Background to this inspection
Updated
23 February 2022
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.
As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.
This inspection took place on 11 February 2022 and was announced. We gave the service 24 hours notice of the inspection.
Updated
23 February 2022
This inspection took place on 20 November 2018 and was unannounced.
Hylands House is a residential home which provides care to older people including some people who are living with dementia. Hylands House is registered to provide care for up to 21 people. At the time of our inspection there were 17 people living at the home. The home has spacious living areas and is set over two floors with lifts to enable people to easily access both floors. The home is set in a residential area with easy access to the local community and has a large garden.
People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.
This service was last inspected in June 2016 when we rated the service as ‘Good’ overall. However, we found some improvements were required in the leadership of the service because systems of audits were not managed or regularly completed so it was difficult to see what had been identified as requiring improvement and what actions had been completed. At this inspection we found similar issues, so whilst the rating of the service remains ‘Good’ overall, further requirements are required to ensure checks and audits are recorded and effective and records are consistently maintained.
There was a registered manager in post. 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 registered manager had recently gone on extended leave of absence and the provider had recruited a new manager to lead the service while the registered manager was away. The new manager had been in post for two weeks at the time of our inspection visit and was in the process of registering with us. This meant they would have the legal responsibilities of a registered person during the other registered manager’s absence.
People’s needs were met by sufficient numbers of staff. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Staff recognised the signs of potential abuse and knew how to protect people from harm. Staff had undertaken training to help them provide effective care to people. Staff had not always had opportunities to speak with a manager about their developmental needs, but this had been recognised by the new manager and action had been taken.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Deprivation of Liberty Safeguards applications had been submitted to the local authority when people’s care plans contained restrictions to keep them safe which people did not have the capacity to consent to.
People had sufficient amounts to eat and drink to ensure their dietary and nutritional needs were met. Staff supported people to access other health and social care services when they needed to and attend healthcare appointments when required. People received their medicines as prescribed.
People were treated with kindness by staff who knew them well and understood them. People were happy with the caring attitude of staff. Staff were respectful of people and promoted their dignity by supporting them to maintain their appearance.
People had person centred care plans which were inclusive of people’s views and wishes. Support plans were regularly reviewed so staff had the most up to date information to support people. Good communication between staff meant people’s changing needs were responded to appropriately.
Records and checks were not consistently maintained. The new manager spoke openly about some policies and procedures that needed to be improved to ensure people received consistent standards of care. They had already started to make improvements which were supported by staff. The new manager understood the need to get to know people and their relatives and listen to their views so they could identify where improvements were needed to improve outcomes for people.