Hamelin

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. At the time of the inspection there were seven people living at the home. Hamelin belongs to a group of homes owned by The Community of St Antony and St Elias. The homes act as a community with group activities and group management meetings and oversight.

At our last inspection in March 2016 we rated Hamelin overall as 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 home has not changed since our last inspection.

People received a service that was safe. The registered manager and staff understood their role and responsibilities to keep people safe from harm, protect people from any type of discrimination and ensure people's rights were protected. Risks had been appropriately assessed and staff had been provided with information on how to support people safely. There were enough staff to meet people's needs and checks were carried out on staff before they started work to assess their suitability.

People were protected from the risks associated with unsafe medicine administration. The home was clean, maintained and people were protected from the risk and/or spread of infection as staff had access to personal protective equipment (PPE) and received training in infection control.

The home was effective in meeting people's needs. People’s health and wellbeing were promoted and protected as the home recognised the importance of seeking advice from community health and social care professionals. People were supported to eat a healthy balanced diet. Staff were knowledgeable about how to provide effective care and support. People were 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 home support this practice.

People received a service that was caring and they were supported by staff who knew them well. People were actively involved in making decisions about their care and support. Staff were passionate about their role and treated people with dignity and respect. People continued to have control over their lives and were free to come and go from the home as they pleased.

The home was responsive to people's needs. Care and support was personalised which ensured people were able to make choices about their day to day lives. Activities were important to people's quality of life at the home and staff ensured people had the opportunity to take part in one-to-one activities both in the home and the wider community. People were aware of how to make a complaint and felt able to raise concerns if something was not right.

People benefitted from a home that was well led. People, relatives and staff were positive about the leadership of the home and told us the management team were open and approachable. The provider had systems in place to review, monitor and improve the quality of service provided. This included a programme of audits and checks, reviewing medicines management, quality of care records, support to staff and environmental health and safety checks.

We have made two recommendations one in relation to the provider’s recruitment systems and one in relation to staff training. Further information is in the detailed findings below.

The home had a registered manager. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

This inspection took place on 4 March 2016 and was unannounced. At the time of our inspection there were seven people using the service. People had a range of needs with some people being more independent and others requiring more support with their care needs. People who lived in Hamelin were living with a variety of mental health needs.

We carried out a previous inspection of Hamelin on 4 November 2013 and found them to be meeting the regulations we inspected.

People who lived at Hamlin received effective support which met their individual needs. The Community held values which revolved around people being seen as individuals and being supported to lead more independent lives through activities and proactive support. Staff at Hamlin believed in these values and demonstrated these through their practice.

Each person’s care needs were assessed on a regular basis and risks were identified and acted upon. Clear and detailed management plans were in place in relation to each person’s needs. These gave staff information about each person’s specific needs, how their needs presented themselves, how to identify people’s specific behaviours and how to respond to these in order to ensure people’s wellbeing was maintained. Each person had a care plan which detailed their support needs and also identified what people were able to do for themselves. People were encouraged to become as independent as possible and were supported to learn new skills. People’s skills were reviewed yearly in order to ascertain how people had progressed and which areas they needed to gain further skills in.

People felt safe at Hamelin and staff had received training in safeguarding people. Staff knew how to raise concerns if they were worried about anybody being harmed or neglected. Staff had received information about whistleblowing and felt confident about doing this if they needed to. People, relatives and staff felt confident any concerns they had would be acted upon quickly and effectively by the registered manager.

People spoke highly of the staff and staff had enough time to meet people’s individual needs. Staff supported people to attend activities, tend to people’s needs and spend time with people one on one. People had access to a wide variety of activities which met their individual preferences and interests. There was a comprehensive activities programme which people took advantage of and people also engaged in their own activities, either on their own or supported by staff.

Staff received sufficient training to meet people’s needs well and further training was available to those who wanted it. Staff were encouraged to gain further qualifications and pursue their interests through further training. Staff experience and knowledge was shared amongst the staff team and used to provide the best support for people.

