At the last inspection, the service was rated Good. During this inspection we found the service remained Good. The service remained good because effective care was carried out by staff and the management team who had the skills and knowledge to ensure people received safe care. Health care services were accessed to regularly monitor people’s well being and they were supported by staff that provided personalised care and support.
We conducted an unannounced inspection of Hazel House on 28 October 2014. The service provides care and support for up to 10 people with mental health problems or learning disabilities. There were 10 people using the service when we visited.
At our last inspection on 18 October 2013, the service met the regulations inspected.
The service had 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.
Safeguarding adults from abuse procedures were robust and staff understood how to safeguard the people they supported. Staff had received training on safeguarding adults and were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.
Safe practices for administering and storing medicines were followed. Records were kept when medicines were administered and a second member of staff countersigned these.
Staff were trained in the Mental Capacity Act 2005 which is a law to protect people who do not have the capacity to make decisions for themselves. Staff were also trained in the Deprivation of Liberty Safeguards which are part of the Mental Capacity Act and exist to make sure that people’s freedom is not inappropriately restricted where they lack the capacity to make certain decisions. Staff demonstrated a good understanding of their responsibilities.
People and their relatives were involved in decisions about their care and how their needs were met. People had care plans in place that reflected their assessed needs.
Recruitment procedures ensured that only people who were suitable, worked within the service. There was an induction programme for new staff, which prepared them to do their role. Staff were provided with a range of training to help them carry out their duties. Staff received regular supervision and appraisal to support them to meet people’s needs. There were enough staff employed in the service to meet people’s needs.
People were supported to eat a varied diet that took account of their preferences and their nutritional needs were monitored. People were supported effectively with their health needs and had access to a range of healthcare professionals. People were involved in making decisions about what kind of support they wanted.
Staff and people who used the service felt able to speak with the registered manager and provided feedback on the service. They knew how to make complaints and there was an effective complaints policy and procedure in place. We found complaints were dealt with appropriately and in accordance with the provider’s policy.
The service carried out regular audits to monitor the quality of the service and to plan improvements. Where concerns were identified action plans were put in place to rectify these.
People's support plans and assessments of risks were reviewed every three months in line with the service's own guidelines and updated in between those times when required.
The registered manager was the safeguarding lead in the service. There was a safeguarding policy and a safeguarding flow chart to summarise the safeguarding adults' process for staff to follow.
Staffing levels were planned and adjusted to accommodate the needs of people using the service and these were generally being met. There were also arrangements in place to cover for shortfalls. People told us how staff supported them with particular tasks, such as with shopping and organising appointments.
The provider had systems to identify, assess and manage risks to the health, safety and welfare of people and staff using the service. The service carried out quarterly audits as determined by Turning Point's head office. They carried out these audits against an internal quality assurance tool (IQAT) which were organised against the Care Quality Commission's essential standards of quality and safety.
People who used the service told us they were able to choose what they wanted to do with their day and most of them said they had given their written consent for specific tasks. They told us they felt cared for and their welfare was looked after by staff. One person said 'they do look after me'. One person said if they were 'upset' about anything they would talk to staff. People also knew how to raise concerns if they needed to. One person said they would approach anyone in the staff office or the manager and felt their concerns would be acted on.
On the day of the inspection we found there were appropriate arrangements in place in relation to the management and administration of medicines.