Hayes Close

About the service

Hayes Close Residential Home is a residential care home providing personal care. It is registered to support up to seven people with a learning disability or autistic people. At the time of our inspection there were six people using the service.

People's experience of using this service and what we found

We have made recommendations about risk management, governance and oversight.

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support

People were supported and encouraged to take part in a range of activities, both at the service and in the wider community. The registered manager and staff ensured people’s relatives were involved in the care and support of people, providing updates via telephone and social media. The premises were homely, mostly clean, comfortable and had a large secure garden with a summer house and plant potting area. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right care

Staff provided people with care and support which was personalised to their individual needs. They knew people well and communicated effectively with them using pictures, signs and speech. People had the opportunity to make choices about their daily routines and activities and staff encouraged people to do this. People and their relatives told us they were treated with dignity and respect. Staff protected people’s privacy and knew how to do this safely.

Right culture

There was a lack of oversight of the service in some areas. Governance and performance management was not always reliable and effective, and risks not always identified. This was accepted by the registered manager who acted promptly to address shortfalls. However, the culture of the service was always caring, and staff put people first and empowered them to lead meaningful lives and be part of their local community.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 21 November 2018).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well Led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hayes Close on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Hayes Close is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates seven people. On the day of our inspection seven people were using the service.

The care service had not originally been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. However, people were given choices and their independence and participation within the local community encouraged.

At our last inspection on 23 March 2016 we rated the service ‘good.’ At this inspection we found the evidence continued to support the rating of ‘good’ overall but there had been a deterioration in well led which was rated as ‘requires improvement’. 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.

People continued to receive a safe service where they were protected from avoidable harm, discrimination and abuse. Risks associated with people’s needs had been assessed and planned for. Risk assessments were reviewed monthly to ensure they reflected people’s most up to date circumstances. Staff followed the information in people’s risk assessments which ensured that people consistently experienced care and support that was safe. People did not have any undue restrictions placed upon them and were encouraged to be as independent as possible.

There were sufficient suitably skilled and experienced staff to consistently meet people’s needs. Safe staff recruitment procedures were in place and used to ensure that only staff who met the services high standards worked there. People received their prescribed medicines safely and these were managed in line with best practice guidance. Accidents and incidents were analysed for lessons learnt and these were shared with the staff team to reduce further reoccurrence and protect people from harm.

People continued to receive an effective service. Staff received the training and support that was specific and relevant to people’s individual needs. People were supported with their nutritional needs. The staff worked very well with external health care professionals, people were supported with their needs and accessed health services when required. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The principles of the Mental Capacity Act (MCA) were followed.

People continued to receive care from staff who were kind, compassionate and treated them with dignity and respected their privacy. Staff had developed positive relationships with the people they supported. They had a very good understanding of people’s needs, preferences, and what was important to them. Staff used innovative and creative means of communication with people who had communication difficulties. They knew how to comfort people when they were distressed and made sure that emotional support was provided. People’s independence was promoted and they were supported to make informed choices about their care and support.

People continued to receive a responsive service that was strongly focused on their unique individual needs. People’s needs were assessed and planned for with the involvement of the person and or their relative where required. Care plans were highly personalised. People were supported to pursue their interests and hobbies, and they participated in social activities at the home in Whitwick and neighbouring areas. There was a complaint procedure in an easy to read format that people could access if they wanted to make a complaint.

The service was rated ‘requires improvement for ‘well led’ at this inspection. This was because several incidents that should have been notified to the Care Quality Commission (CQC) had not been notified. Action was taken immediately by the provider’s audit, quality and compliance manager and the registered manager to ensure that in future all necessary notifications would be made to the CQC. There was an open and transparent and person-centred culture with strong leadership.

Further information is in the detailed findings below.

Hayes Close provides accommodation for up to seven people who have a learning disability. At the time of our inspection seven people were living at the home. The service is on two floors accessible by stairs. There is a communal lounge as well as two separate dining areas for people to use. All of the bedrooms are single occupancy. There is also access to a garden area for people to use should they choose to.

It is a requirement that the home has a registered manager. 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. The service had a registered manager in place at the time of our inspection.

