We carried out a review of the data available to us about Hunsbury House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hunsbury House, you can give feedback on this service.
At the last inspection in November 2015, the service was rated Good.
At this inspection on 6 and 8 November 2017 we found the service remained Good.
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.
People continued to feel safe. Staff understood their roles and responsibilities to safeguard people from the risk of harm and risks to people were assessed and monitored regularly. The premises were appropriately maintained to support people to stay safe. Staff understood how to prevent and manage behaviours that challenged the service. .
Staffing levels ensured people's care and support needs were safely met and safe recruitment processes were in place. Medicines were managed safely. The processes in place ensured the administration and handling of medicines was suitable for the people who used the service. Systems were in place to ensure the premises were kept clean and hygienic so people were protected by the prevention and control of infection. There were arrangements in place to make sure action was taken and lessons learned when things went wrong, to improve safety across the service
People’s needs and choices were assessed and their care provided in line with up to date guidance and best practice. They received care from staff that had received training and support to carry out their roles. People were encouraged to prepare their own meals and make healthy choices to maintain their health and well-being. Staff supported people to book and attend appointments with healthcare professionals, and supported them to maintain a healthy lifestyle. The service worked with other organisations to ensure that people received coordinated and person-centred care and support.
People’s diverse needs were met by the adaptation, design and decoration of premises and they were involved in decisions about the environment. Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA) and they gained people's consent before providing personal care.
Staff were caring and compassionate and meaningful relationships had developed between people and staff. People were treated with dignity and respect and staff ensured their privacy was maintained. People were encouraged to make decisions about how their care was provided. Staff had a good understanding of people's needs and preferences.
People were listened to, their views were acknowledged and acted upon and care and support was delivered in the way people chose and preferred. Care plans were person centred and reflected how people’s needs were to be met. Records showed people and their relatives were involved in the assessment process and the on-going reviews of their care. They were supported to take part in activities which they wanted to do, within the service and the local community. There was a complaints procedure in place to enable people to raise complaints about the service.
The service had an open culture which encouraged communication and learning. People, relatives and staff were encouraged to provide feedback about the service and it was used to drive continuous improvement. Staff were motivated to perform their roles and worked to empower people to be as independent as possible. The provider had quality assurance systems to review the quality of the service to help drive improvement.
This unannounced inspection took place on 30 September 2015. The service provides support for up to five people with acquired brain injuries. At the time of the inspection there were three people living at the home.
There is 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.
People felt safe in the house. Staff understood the need to protect people from harm and abuse and knew what action they should take if they had any concerns.
Staffing levels ensured that people received the support they required at the times they needed it. The recruitment practices were thorough and protected people from being cared for by staff that were unsuitable to work at the service.
Care records contained individual risk assessments to protect people from identified risks and help keep them safe. They provided information to staff about action to be taken to minimise any risks whilst allowing people to be as independent as possible.
Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their support. People participated in a range of activities both in the house and in the community and received the support they needed to help them to do this. People were able to choose where they spent their time and what they did.
People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.
People were actively involved in decision about their care and support needs There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).
Staff had good relationships with the people who lived at the house. Staff were aware of the importance of managing complaints promptly and in line with the provider’s policy. Staff and people living in the house were confident that issues would be addressed and that any concerns they had would be listened to.
The registered manager was visible and accessible and staff and people had confidence in the way the service was run.
Is the service safe?
We found that assessments of people's needs had been completed before two people came to live at Hunsbury House. We saw that people had been assessed to ensure that they were safe for example with road safety or when cooking. We found that all the records relating to one other person's care and treatment requirements had not been updated since they came to live at Hunsbury House. These were updated during the day of our inspection. We also found that when improvements had been identified to keep people safe these actions had been completed promptly.
Is the service effective?
We saw that individualised care plans had been put in place for two people which ensured people's health and wellbeing needs were met. We found that people's capacity to consent to treatment had been assessed and that treatment had been discussed with people in order to prepare them for their appointments. It was clear from our observations and from speaking with staff that they had a good understanding of the individual care and support needs that people required.
Is the service caring?
We observed staff responding to people with patience and gave them time to be as independent as possible. We saw that people were supported by knowledgeable and approachable staff. We heard staff speak to people in an encouraging and sensitive way which evidenced their knowledge of people's individual needs. We found that whenever possible people had been involved in the planning of their care and support requirements so that their wishes were respected.
Is the service responsive?
Assessments included identifying any risks to people and detailing how staff should care for people to support their safety and well-being. People told us that they had access to activities and social events that were important to them. We saw records that confirmed people's interests, preferences and diverse needs had been taken into account when planning their care. This meant that care and support had been provided in accordance with peoples wishes.
Is the service well led?
The staff we spoke with had a good understanding of the ethos of Hunsbury House and their individual part they played to ensure that people were well supported in all of their day to day activities. We found that there was a system in place to monitor the quality and safety of the environment via regular audits. We were made aware that satisfaction surveys to gain feedback on the service were planned to take place within the following month.
We found that Hunsbury House was clean and well maintained.
We found that people's health needs were being looked after and that arrangements were in place to keep people safe.
We found that there was a good system in place for the management of medicines that people needed.
We found that records relating to the management of the service and staff files were accurate and fit for purpose. We had some concerns that some care plans had not been reviewed since people had recently come to live at the property, but we were satisfied that the care plans had been updated shortly after our inspection.
We found that Hunsbury House was safe, effective, and well managed.
We spoke with two staff members who told us, "I still get the same satisfaction today as I did on my first day, I reflect on things that we've achieved each day" and "the expressions of people who use the service make my job so rewarding".
We found that people who used the service had detailed care and support plans and that risks had been assessed. We found that staff had received regular training and that the provider had a suitable complaints policy in place. However we did find some concerns with the way that medication was recorded and disposed of.
One person explained that staff were 'very supportive of what residents want to achieve'. He went on to say that residents are involved in running the house and that their 'ideas are taken on board as staff are very receptive.'