Archived: Hartfield House Rest Home

Updated 30 December 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was an unannounced inspection on 2 and 3 November 2015. It was undertaken by an inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information we held about the home, including previous inspection reports. We contacted the local authority to obtain their views about the care provided. We considered the information which had been shared with us by the local authority and other people, looked at safeguarding alerts which had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

During the inspection we reviewed the records of the home. These included staff training records, staff files including staff recruitment, training and supervision records, medicine records complaint records , accidents and incidents, quality audits and policies and procedures along with information in regards to the upkeep of the premises.

We also looked at seven care plans and risk assessments along with other relevant documentation to support our findings. We also ‘pathway tracked’ people living at the home. This is when we looked at their care documentation in depth and obtained their views on their life at the home. It is an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.

During the inspection, we spoke with seven people who lived at the home, four visiting relatives, and eight staff members including the manager. We also spoke with three visiting healthcare professionals. We also spoke with the owner who was present throughout the inspection.

We met with people who lived at Hartfield House; we observed the care which was delivered in communal areas to get a view of care and support provided across all areas. This included the lunchtime meals.

Updated 30 December 2015

Hartfield House Rest Home provides accommodation for up to 20 older people. There were 14 people living at the home at the time of the inspection. People required a range of care and support. Some people lived independent lives but required support for example with personal care and moving and walking safely. People were able to stay at the home for short periods of time on respite care or can choose to live at the home permanently. Staff provided end of life care with support from the community health care professionals but usually cared for people who needed prompting and minimal personal care support. People spoke well of the home and the staff. They told us they were happy living there.

There was currently no registered manager at the home. 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. There was a manager in post who was in the process of registering with CQC to become a registered manager; they were also the registered person. The owner visited the home most days to support the manager and staff.

This was an unannounced inspection which meant the provider and staff did not know we were coming. It took place on 2 and 3 November 2015.

Staff knew people well and had a good understanding of people’s individual needs and choices however risks were not always safely managed and care plans did not reflect the care and support people. Individual risk assessments to maintain people’s health, safety and well-being were not in place for everyone. Nutritional assessments did not always contain information staff needed to support people.

People’s medicines were not always managed safely. There was no guidance for ‘as required’ medicines.

Recruitment procedures were in place to ensure only suitable people worked at the home. There were enough staff working at Hartfield House to meet people’s needs.

Staff had an understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards however; there was no information about how people were able to make choices or decisions. Staff had a good understanding of abuse and how to protect people from the risks associated with abuse.

People were given choice about what they wanted to eat and drink and received food that they enjoyed. They were supported to maintain good health and had access to on-going healthcare support.

People were encouraged to make their own choices and maintain their independence. They and had their privacy and dignity respected and were complimentary about the staff who looked after them. People told us they did not have any complaints but would be happy to discuss them with the staff if they did.

The owner and manager were seen as approachable and supportive and took an active role in the day to day running of the home.

There were a number of breaches of the regulations. You can see what action we told the provider to take at the back of the full version of the report.