Hadfield House

Updated 8 February 2022

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.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 13 January 2022 and was announced. We gave the service 48 hours notice of the inspection.

Updated 8 February 2022

This inspection was carried out on 6 and 7 November 2018 and the first day was unannounced.

Hadfield House is a large converted Victorian house, overlooking Alexandra Park and within one mile of Oldham Town Centre. There are two storeys with bedrooms on both ground and first floors. Set back from the road, the home has gardens to the front, and a secure paved 'sensory garden' at the side containing raised beds, garden furniture and lighting which was directly accessible from the dining/lounge area. The service is registered to provide personal care and accommodation for up to 28 people living with dementia and mental health conditions. At the time of our inspection there were 26 people living at the home.

Hadfield House is a ‘care home’. 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.

We last inspected the service on 3 and 4 October 2017, when we rated the home requires improvement overall and identified breaches of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to safe care and treatment; premises and equipment; fit and proper persons employed and good governance. Following the inspection, the provider sent us an action plan which stated the breaches would be addressed. At this inspection we found significant improvements in all areas.

At this inspection we found that the provider had improved the environment in order to mitigate risks to the health and safety of service users and was compliant with this regulation. Mobile hoists were no longer being used for people living at the home and therefore were no longer causing an obstruction. All first-floor windows had restrictors fitted during the last inspection, we saw restrictors were still in place. We found that any cupboards that stored hazardous chemicals were kept locked.

Medicines were stored and managed safely. We found there were plans in place to administer ‘when required’ medicines to inform staff when and how to administer medicines that were not required routinely. Creams were stored appropriately.

We recommended that the service review the recording of thickeners used to adapt the consistency of fluids, to ensure that records were more detailed. The registered manager put new documentation in place during the inspection.

Staff employed since the last inspection had been recruited safely and the service had completed all the necessary checks to ensure that staff were suitable to work with vulnerable people.

Audits were taking place to monitor and improve the quality of the service provided. The service had a clear record of actions recorded and reviewed on a regular basis by the registered manager.

At the last inspection we found the provider did not have a formal risk assessment in relation to legionella. However, we found the provider had completed routine sampling to help control the risks of legionella and carried out appropriate water temperature checks and flushes. The provider had carried out an assessment and was taking the necessary steps to reduce the risk of exposure to legionella.

We recommended that the provider review best practice in relation to formally assessing the risks of legionella and carry out a written risk assessment. The provider had started this process before we completed the inspection.

There was a registered manager in place. 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 manager had been registered since October 2010.

The service used the local authority safeguarding procedures to report any safeguarding concerns. Staff had been trained in safeguarding topics and were aware of their responsibilities to report any possible abuse.

The home was clean, tidy and homely in character. During the inspection areas of the home were being refurbished with new flooring. Since the last inspection the dining/lounge area had undergone a significant transformation and we observed this was now a light, airy space that people enjoyed.

Electrical and gas appliances were serviced regularly. Each person had a personal emergency evacuation plan (PEEP) and there was a business plan for any unforeseen emergencies.

There were systems in place to prevent the spread of infection. Staff were trained in infection control and provided with the necessary equipment and hand washing facilities. This helped to protect the health and welfare of staff and people who used the service.

People were given choices in the food they ate and told us it was good. People were encouraged to eat and drink to ensure they were hydrated and well fed.

We observed meaningful interactions between staff and people who used the service. People told us staff were kind and caring.

People's day to day health needs were met by the staff and the service had effective relationships with external healthcare professionals.

Care records showed that people's needs were assessed before they started using the service and they were supported to transition to the service as smoothly as possible.

We saw from our observations of staff and records that people who used the service were given choices in many aspects of their lives and helped to develop their independence where possible.

We saw that the quality of care plans gave staff sufficient information to look after people accommodated at the care home and they were regularly reviewed.

Staff had been trained in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The registered manager was aware of their responsibilities of how to apply for any best interest decisions under the Mental Capacity Act (2005) and followed the correct procedures using independent professionals.

New staff received induction training to provide them with the skills to care for people. Staff files and the training matrix showed staff had undertaken sufficient training to meet the needs of people and they were supervised regularly to check their competence. Supervision sessions also gave staff the opportunity to discuss their work and ask for any training they felt necessary.