Hay House Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Staff supported people to make decisions about risk. Risk assessments were completed to promote independence and minimise risks to people. Care plans provided sufficient guidance to staff to keep people safe. Any incidents or accidents were reviewed and investigated by the registered manager to identify any developing trends that might indicate further changes were needed. This helped to maximise people’s safety and enabled staff to deliver safe care and support. Safeguarding systems, processes and practices were effective to help ensure people were protected from the risk of abuse and neglect. There was a safeguarding policy, staff had safeguarding training and told us how they would report any concerns. They were confident all concerns would be dealt with appropriately. The service was generally working within the principles of the Mental Capacity Act 2005 (MCA). Where required appropriate legal authorisations were requested to deprive a person of their liberty. Some equipment was in use to manage risk, which could be restrictive. For example, senor mats which alert staff to a person’s movements. There was no record of a metal capacity assessment or best interest decision for the use of this equipment. The registered manager addressed this during the inspection. There were enough staff to meet people's needs. Staff had been recruited safely and received appropriate training for their role.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People were protected from the risk of potential harm and told us they felt safe and protected. Comments included, “Yes, I am safe. I’ve had no accidents or falls. I am happy here. I have no concerns”. People were safeguarded from abuse and avoidable harm. People and their relatives knew who to speak with if they had any concerns. They said the registered manager and staff were approachable and would listen to any concerns. During the site visit we saw kind and respectful interactions between people and staff. People’s human rights were being respected. The service was generally working within the principles of the Mental Capacity Act 2005. We saw staff supported people to make as many of their own decisions as possible. Staff avoided using restrictions and people were supported to walk with purpose and engage in activities of their choice.

Systems were in place to help keep people safe. A safeguarding policy was available which staff were aware of. All staff had received safeguarding training which was mandatory. The registered manager had completed the local authority safeguarding referrals where necessary. Where appropriate DoLS authorisations had applied for with the local authority. The registered manager was working to ensure mental capacity assessments and best interest decisions were completed where equipment could be restrictive.

Staff had received training on safeguarding and abuse. All were confident any issues raised with the registered manager or provider would be fully investigated to make sure people were protected. The registered manager was aware of their responsibility to inform the local authority and the Care Quality Commission of any safeguarding issues.

Detailed care plans were in place which staff understood and followed. The provider assessed risks to ensure people were safe and took action to mitigate any identified risks. Staff liaised with relevant external professionals to ensure changes in people’s needs, such as health or behavioural, were reviewed and supported appropriately.

Staff told us they knew where to find people’s risk management plans and they there was time to read them. Daily handover and good team communication meant staff were up to date with any changes. Where required people had specialist equipment in place. Staff spoke confidently about the use of equipment such as sensor mats; to minimise the risk from falls.

Risks to people were assessed and measures were put in place to minimise identified risks. For example, specialist equipment was in place to reduce pressure wounds; mattresses were set appropriately.

Risk assessments and associated care plans provided sufficient information for staff to support people safely in their preferred way. When people’s needs changed, staff updated relevant care records. Staff supported people to reduce identified risks, for example, risks relating to food safety and preparation. Where necessary, modified diets were provided. Specialist equipment was in place to reduce the risk of pressure wounds. People were supported in the least restrictive way and were able to take positive risks. For example, one person living with dementia required 1 to 1 care when awake. Staff supported the person in a discreet way, enabling them to walk with purpose and engage with activities as they chose to.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff were happy in their roles and felt well supported. They told us they received appropriate training and supervision. Overall, they felt staffing levels were sufficient to be able deliver safe care and support.

Throughout the day we observed there were adequate staff to meet people's needs and to keep them safe. Call bells were answered quickly. Staffing levels generally maintained at provider’s preferred level unless very short notice absence due to sickness etc.

Systems were in place to make sure staff had the required pre-employment checks before starting work. New staff received an induction and provider’s mandatory training. Staffing numbers were calculated dependent on people's needs and staff feedback.

There were enough skilled and experienced staff on duty to ensure the safety of people living at the service. We observed staff had time to spend with people on an individual and social basis as well as respond to their care needs in a timely way. Where people required support with mealtimes, 1 to 1 support was provided in a unhurried manner. People said staff responded quickly when they required attention. One person said, “They (staff) are here when I need them. They come quickly”. People and relatives spoke highly of staff’s caring approach. One relative said, “The care has always been super”; another told us, “The staff are clearly very caring, respectful and attentive”. Staff were supported to complete training relevant to their roles, including vocational training and training to meet people’s specific needs. Staff said they felt well supported by the registered manager and they worked well as team. Staff were recruited safely. Pre-employment checks, such as, the right to work in the UK and Disclosure and Barring Service (DBS) checks were completed. These checks made sure the applicant had not been barred from working with vulnerable people.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.