Archived: Halcyon House

Updated 31 October 2017

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 inspection took place on 13 and 18 September 2017 and was unannounced. The inspection team included an adult social care 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 our inspection we reviewed the information we held about the service. This included the statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We also contacted the commissioners of the service to gather their feedback.

We used all of this information to plan how the inspection should be conducted.

During the inspection we spoke with the registered manager, deputy manager, the maintenance person, four members of the care staff, six people living in the home and three relatives.

We looked at the care files of four people receiving support from the service, four staff recruitment files, medicine administration charts and other records relevant to the quality monitoring of the service. We also observed the delivery of care at various points during the inspection.

Updated 31 October 2017

This inspection took place on 13 and 18 September 2017 and was unannounced.

Halcyon House is a care home located in a residential area of Formby. The home provides accommodation, residential and nursing care for up to 31 older people. The home is owned and managed by Abbeyfield North Mersey Society Ltd, which is a charitable organisation. The building is single storey with a large garden and patio area with seating in the centre. During the inspection, there were 29 people living in the home.

At the last inspection in January 2017, we identified that the provider was in breach of regulations in relation to the management of medicines, fire safety, staffing, safe recruitment, consent, staff support systems, care planning and the governance of the service. Following the inspection we issued a warning notice in relation to Regulation 17; Good governance. The provider also submitted an action plan which told us what action they planned to take to ensure the breaches of regulations were met. During this inspection we looked to see if improvements had been made.

A registered manager was in post. 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 requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was on leave during the inspection but did call into the home on the first day of the inspection.

During the last inspection we found that consent was not always sought in line with the principles of the Mental Capacity Act 2005 (MCA) and applications to deprive people of their liberty had not been made as required. During this inspection we found that when required, applications to deprive people of their liberty had now been made.

When people were unable to provide consent, mental capacity assessments were completed. We found however, that these did not always follow the principles of the MCA. The provider was still not meeting regulations regarding this.

At the last inspection we found that audits completed were not effective. During this inspection we saw that audits were completed regularly and actions taken to address any areas that required improvement. However, not all of the issues identified during the inspection had been highlighted. The provider was still in breach of regulations regarding this.

In order to enable staff access to information regarding people’s care needs, copies of relevant care plans were stored within people’s bedrooms. This meant that private information was available to people who may not need access to it and confidential information was not always stored securely.

During the last inspection we found that plans were not in place to address all identified needs and did not all contain sufficient detail to ensure all staff knew how to best support people. We also found that planned care was not always evidenced as provided. During this inspection we found that the provider was no longer in breach of regulation regarding this. Care plans we viewed were detailed and provided information specific to the individual, including their needs and preferences. We saw that planned care was evidenced as provided.

At the last inspection we found that staff were not provided with regular supervisions or an annual appraisal to support them in their roles. During this inspection, staff told us that they were well supported and had received supervision recently as well as an appraisal and records we viewed reflected this. The provider was no longer in breach of regulation regarding this.

During the last inspection we found that there was not always adequate numbers of staff on duty to meet people’s needs in a timely way. During this inspection we saw that staffing levels were maintained, but feedback regarding staffing levels was mixed. Staff told us there was always enough staff on duty, however some people living in the home told us they had to wait for support at times. We saw that call bells were answered quickly during the inspection and staff were available to support people at meal times. Although it was clear that improvements had been made since the last inspection some people living in the home felt that they had to wait too long for care when they needed it.

During the last inspection we found that people were not always protected from risks as fire doors were seen to be wedged open. During this inspection, we saw that fire doors were either closed, or held open appropriately with automatic closure devices. Internal and external contracts were in place to check the safety of the building and its equipment. The provider was no longer in breach of regulation regarding this.

At the last inspection we found that medicines were not always managed safely. During this inspection we saw that improvements had been made. Medicines were stored safely and stock balances we checked were correct. People told us they received their medicines when they needed them, however there were no protocols in place to inform staff when to administer medicines prescribed as and when required. The provider was no longer in breach of regulation regarding the management of medicines.

During the last inspection we found that safe staff recruitment procedures were not always adhered to. At this inspection we saw that staff were recruited following completion of relevant checks. This helped to ensure people were suitable to work with vulnerable people.

Staff were knowledgeable about adult safeguarding and how to report concerns and records we viewed showed that accidents were recorded and reported appropriately. The care files we looked at showed staff had completed risk assessments to assess and monitor people’s health and safety and appropriate actions were taken to minimise the risks.

People’s nutritional needs were known and met by staff, although feedback regarding meals was mixed.

People told us staff were kind and caring and treated them with respect and relatives agreed. We saw people’s dignity and privacy being protected during the inspection and heard interactions between staff and people living in the home were warm and kind.

There was a schedule of activities available for people to participate in and people told us they were happy with what was offered.

Systems were in place to gather feedback from people, including surveys and regular meetings. People had access to a complaints procedure and told us they knew how to raise any concerns. Complaints made were investigated and responded to.

Feedback regarding the running of the service was positive. People felt able to raise any issues with the registered manager and deputy manager.

There was a range of policies available to help guide staff in their role and many of these had been recently updated. Staff we spoke with were aware of the home’s whistle blowing policy and told us they would not hesitate to raise any concerns.

Ratings from the last inspection were displayed as required.