Hascott House

Hascott House is a residential care home providing accommodation and personal care for up to nine people, over the age of 18, who have a learning disability. At the time of the inspection seven people were living Hascott House.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people. Seven people were using the service. The size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

People were supported by staff who were skilled and competent to carry out their roles and responsibilities. Staff were aware of how to keep people safe and risks to people and the environment had been managed.

People received their medicines on time and as prescribed. The provider carried out checks on new staff to ensure they were suitable to work. Suitable infection control arrangements were in place. We identified some minor infection control issues which were being addressed.

The staff knew people well and were kind and caring. Staff planned and provided care to meet people's needs and to take account of their preferences.

People were offered choices around their meals and maintained a well-balanced diet. People received access to health care services when required. Various professionals were in involved in providing healthcare to people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

There was no registered manager in post, however a new manager had been employed and intended to apply to be the registered manager. The provider had suitable and safe systems in place to monitor the service and were carrying out learning from accidents and incidents.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was [good (published 12 March 2016)]. There was also an inspection on [ 8 January 2018] however, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.

Why we inspected

This is a planned re-inspection because of the issue highlighted above.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Hascott House provides accommodation and personal care for up to nine people, over the age of eighteen, who have a learning disability. The home is located in the Gleadless area of Sheffield, close to local amenities and transport links.

The service had a registered manager in post at the time of our inspection. 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 provider had a policy and procedure in place for safeguarding people from abuse. This included the types of abuse and how to recognise and report it. Staff we spoke with told us how they would recognise abuse and the signs they would look for.

We found there were enough staff available to meet the needs of people living at the service. Staff were available to support people as required, including supporting people on trips out in the community.

We looked at systems in place for managing medicines and found people received their medicines safely and appropriately. Medication was stored in a locked room in a locked cabinet and the temperature of the room was taken daily to ensure medicines were stored correctly.

We saw the service had a safe recruitment system in place which was used when employing staff. We looked at four staff files and found the recruitment process had been followed.

We looked at support plans and found risks associated with peoples’ care and support had been identified. However, we saw one support plan stated someone was at risk of losing weight, but there was no risk assessment in place to address this.

We looked at staff training records and saw training took place on subjects such as medication management, infection control, moving and handling, nutrition, safeguarding, and food safety. Training was completed electronically and face to face depending on the subject.

We found the service to be meeting the requirements of the MCA and DoLS. Staff training records confirmed training in this subject had taken place. We spoke with the registered manager who told us that appropriate DoLS requests had been made to the authorising body and they were waiting to hear the outcome.

People were supported to have sufficient quantities of food and drink. People were involved in menu planning, food shopping and meal preparation where possible. People decided on a weekly menu for evening meals.

We looked at peoples support plans and found that relevant healthcare professionals were involved in their care when required.

We observed staff interacting with people and found they were kind, caring and patient. Staff were supportive and involved people in their care and support. We saw staff offered choices and gave time for people to respond and they respected the person’s decision.

We looked at support plans belonging to people and found they reflected the support being offered by staff. Support plans were person centred and reflective of the person’s needs and wishes and included their likes and dislikes.

People were supported to pursue hobbies and interests and engage with the community. For example, people were involved in work programmes, church activities, shopping, and community groups.

The provider had a complaints procedure in place which was also available in an easy read version. Staff we spoke with told us that if anyone had a problem they would tell the staff or it would be raised at the residents meetings.

We saw that audits took place to monitor the quality of service provision. Any actions were identified and resolved.

People were supported to comment about the home and staff were able to suggest ways to improve the service. We saw results from an annual family survey which had been completed in August 2015. We were also informed that the service had completed their first staff survey.

We gathered evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. The summary is based on observing and speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People supported by the service told us they felt safe.

We observed, and people told us they felt their rights and dignity were respected.

Systems were in place to make sure managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

We found that risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

The home had policies and procedures in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant people would be safeguarded as required.

Policies and procedures were in place in relation to the safe management of medication. Staff that administered medication had been provided with training in the safe handling of medication. This meant that people’s health and safety was promoted.

At our previous inspection we identified some concerns as some areas of the home were in need of maintenance and posed potential tripping hazards to people. We found some improvements had been made to the condition of individual and communal areas so that they were safe. We found that some areas of the home remained in need of refurbishment. These improvements were identified within the home's maintenance plan and were due to take place following planned reconstruction to an identified area of the home.

Is the service effective?

People’s health and care needs were assessed with them and their representatives, and they were involved in writing their plans of care. Specialist needs had been identified in care plans where required.

Staff were provided with training to ensure they had the skills to meet people’s needs. Staff were provided with formal individual supervision and appraisals at an appropriate frequency to ensure they were adequately supported and their performance was appraised. The manager was accessible to staff for advice and support.

Is the service caring?

We were able to verbally communicate with one person and asked them for their opinions about the support provided. Feedback was positive, for example, “they (staff) are good, they are kind" and “I am happy here". Interactions between people living at the home and staff were kind, patient and respectful. All of the people living at Hascott House appeared content and happy.

When speaking with staff it was clear that they genuinely cared for the people they supported and had a detailed knowledge of the person’s interests, personality and support needs.

People’s preferences and interests had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People’s individual choices regarding how they spent their day were supported by staff.

People spoken with said they had no worries about living at Hascott House. Information on how to make a complaint was provided to people and staff were aware of the procedure to support people if they wanted to make a complaint. We found appropriate procedures were in place to respond to and record any complaints received. People could be assured that systems were in place to investigate complaints and take action as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system in place. At our previous inspection we identified some concerns as the systems in place did not cover all aspects of the running of the home and staff were not formally asked their opinion of the service. We found that improvements had been made to the quality assurance systems to ensure that all areas of the home were audited, and staff were asked their opinion. Records seen by us showed that if shortfalls were identified they were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

We observed instances where staff were discussing the risks, benefits and alternative choices with people who used the service to help them understand and make their decisions.

We saw and heard evidence that there was no ‘one size fits all’ approach to care here. It was very clear that every effort was made to tailor care to the person’s needs.

People who used the service attended day centres and other services as part of their living arrangements. Staff gave them support and made necessary contacts to maintain continuity of support.

There were effective systems in place to reduce the risk and spread of infection.

The provider did not make suitable arrangements for the maintenance of the building to ensure it remained fit for purpose. People said parts of the home looked “Dark and unloved.” Regular maintenance was not carried out in a timely manner.

People were protected from unsafe or unsuitable equipment.

The provider’s system for monitoring the quality of service that people received was not satisfactory. Staff said, “No one listens to us.” The provider had not ensured staff were kept informed of the outcome of incidents or complaints so that they were involved in the changes.

We saw that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People told us, and we saw, they decided things and staff respected these decisions.

People's needs were assessed and care and treatment had been planned and delivered as they preferred. We saw people were involved in a variety of social activities in the community and also carried out day to day living skills. One person told us, 'I am happy here, I don't want to move. I do everything I want to do and I'm always busy going places.'

The premises were generally in a good condition, were clean and fresh. The people we spoke with said they were happy with their rooms and the home's general facilities.

People received the support they needed in a timely manner because there was sufficient staff on duty to meet their needs. Staff had received training and support to assist them to do their job properly. However appraisals of their work had not been carried out regularly.

We saw the complaints procedure was available to people who used and visited the service. The people we spoke with told us they had no complaints but felt comfortable taking any concerns to staff.