Handford House Care Home

Updated 22 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 10 February 2022 and was announced. We gave the service two days’ notice of the inspection.

Updated 22 February 2022

Handford House Care Home 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 provides residential and nursing care in a purpose built building for up to 52 older people, some of whom are living with dementia. There were 51 people living in the service when we inspected on 19 and 20 April 2018. This was an unannounced comprehensive inspection.

We last inspected this service in April 2017 and rated the service as ‘requires improvement’ in all key questions. We found the home was in breach of five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

During that inspection, we found that, there were insufficient numbers of staff on duty; staff were not always deployed effectively in order that they could meet people's needs effectively. Staff were not always well supported, and they did not receive any formal supervision or appraisal.

We also found that, although all medicines were administered by staff who were trained to do so, some aspects of the medicines management needed improvement. People's care records did not demonstrate their involvement in decision making. Mental capacity assessments were not completed and best interest meetings had not always taken place for people who lacked capacity to make decisions for themselves.

Care plans were not all up to date; the information within them was not always current. We could not be confident that people always received the care and support they needed. People received support from staff that were mainly kind and caring. However, people were not always treated with dignity and respect because staff were task focussed and care took place in a manner that was not centred on people as individuals and was at times hurried.

There was a quality assurance audit in place however the system was not always effective because issues identified at the inspection had not been recognised during the monitoring and auditing process. This meant that the systems in place to assess and monitor the quality of care provided were not effective.

Following that last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the quality of care a support people received to at least good.

During this inspection on 19 and 20 April 2018, we found that improvements had been made to meet the requirements to help ensure that people received a good service and were no longer in breach of regulations.

Handford House Care Home has had a newly registered manager since our last inspection in April 2017. 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 took up their post in June 2017 shortly after the previous manager had left. The new manager completed their registration process with us in September 2017. The people who used the service, their relatives and staff told us that they thought the new registered manager had made many positive changes to the quality of the service people received.

The people we spoke with and relatives also said they believed people were safe and well cared for. There were systems in place that provided guidance for staff on how to safeguard the people who used the service from the potential risk of abuse. Staff understood their roles and responsibilities in keeping people safe. There were processes in place to ensure the safety of the people who used the service. These included risk assessments, which identified how risks to people were minimised.

There were sufficient numbers of trained and well supported staff to keep people safe and to meet their needs. Where people required assistance to take their medicines there were arrangements in place to provide this support safely, following best practice guidelines.

Both the registered manager and the staff understood their obligations under the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The registered manager knew how to make a referral if 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 support this practice.

People were supported to eat and drink enough to maintain a balanced diet. They were also supported to maintain good health and access healthcare services.

There were arrangements in place to make sure the service was kept clean and hygienic.

We saw many examples of positive and caring interactions between the staff and people living in the service. People were able to express their views and staff listened to what they said and took action to ensure their decisions were acted on. Staff protected people’s privacy and dignity.

People received care that was personalised and responsive to their assessed needs. The service listened to people’s experiences, concerns and complaints. Staff took steps to investigate complaints and to make any changes needed.

People’s relatives and the staff told us that the registered manager had made positive changes in the service and that they were open and had good leadership skills. There were systems in place to monitor the quality of service offered people.

Further information is in the detailed findings below.