Halcyon Days

We found the following examples of good practice.

Safe visiting procedures were in place. Visitors were required to provide a negative test before being allowed to enter the home. Alternative arrangements were in place for visits at the time of our inspection due to a COVID-19 outbreak.

Staff were trained in safe use of their personal protective equipment (PPE) which was readily available around the home. Staff wore their PPE correctly and washed their hands often. They were allocated to work as much as possible to the same areas in the home.

The management team carried out regular observations of staff practices as well as infection control audits. Any actions needed were completed promptly. People lived in a clean and well-ventilated environment.

There were enough staff on duty to meet people’s needs safely and in a timely manner. When agency staff were used, they were tested prior of their shift. The management team aimed to book the same agency staff for the available shifts to lower the number of new staff working in the home.

Halcyon Days provides care and support to up to 57 people some of who live with dementia. At the time of our inspection 39 people were living at the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service does not have a registered manager. 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 at the service. Staff had received relevant training on how to safeguard people and understood their responsibilities to report any concerns. Risks to people’s safety and well-being were identified and managed to keep them safe from harm. Assessments were in place that gave guidance to staff on how individual risks to people could be reduced. Medicines were stored appropriately, managed safely and audits completed. Relevant pre-employment checks had been completed for all staff and safe recruitment practices followed. People were supported by sufficient numbers of staff.

People felt staff were well trained. Staff had attended relevant training to undertake their role and spoke positively about the training they were provided. Staff felt supported and attended regular supervisions and appraisals. People’s consent was obtained, and staff were aware of how to support those people who may not be able to provide their consent. People’s nutritional needs were met and the deputy manager was reviewing how people were provided with additional nutritional snacks.

People told us that staff were friendly and respected their privacy. Staff knew people well and were knowledgeable with regards to people’s individual needs. People felt staff knew what was important to them and knew how people chose to spend their day. People's privacy and dignity was promoted.

People’s individual needs were assessed and people or where appropriate, their relatives were involved in the planning of how their support would be delivered. Care and support plans had been regularly reviewed to ensure that they were reflective of people's current needs. People were encouraged to provide feedback on the service they received and knew how to make a complaint.

People were not aware who the acting manager was. Staff were not aware of the plans to fill the managers vacancy, however were supportive and positive about the interim management of the service. People’s care records were not always updated when people’s needs changed. Quality assurance systems were in place and regular audits completed but although these were not effective, we could see ongoing development work was in place as a result of these findings. Staff were encouraged to attend team meetings which were held regularly.

The service had a registered manager in post who had registered with the Care Quality Commission as they are required to do. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 occasionally experienced delays whilst waiting for their care to be provided. Staff however took sufficient time to carry out their tasks and the registered manager took action to remedy the deployment of staff during the inspection. Risks to people’s safety and wellbeing were safely managed with appropriate equipment in place to support people’s health needs. Staff were aware of how to keep people safe and were aware of when to report a concern. People were supported by staff who had undergone a robust recruitment process to ensure they were suitable to work with vulnerable people. People’s medicines were administered as the prescriber intended, although we identified one issue with management of medicines that we have reported in the ‘well led’ domain.

People were supported by staff who were well trained and supported by effective leadership to develop their skills and provide effective care. Care staff received regular supervision of their conduct and practise. People's consent was sought and staff worked within the principles of the Mental Capacity Act 2005 when people lacked the capacity to make their own decisions. However these decisions were not consistently documented. People were happy with the food and drink provided to them and where people were at risk of weight loss, staff took appropriate the actions. People were supported by a range of health professionals.

Staff spoke and interacted with people in a kind and friendly manner, and clearly demonstrated a caring approach to meeting people’s individual needs. Staff ensured people’s dignity and privacy was maintained at all times and supported people's social needs. People felt able to raise a concern or complaint with staff who they felt would take appropriate action to resolve these. People were provided with regular opportunities to meet in order to discuss improvements in the home or be kept abreast of developments.

Changes over the previous 12 months within the providers management team meant the service had not received consistent levels of support including the registered manager until the recent changes to the providers registration. Systems to monitor and improve the quality and safety of the service had identified issues with governance arrangements, but had not effectively managed these. Systems that were in place regarding the management of medicines were not followed by those staff trained to do so. Peoples care records including those relating to mental capacity required reviewing to ensure they were accurate and up to date. Management of staff deployment had not been sufficiently reviewed to ensure people’s needs were met. People and staff told us the management team were visible and responsive. The views and opinions of people, relatives, staff and health professionals had been sought. Meetings were held regularly with staff and feedback regarding the quality of care people received was in the process of being obtained.