The inspection of Hallgarth Care Home took place on Tuesday 11 November 2014 and it was unannounced. We last inspected the service in May 2013 when we found there was a breach of regulation 12 on cleanliness and infection control. In September 2013 the provider had improved in this area. Audits had been carried out, cleaning schedules completed (the shower chair was clean) and hoist slings stored safely. There was no longer a breach of regulation 12.
The service provided care for 45 older people and younger adults, some of whom may have had a dementia related condition. There were single occupancy bedrooms, some with en-suite toilet. Bathrooms were shared. There was a large dining room and two lounges with small sitting areas in other parts of the building. At the time of our visit there were 43 people using the service.
It was a requirement of registration that this type of service had a registered manager in post. There was a registered manager in post who had been registered and working at Hallgarth for the past six years. 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 we spoke with told us they felt safe living at Hallgarth and that staff treated them well. Staff had good knowledge of how to keep people safe because of training in safeguarding people from harm. There were systems in place to ensure any concerns or allegations of harm were investigated by the local authority safeguarding team.
Risks to people were well managed, the premises were well maintained and there were emergency plans available to staff should a crisis arise.
Staffing levels were determined by people’s needs and staff were deployed to meet people’s needs based on when people required the most help. Staff were safely recruited in line with regulation 21. People received their medication safely because management of medicines was safe.
We found that staff were trained to provide the care people needed. Staff were regularly supervised, supported to provide the best care their skills would allow and rewarded for their performance. They understood the requirements of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards when these applied to the people they cared for.
Staff knew the importance of obtaining consent from people to support them and they had knowledge of people’s nutritional requirements, choices and needs. People’s health care needs were effectively understood, monitored and addressed when required. There was effective communication between the organisation and the registered manager and between the registered manager and staff.
The registered manager expected staff to have and demonstrate caring values in their daily work. People and relatives told us staff were kind and caring. We observed staff approaching people professionally but compassionately and they were sensitive to people’s demeanour.
Care plans contained the information staff needed to support people well. People had been assessed and plans had been put in place to tell staff how best to support them. This was in the way people chose and wanted to be supported.
We saw that activities were facilitated by staff and enjoyed by people that used the service.
Complaints were positively addressed. People told us they could speak up any time about anything and were confident they would be listened to and their concerns would be resolved.
We found there was an open and pro-active culture within the service, based on a need to learn from mistakes and improve on performance. The registered manager led by example and instilled values in the staff that put people’s welfare at the forefront of the service.
Opportunities were taken by the management to seek people, relative and staff views about the service. These views were quality monitored, assessed, analysed and used to inform future improvements in practice and care delivery.