Background to this inspection
Updated
1 November 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was carried out by an 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.
Service and service type
Hummingbird Care Residential Home 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.
The provider also has a domiciliary care agency operating from the home. It provides personal care to people living in their own homes. The agency provides care to adults, including people with dementia, physical disabilities, sensory impairments or mental health issues.
The service had a manager registered with the Care Quality Commission who was also one of the owners. A registered manager means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We had not requested a provider information return from the provider. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We reviewed notifications. Notifications are specific events registered people must tell us about by law. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
We spoke with two people, four relatives and ten members of staff. This included the registered manager who is also the owner, deputy manager, quality compliance advocate, senior care co-ordinator of the domiciliary agency, senior care workers, care staff, the cook and housekeeping staff.
We reviewed a range of records. This included two people’s care records and medication records. We looked at two staff files in relation to recruitment, training and induction. We also reviewed a variety of records relating to the management of the service, including policies and procedures, complaints, quality assurance and quality monitoring.
Throughout the inspection we were able to observe staff interactions with people in the communal areas to see how staff cared for and supported people. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us to understand the experience of people who cannot talk with us. We observed the lunchtime meal time experiences and used the SOFI to observe how staff interacted and cared for people.
After the inspection
We sought feedback from a local GP and the community nurse team who supports the home.
Updated
1 November 2019
About the service
Hummingbird Care is a care home providing personal care to a maximum of 18 older people. They provide care and support for frail older people and those people living with dementia. It does not provide nursing care. The home is a detached recently refurbished house in the village of Churchinford, seven miles east of the town of Wellington in the Blackdown hills in Somerset. There were 15 people living at the service during this inspection.
The provider also operates a domiciliary care agency which provides personal care to people living in their own homes in the community, within a five-mile radius of the care home. Not everyone using the domiciliary service receives the regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection there were 13 people receiving personal care in their own homes.
People’s experience of using this service and what we found
The service had improved since the last inspection, the provider had checks and audits in place to identifying shortfalls in the record keeping and identifying possible risks to people. The provider had informed the Commission of notifiable incidents in line with their legal responsibilities.
People lived in a service that kept them safe. The home was well maintained, modern and homely in appearance, with a relaxed, welcoming atmosphere. Staff had been recruited safely and had received training on how to recognise and report abuse. Medicines were safely managed. There was appropriate control of infection processes in place which meant people lived in a home which was clean.
People at Hummingbird Care were valued as individuals and treated with kindness and compassion. Staff knew each person well and were attentive, caring and they engaged with people with kindness and understanding. Staff knew how to communicate with people, so people understood the options available to them.
People received personalised care to meet their needs. The registered manager and staff were very passionate about ensuring people’s social needs were met. People enjoyed a variety of social activities which included in house activities, trips out, local events, social events and family visits.
People were very positive about the staff and the management team and said they were treated with dignity and respect. People’s care plans were in a new format and were personalised and included information for staff about the support people required to meet their needs.
Staff understood their responsibilities to protect people from abuse and discrimination. They knew to report any concerns and ensure action was taken.
People’s and relatives’ views were sought, and opportunities were taken to improve the service. Staff were supervised, supported and were clear about their roles and responsibilities. People were cared for by staff who received regular training that was tailored to meet the needs of the people living in the service and to their specific roles.
People’s needs and preferences regarding food and drink were known and respected. People were positive about the food they received. Comments included, “A good variety of food.”
People were supported to access healthcare services. Staff worked closely with health professionals, including the GP and community nurses and referred people promptly. They held a three monthly review for people at the home to review their presentation and health needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff ensured people living with dementia had given consent or received care in their best interests in line with current legislation.
People knew how to make a complaint if necessary. They said if they had a concern or complaint they would feel happy to raise it.
Procedures were in place for people to identify their wishes for their end-of-life care. This included any wishes they had for receiving future treatment or being resuscitated.
More information is in the full report.
Rating at last inspection and update: The last rating for this service was requires improvement (published 22 November 201) and there were two breaches of regulations. The provider completed an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. Following this inspection, the ratings for the service has improved and is now good.
Why we inspected: This was a planned inspection based on the rating of the service at the last inspection.
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.