Archived: Little Hayes Rest Home

Updated 10 March 2016

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 25 January 2016 and was unannounced. It was conducted by two inspectors and an expert by experience in the care of older people. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we reviewed information we held about the service, including previous inspection reports and notifications we had been sent by the provider. A notification is information about important events which the service is required to send us by law.

We spoke with 15 people living at the home and one family member. We also spoke with the registered manager, the deputy manager, six care staff, a member of kitchen staff and two cleaners.

We looked at care plans and associated records for five people and records relating to the management of the service. These included staff duty records, staff training and recruitment files, records of complaints, accidents and incidents, and quality assurance records.

We observed care and support being delivered in communal areas. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

The home was last inspected on 1 July 2014, when we identified no concerns.

Updated 10 March 2016

This inspection took place on 25 January 2016 and was unannounced. The home provides accommodation for up to 32 people, including some people living with dementia care needs. There were 28 people living at the home when we visited. The home was based on two floors connected by two passenger lifts; there was a good choice of communal spaces where people were able to socialise; all bedrooms had en-suite facilities.

There was a registered manager in place. 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’s safety was compromised as the risks to their health and safety were not always managed appropriately and action was not always taken to reduce the level of risk. This included the risks of people falling, choking or developing pressure injuries. People were not protected from the risk of infection as relevant guidance was not being followed in the laundry and care staff did not consistently make sure that people’s bedding was kept clean.

Staff did not followed legislation designed to protect people’s rights and ensure that decisions are only taken in the best interests of people. However, they did seek consent from people before providing care and understood how to protect people’s freedom.

People received personalised care from staff who understood their needs. However, this was not supported by the care planning system, which was disorganised and inconsistent. The registered manager showed us a new care planning system they were planning to introduce to address this.

With the exception of medicines audits, there were no effective systems in place to assess, monitor and improve the service, such as the management of risks to people, infection control arrangements and care planning.

Medicines were managed safely, although procedures to make sure medicines were always available were not robust. We have made a recommendation about this.

People told us they felt safe at the home. Staff knew how to identify, prevent and report abuse, and the provider responded appropriately to allegations of abuse.

The process used to recruit staff helped make sure that only suitable staff were employed. There were enough staff to meet people’s needs at all times. Staff were knowledgeable, suitably trained and were supported appropriately in their work.

People were offered varied and nutritious meals, enjoyed the food and received appropriate support to eat and drink enough. They had access to healthcare services, such as doctors and nurses, when needed.

People were involved in planning the care and support they received, although they were not always involved in reviews of their care. They were treated with kindness and compassion by staff who knew them well. Their privacy and dignity was protected and staff encouraged them to remain as independent as possible.

Staff encouraged people to make choices about all aspects of their lives and were responsive to people’s needs. People had access to a range of suitable activities. The provider sought and acted on feedback from people and staff.

There was a clear management structure in place. Staff understood their roles, were motivated, and worked well as a team. There was an open and transparent culture; visitors were welcomed and there were strong links to the local community.

We identified breaches of regulations 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.