Archived: Hevercourt

Updated 30 June 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 7 and 8 April 2015. The inspection team consisted of three inspectors and an expert by experience. The expert-by-experience had a good knowledge of services that provided care for older people living with dementia.

Prior to the inspection we looked at previous inspection reports and notifications of important events that had taken place at the service that the provider had a legal duty to tell us about. We took account of information sent to us by the local authority contracts team. We asked the registered manager to send us information about independent quality audits that had been carried out. They sent this to us within 24 hours of the inspection.

We spoke with nine people and eight relatives about their experience of the service. We spoke with 11 staff including nine care workers, the deputy manager of the service to gain their views. We asked three health and social care professionals for their views about the service. We observed the care provided to people who were unable to tell us about their experiences.

We spent time looking at records, policies and procedures, complaint and incident and accident monitoring systems. We looked at four people’s care files, ten staff record files, the staff training programme, the staff rota and medicine records.

Updated 30 June 2015

The inspection was carried out on 7 and 8 April 2015 and was unannounced.

At the previous inspection in April 2014 we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The breaches were in relation to the accuracy of records because not all risks associated with people’s care had sufficient guidance for staff to follow and staff were not always receiving supervision. The provider sent us an action plan telling us they would be meeting the regulations by 2 January 2015. At this inspection we found they were meeting the regulations and improvements had been made.

The service provided accommodation and personal care for older people some of whom may be living with dementia. The accommodation was adapted for people living with dementia and is arranged over three floors. There were 36 people living in the service when we inspected. A passenger lift is available to take people between floors.

There was a registered manager employed at the service. 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) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice. The registered manager understood when an application should be made. Decisions people made about their care or medical treatment were dealt with lawfully and fully recorded.

Appropriately trained staff were not always deployed to deliver care in a timely way which meant people did not receive their medicines at the times it had been prescribed.

We have made a recommendation about this.

People felt safe. Staff had received training about protecting people from abuse and showed a good understanding of what their responsibilities were in preventing abuse. Staff were trained to spot the signs of abuse in people living with dementia. The management team had access to and understood the safeguarding policies of the local authority.

Risks were assessed and management plans implemented by staff to protect people from harm. The risk in the service was assessed and the steps to be taken to minimise them were understood by staff.

The registered manager and care staff assessed people’s needs and planned people’s care to maintain their safety, health and wellbeing. Assessments and care plans were reviewed as people’s needs changed or their dementia became more challenging.

There were policies and a procedure in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.

People had access to GPs and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell. There were good links with the district nursing team to promote people’s health and wellbeing. Additional training and skills development was provided to staff so that they understood how to manage people with behaviours that may challenge.

People and their relatives described a service that was welcoming and friendly. Staff provided friendly compassionate care and support. People were encouraged to get involved in how their care was planned and delivered.

Staff upheld people’s right to choose who was involved in their care and people’s right to do things for themselves was respected.

The registered manager involved people in planning their care by assessing their needs when they first moved in and then by asking people if they were happy with the care they received. Staff received training about dementia and knew people well. People had been asked about who they were and about their life experiences. This helped staff deliver care to people as individuals.

Incidents and accidents were recorded and checked by the registered manager to see what steps could be taken to prevent these happening again. However we found one incident that had not been checked by the registered manager.

The registered manager ensured that they had planned for foreseeable emergencies, so that should they happen people’s care needs would continue to be met. The premises and equipment in the service were well maintained.

Recruitment policies were in place. Safe recruitment practices had been followed before staff started working at the service. The registered manager ensured that they employed enough staff to meet people’s assessed needs. Staffing levels were kept under constant review as people’s needs changed.

Staff supported people to maintain their health by ensuring people had enough to eat and drink. All of the comments about the food were good.

If people complained they were listened to and the registered manager made changes or suggested solutions that people were happy with.

People felt that the service was well led. They told us that the management team were approachable and listened to their views. The registered manger and provider monitored health and safety within the service to prevent accidents. The care being delivered and the development of the service was focused on recognised best practice for people living with dementia.

We found a of breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.