There were robust recruitment processes in place to ensure that suitable staff were employed. Staff performance was monitored with supervisions, appraisals and spot check observations. Poor practice was picked up and acted on and staff knowledge was regularly tested. Where staff did not answer test questions to the registered manager’s satisfaction, they received further training and coaching.

Staff were encouraged to share their views and ideas in the form of supervisions, team meetings and staff handovers. Staff felt confident the registered manager valued their ideas and implemented them where appropriate.

Staff knew people well and were knowledgeable and confident when they spoke about people’s support needs. Staff knew people’s histories, their likes, dislikes, interests and preferences. Staff spoke highly of the people in their care and respected their experiences and knowledge.

Staff had received training in, and understood the principles of the Mental Capacity Act 2005 and the presumption that people could make their own decisions about their care and treatment. All the people who lived in Hamlin had the capacity to make decisions about their care and they were supported to make choices about every aspect of their lives. People were involved in every aspect of their care and had full access to their care records. The registered manager had a good understanding of the laws regarding the Deprivation of Liberty Safeguards and would know how to recognise a situation which would require an application to be made to the local authority.

Where people were at risks relating to their mental health, their general health, their wellbeing or their safety, these had been identified. Staff had sought advice from external healthcare professionals and had created plans to minimise risks for people. People’s care plans and risk assessments were regularly reviewed and updated with any changes.

People had a range of different diets and a range of different abilities with regards to cooking. Some people were self-catering and did their own shopping whereas others required more support. People were supported to eat and drink enough to ensure they maintained good health. People were encouraged to eat a healthy balanced diet but could choose what foods they wanted to eat. People’s diets and preferences were catered for and where people required encouragement with eating this was done in a sensitive way.

Hamlin had a very homely atmosphere which fitted the personalities of the people who lived there. The home was very artistic and musical and people’s own beautiful paintings hung on the walls. People played music throughout the day and the atmosphere was a happy and social one. Throughout our inspection we heard laughter, chatting and gentle friendly banter.

People, relatives, staff and healthcare professionals spoke highly of the registered manager. The leadership structure at the home was clear and staff were confident in their responsibilities. The registered manager had an effective quality monitoring system in place which was used continually to review and improve the service. People’s views, opinions and feedback were sought through the means of meetings and questionnaires.

We saw from care records that people's choices about their care were considered. This was supported by what people told us. One person said 'We talk about our care plans and what we want'. We found detailed daily records kept for each person. The daily records related to care plans unique to each person. We saw that care plans were signed by people who lived at the home.

We observed that people were treated respectfully. We saw that care workers respected people's privacy and dignity.

The organisation provided an activity programme that was available to all the people that used its services. People told us that they were supported to use community facilities and pursue their hobbies and interests. One person said 'The activities are excellent. I'm going to Tai Chi later and I've got badminton tomorrow'.

People told us that they felt safe. The care workers were knowledgeable about different types of abuse and knew what to do if they witnessed abuse.

People were protected from the risks associated with care workers who may be unsuitable to work with vulnerable people because the provider had effective recruitment procedures in place.

The provider had systems in place to assess and monitor the quality of the service provided.

People we spoke with told us that they were happy with the service they received. One person said 'It's great, I like the staff, I like my housemates and I like my life here.' Another person said 'We all get on. The cats argue more than we do.'

People told us that they felt safe and that the manager and staff were supportive. The home provided activities and people told us they were able to choose whether they took part in them. We observed that people were treated respectfully. People told us they were involved in decisions about their care.

Records showed that people's care needs were assessed and had been reviewed on a regular basis. Daily care records showed us that care had been delivered in line with the care plans. The home had measures in place to deal with emergencies. Medicines were well managed at the home.

People were very complimentary about the staff and we saw there was a mutual respect shared. Staff were knowledgeable about peoples care needs and were supported through effective training systems.

Records were well maintained and reflected the level of the service provided and showed that the service monitored the safety and efficiency of the business.