Archived: Hickling House

Updated 8 March 2016

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 4 February 2016 and was unannounced. Our visit was carried out by two inspectors 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 we carried out the inspection we reviewed the information we held about the service. This included statutory notifications that the provider had sent us in the last year. A statutory notification contains information about significant events that affect people’s safety, which the provider is required to send to us by law. We also contacted the local safeguarding team and the local quality assurance team for their views on the service.

During our visit we spoke with six people who used the service and four relatives. Observations were made throughout the day.

We gained feedback on the service from three visiting healthcare professionals. We also spoke with the owner of the home, the registered manager, two senior care assistants, four care assistants and a kitchen assistant.

We viewed the care records for seven people and the medicines records for four people who used the service. We tracked the care and support of two of these people. We also looked at records related to the management of the home. These included staff recruitment files, staff training records, quality auditing systems, health and safety records and minutes of meetings.

Updated 8 March 2016

This inspection took place on 4 February 2016 and was unannounced.

Hickling House provides residential care for up to 29 people, some of whom may be living with Dementia. Accommodation is over two floors and, all bar one, every room has en-suite facilities. The home has a lift, conservatory, dining room and a number of communal lounges. At the time of our inspection, 28 people were living in the home.

There was a registered manager 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 people living at Hickling House were supported by staff who were well trained and had the skills and knowledge to perform their roles. Appropriate recruitment checks had taken place to ensure that only those staff that were safe to work in care had been employed. Staff felt supported in their roles and worked well as a team. There were enough staff to meet people’s individual needs in a timely and person-centred manner.

The service understood the importance of staff development and staff received regular support and supervision to assist them in developing their skills and performance. Staff had received training in areas specific to the people they were supporting and this assisted in ensuring people received care individual to their needs.

Staff understood how to prevent, protect and report incidents of abuse. They were knowledgeable in the types of abuse that people could experience and were able to give us examples of these. Staff had knowledge of the agencies they could speak to if they had any safeguarding concerns. Risks to people had been identified, assessed and reviewed on a regular basis. People received their medicines on time and in the manner the prescriber intended. The service safely stored, managed and administered medicines.

People had confidence in the staff that supported them and found them kind, caring and patient. People told us they were encouraged to be as independent as possible and make their own choices. Staff demonstrated a respectful, professional and cheerful approach to their work and had time for the people they cared for. People’s dignity and privacy was promoted and staff demonstrated a discreet approach to this. Staff were quick to respond to people’s needs and could effectively offer reassurance and comfort to those needing it.

The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. Although the service had not recorded the capacity assessments they had made on the people they supported, the principles of the MCA had been adhered to and staff had knowledge of this. The service had made some appropriate DoLS applications but we identified that two more were needed. The registered manager told us this would be completed following our inspection. Staff had a strong understanding for the need to gain people’s consent before assisting them and people told us this took place.

People received care and support that was personal to them. Care plans were detailed and person-centred and manged in a way that gave staff the information they needed to offer care and support. People’s needs had been identified, assessed and reviewed on a regular basis. People’s personal histories were available to assist staff in forming meaningful relationships with them.

The service had good working relationships with healthcare professionals that ensured people’s health and wellbeing was properly maintained. The service liaised with healthcare professionals promptly and appropriately. Those that we spoke with talked highly of the service and said their recommendations were always followed by staff.

People told us their social and leisure needs were met. The service encouraged people to maintain their interests and provided a range of activities for people both inside, and outside, of the home.

The management team was visible and people told us they had confidence in them. They found the registered manager easy to talk to and responsive in addressing any issues or concerns. The service promoted accountability amongst its staff. It demonstrated it took concerns and complaints seriously and investigated them fully.

People were encouraged to provide feedback on the service and, although regular meetings did not take place, felt they could openly talk to the staff and registered manager about any concerns they may have. People told us they felt listened to. The service had systems in place to monitor the quality of the service and these were used to develop the service further.