Archived: Haddon House

After the comprehensive inspection the provider wrote to us to say what they would do to meet the legal requirements in relation to the breaches.

We carried out this unannounced comprehensive inspection on 1 February 2016 to check that the provider had followed their plan and to confirm that they now met the legal requirements and also to check the overall quality of the service.

Haddon House is a registered care home providing accommodation and personal care for up to 15 younger adults who live with a learning disability or autism. There were eight people living at the home and one person on respite during the day at the time of our visit. The home has accommodation provided on two floors. Accommodation consists of single occupancy bedrooms with en-suite facilities and on the first floor there are two, two bedroom flats. There are internal and external communal areas, including kitchens, lounge/ dining areas, conservatory, activities room, sensory room, and a secure garden for people and their visitors to use. There are security cameras in all communal areas of the home and this was clearly communicated to people and their visitors via notices.

There was a registered manager in place. 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 Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. There were formal systems in place to assess people’s capacity for decision making. Where people had been assessed as lacking capacity to make day-to-day decisions, applications had been made to the local authorising agencies. Staff respected people’s choices about how they wished to be supported. Staff were able to show a sufficient understanding of MCA and DoLS to make sure that people would not have their freedom restricted in an unlawful manner.

People were supported by staff in a caring and respectful way that maintained their safety, but also supported their independence. People had individualised care and support plans in place which recorded their likes and dislikes, care and support needs and the person’s wishes and goals. These plans gave staff guidelines and prompts on any assistance a person may require and information on how they would like to be supported.

Risks to people were identified by staff. Plans were put into place to minimise these individual risks to enable people to live as safe and independent a life as possible. There were arrangements in place for the safe storage of people’s prescribed medicines. Staff understood their responsibilities in the management and recording of medicines. Medicines audits, to check the amount of medication held in stock, were carried out on a daily basis to ensure accuracy. Accurate and detailed records of medicines and medicines administration were kept.

Staff cared for people in a kind way. Staff took time to reassure people who were becoming anxious in an understanding manner. People and their relatives were able to raise any suggestions or concerns that they might have had with staff and the registered manager and were listened too.

There were a sufficient number of staff on duty to meet people’s individual care and support needs. Staff were trained to provide effective care which met people’s health and social care needs. Staff understood their role and responsibilities. They were supported by the registered manager to maintain their skills through supervision, appraisals, observations and training.

There was an on-going quality monitoring process in place to identify areas of improvement required within the home. Where improvements had been identified there were actions plans in place which documented any action taken.

As part of this inspection we observed activities taking place and spoke with, or observed, six people who used the service. We also spoke with the registered manager and seven members of care staff. We reviewed records relating to the management of the service which included three care plans, daily records, staff records and quality assurance monitoring records.

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

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

Is the service safe?

People who used the service indicated that their social and health care needs were met in a safe and appropriate way. People felt safe because they showed, and said, that they liked members of staff.

Health and safety risk assessments had been carried out and measures were in place to minimise the risks, to keep people safe.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care services. Applications had needed to be submitted and proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

There was a sufficient number of staff employed or supplied to the home, to provide people with safe care. Active recruitment of new staff was taking place.

Is the service effective?

People's choices and decisions about their support and care were respected and valued.

Procedures were in place to assess people's mental capacity. People, who were considered not able to understand complex information, were represented by people who were legally appointed to do so.

People were supported to engage in social and recreational activities. People told us that they did not get bored or feel isolated during the weekdays. However, they said that they would like to be able to do more during the weekends.

Staff were trained and supported to provide people they looked after with safe and appropriate care.

Is the service caring?

People who used the service, told us that they liked members of staff because they were kind and showed an interest in the individual person. Our observations noted that members of staff interacted with people who used the service in an attentive, patient and caring way.

Is the service responsive?

Members of staff demonstrated to us that they were responsive to people's complex communication, mental health and behavioural needs. This included being able to communicate with people in a way that they could understand what was being said to them.

People's individual social and health care needs were responded to. People were supported to maintain contact with their family members. They were also supported to access a range of health care services, including psychiatric and psychology services.

Is the service well-led?

Members of staff told us that they had the training and support to safely do their job, which they said they enjoyed.

People who used the service and members of staff were provided with opportunities to make suggestions and comments to improve the quality of how the home was run.

Information in relation to accidents and incidents was analysed and remedial action was taken, if required. This was to improve the health and safety of people living, visiting or working at Haddon House.

A system was in place to carry out audits of a number of areas and by different designated people. These audits included those for medication, care records and the health and wellbeing of people living at the care home. Actions were identified with the aim to improve the quality and safety of people's support and care.

After this inspection the provider wrote to us and said that it had completed all of the necessary improvements.

At our inspection of 16 October 2013 we spent time with two people who used the service. They told us that the service provided a comfortable setting in which to live. They also said that staff were kind, caring and trustworthy. One of them said, "Staff are good to me and help me a lot."

At this inspection we found that the fire safety system had been strengthened to increase the level of protection provided for people who used the service. In addition we found that gas appliances had been certified as being safe to use.

Arrangements to protect people from the risk of fire and to ensure that utilities remained in a good condition increased the provider's ability to support people in a safe environment.

We saw that people or their representatives had been given accurate information about the fees they would have to pay. Records showed that people had been correctly charged for the facilities and services they had received.

People said or showed us that they received all of the health and personal care they needed. Records confirmed that assistance had been provided in a safe, reliable and responsive way.

We saw that people enjoyed their meals and that they had enough to eat and drink.

We found that people were not fully protected against the risk of unsafe or unsuitable premises. This was because the provider had not confirmed that there was sufficient fire safety protection. Also, gas fittings and appliances had not been checked by a competent person to ensure they remained in good working order.

We noted that staff had the knowledge and skills they needed to provide people with support that was right for them.

Documents showed that there was an effective complaints system so that concerns and complaints could be investigated and resolved.