-led. A relative said, “Everything runs smoothly.” People, staff and relatives remained engaged and involved in the service provided. A member of staff said, “I love it here, everyone is supportive.” Daily feedback was sought through people's engagement with staff, key worker meetings and care reviews.

Hyman Fine House provides accommodation, personal and nursing care for up to 51 older people. Some people had illnesses or disabilities associated with old age such as limited mobility, physical frailty or lived with health problems such as heart disease, diabetes and strokes. Some people lived with dementia. There were 38 people living at the home at the time of our inspection. Accommodation is arranged over four floors and each person had their own bedroom. Each floor had lift access, making all areas of the home accessible to people.

Hyman Fine House is a large building in a residential area of Brighton, close to the sea, public transport, local amenities and shops. The service is owned by the charity, Jewish Care and is one of their homes in the United Kingdom.

The home had a registered manager. A registered manager is a person who has registered with the 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 home is run.

There was a focus on providing care and support that looked at the need of the person but also empowered their individuality and identity. The registered manager told us, "Getting to know individuals is key to good care". Considerable thought and energy created an environment that provided stimulation and interaction. The provider had worked to recruit over 30 volunteers. Staff told us how they actively worked against any risk of social isolation. One member of staff said, “The philosophy of [the management] and Jewish Care is that people are given freedom and purpose through therapeutic activity. Since your last inspection this idea has had time to be embedded. We have looked at how we fit into the wider community as a whole.”

People commented they felt safe living at Hyman Fine House. People commented positively about the care, treatment and support received. One person said, “Yes, I feel safe here. It’s the trademark of the home.”

People we spoke with were complimentary about the caring nature of staff. People told us care staff were kind and compassionate. People were treated with respect when they received care. A health care professional told us, “There is respect for the individual residents and their families’ wishes.”

Care plans reflected people’s assessed level of needs. Care was person specific and holistic. People with specific health problems had guidance in place for staff to deliver safe care. They had risk assessments that guided staff and promoted people’s comfort in such areas as nutrition and the prevention of pressure damage.

The delivery of care met people’s individual choice. Care plans gave information on people’s likes, dislikes. People’s changing health needs, such as changes to eating and drinking were reflected and therefore staff were informed of important changes to care.

Information was available on people’s life history and this fed into their care plan. This impacted positively on people’s well-being.

The dining experience was a social and enjoyable experience for people. People were complimentary about food at Hyman Fine House. One person told us, “The meals are superb. The chef does cook traditional Jewish food.” People were supported to eat and drink in a dignified manner.

Quality assurance systems were in place. The registered manager had a range of tools that supported them to ensure the quality of the service being provided.

Arrangements for the supervision and appraisal of staff were in place. Staff told us they felt supported and recognised the part that regular scheduled supervision played. A staff member said, “I feel secure and supported. I can go to my line manager if I have any problems. Outside of those times I receive supervision every six weeks.”

People had access to appropriate healthcare professionals. Staff told us how they had regular contact with the GP if they had concerns about people’s health. A healthcare professional said, “I do a regular weekly surgery at Hyman Fine House. I think the home is well run by the manager and senior staff. They provide a high standard of nursing and personal care to residents in the home.”

People were protected by a safe recruitment system. Each personnel file had a completed application form listing their work history as wells as their skills and qualifications. Nurses employed by Jewish Care had registration with the Nursing and Midwifery Council (NMC) that was up to date.

We found before people received support they were asked for their consent and the provider acted in accordance with their wishes.

Care was planned and delivered in a way that was intended to ensure people's safety and welfare. We noted the comments made by one person, 'From day one the staff took a very personal interest in [my relation's] welfare and did everything possible to meet her needs and to make them feel cared for.'

People were cared for in a clean, hygienic environment. People were protected from the risk of infection because appropriate guidance had been followed. One person told us 'The home is well run and kept beautifully clean.'

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately. We were told by staff, "The manager's door is always open and we can always go in and talk with them if we had a concern or complaint either for the people we work with or ourselves.'

We saw staff supporting people to make their own choices about what they had for lunch and what activities they took part in. Staff knew exactly how each person communicated which meant people's wishes were understood and respected.

There was a synagogue within the building that was purpose built and used frequently by people using the service and the local community.

During the inspection we observed staff spending the majority of their time with people who used the service. They frequently checked on them to ensure they were alright when spending time on their own.

There were many procedures in place to monitor and review the quality of the service provided. Quarterly 'quality circle' meetings took place to discuss any issues within the service and looked at any areas where improvements could be made. These meetings involved people using the service, their family, staff and professionals.