At the time of this inspection the registered manager was no longer working at the service. The designated manager, who was in day to day charge of the service, was aware of the requirement to be registered and was intending to apply for registration with CQC (The Care Quality Commission). During the inspection we spoke with eight people who used the service, six members of staff, the designated manager, deputy manager and administrator. We considered all the evidence we had gathered under the outcomes we inspected. We the information to answer the five questions we always ask;
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well-led?
This is a summary of what we found:
Is the service safe?
People told us they felt safe at the service. One person told us, 'There's never any shouting, I definitely don't feel bullied'. Another person said, 'All the staff are nice'.
People said they were satisfied with the clean, comfortable and well maintained accommodation provided at Hazeldene Care Home. However, we found some improvements were needed for people's well-being, safety and comfort.
Staff recruitment practices were in place to protect people from unsuitable staff. However, progress was needed to make sure gaps in employment histories were always checked and clarified.
We received mixed views from people using the service and staff, about the availability of care workers to provide effective support. We found there were insufficient staff on duty in the unit for people with a dementia. However, the designated manager began to take action in response to these matters during the inspection.
We didn't look fully at medicine practices; however we found there was a lack of directions for staff to follow on some medicines. This meant people may not have been getting proper support with their medicine.
Is the service effective?
We found arrangements were in place to assess people's needs and abilities prior to admission. This meant individual needs and choices would be considered and planned for before they moved into the home.
Records and discussion showed people were getting attention as appropriate, from healthcare professionals. Staff confirmed people had access to a range of healthcare resources.
People spoken with were mostly satisfied with various activities, events and visiting entertainers. Arrangements were in place to offer a range of individual and group activities.
We there was equipment to meet people's needs and to promote independence. However, we found several communal toilets were lacking in suitable adaptations and equipment to promote independence.
Processes were in place for staff to attain nationally recognised qualifications. Staff spoken with, told us of the training they had received. They were aware of people's needs and gave examples of how they delivered support.
Is the service caring?
People who used the service told us they were happy with the care and support they experienced at Hazeldene Care Home. They said: 'They are respectful and caring, very much so', 'It's not bad', 'They keep an eye on me' and 'We get good care'.
We observed staff treating people in a kind, friendly and respectful way. People told us they were happy with the staff team they said, 'I have no problems with the staff', 'The staff are very good' and 'The carers are excellent'. However, we observed people with a dementia were not considerately and sensitively supported with their lunch.
CQC monitors the operation of the DoLS (Deprivation of Liberty Safeguards) which applies to care homes. Policies, procedures and a code of practice were available to support appropriate practice around DoLS and the Mental Capacity Act and staff training had been arranged on these topics. However, improvements were needed with screening people's capacity to make choices and support best interest decisions.
Is the service responsive?
Arrangements were in place to review people's needs and abilities. This meant their individual needs and choices were being be considered and planned for. However, we found some progress was needed, in describing how staff should offer people reassurance and the specific manner in which to approach and respond to people.
Processes were in place to monitor people's health and well-being, arrangements were being made for GP visits and routine healthcare appointments with chiropodists and opticians.
Is the service well-led?
The service had a registered manager; however he was no longer working at the home and was in the process of cancelling his registration. There was a new manager in post who had designated responsibility for the service. There was also a deputy manager, senior care workers and an administrator to provide on-going direction and supervision of the service. Support and expertise was also provided by external management within the organisation.
People told us they were happy with the support they experienced at Hazeldene Care Home. We found people were involved with decisions which affected them on a daily basis. People's views and opinions were also sought and responded to within residents meetings and through satisfaction surveys. Regular audit checks were being carried out on various processes and practices. This meant there were systems in place to assess and monitor how the home was operating and to evaluate the quality of the service. However, we found some of the checking systems needed to more effectively identify and manage areas for improvement.