People did not have concerns about their safety and staff knew how to protect them from abuse and avoidable harm. The registered manager had investigated accidents and incidents to look at ways to prevent them from reoccurring. Risks that people were vulnerable to had been assessed and there were regular checks on the equipment and the premises. There were plans in place that were available to staff to support people to keep safe during emergencies.

People and their relatives were satisfied with the amount of staff available. The provider’s recruitment process was robust and included checking prospective staff before they started to work at the home. This helped the provider to make safer recruitment decisions.

People received their medicines as prescribed. The registered manager had made arrangements for the safe storage and handling of medicines. Only staff that were trained handled medicines. Where people may have needed medicines to help them to reduce their anxieties, this was only offered when other strategies had been tried first.

People received support from staff who had the appropriate skills and knowledge to support people with learning disabilities. Staff had received regular training in areas relevant for the people they supported.

People were being supported by staff that knew about their roles and responsibilities. Staff received an induction when they had started in their role and on-going support from the registered manager.

Staff understood the requirements of the Mental Capacity Act (2005) and understood how to obtain people’s consent before they offered care and support. Staff knew how to support people to make decisions for themselves. Where people may have lacked the capacity to make their own decisions, the provider had followed the requirements of the Act.

People enjoyed the food that was offered to them and were supported to maintain a healthy diet. They could choose what they ate and their preferences and requirements were known by staff.

People had access to healthcare professionals to maintain good health. They were supported to contribute to monitoring their own health and well-being where they could.

People were being supported by staff who cared. They had built relationships with staff that were friendly and warm. Relationships that were important to people had been maintained. People’s dignity and privacy was being upheld by staff and their personal information was being kept secure.

People’s preferences, backgrounds and things that were important to them were known by the staff team. Their care and support was based on these and staff were flexible where people had made specific requests. People enjoyed a full range of activities and interests that they had chosen to be part of.

Where people could, they had been involved in and had contributed to the planning and reviewing of their care and support. Where this had not been possible, relatives had been included. People’s support plans were individual to them and written in detail so that staff would know how to offer care and support. People were being encouraged to retain and learn new skills and to be as independent as possible.

People had independent advocacy services information available to them to help them to speak up if they had required this support. People and their relatives knew how to make a complaint. There was a complaints procedure in an easy to read format to support people to be able to understand it. Feedback about the quality of the service had been sought.

There were clear aims and objectives that the staff knew and worked towards to deliver a quality service. The registered manager was described as approachable and supportive. The provider had supported the registered manager to look at ways to improve the outcomes for people who used the service.

Staff were clear about their roles and responsibilities. They knew how to raise concerns if they had needed to about the practice of a colleague. Staff were able to make suggestions for how the service could improve.

The registered manager understood the requirements of their role. They had carried out quality checks to monitor and improve what the service was offering people.

People had a range of assessments and care plans in place to inform staff about how to support people and meet their daily needs. People were supported to take their medicines. Records showed risks identified were managed to ensure people's care and health needs were met safely by the staff and health care professionals.

People were supported by staff recruited that were suitable and qualified to work with vulnerable people. One person told us they felt safe because staff understood them and said: 'I can always talk to ', she's my key worker.'

Information about the people who used Hayes Close was kept in their individual care files and stored securely. Staff were aware of their responsibilities to maintain accurate records. Other records relating to the staff and the management of the service were accurate, kept secure and could be easily accessed when required.

Information about the service was produced in formats suitable for people using the service. Care plans were written with the person's involvement and pictures and photographs were used to signify important aspects of their life.

People received a choice of meals to suit their dietary requirements and preferences. Meals were prepared by trained staff taking account of people's dietary needs. Whilst staff knew people's preference of food and drink, this was not always evident in the care plans.

People were cared for and supported by trained staff that promoted their safety, independence and wellbeing. Staff maintained their knowledge and skills through regular updates, support and supervision.

Information about how to make a complaint was available in suitable formats for people using the service. People were confident to express concerns verbally or using other modes to communicate their concerns. One person said: 'I've got no complaints, but if I did I would tell the manager, she will sort it out for me.'