Haddon Hall Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The provider had systems in place to ensure risks to people were reduced. The environment was safe and clean throughout. People’s needs were assessed and people’s transition into the service was well managed. Staff knew people well and knew how to provide them with the support they needed. People were protected from the risk of abuse. There were enough staff to respond to people’s needs. Staff had the training and knowledge they needed to support people. Appropriate actions were taken following accidents or incidents. When things went wrong, action was taken to reduce the risk of events re-occurring. People and their relatives were happy with the support provided. Medicines were administered safely.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives told us the home was open and transparent. People told us the provider’s processes had improved since the previous inspection and they had systems in place to ensure this was communicated. Relatives said they were informed of any safety concerns, and they were given regular updates. Meetings were held with people and their relatives. They were asked how the provider could make things better and people felt improvements were visible. A relative told us, “I was impressed with the honesty of management following the last CQC report”.

Not all staff spoken with told us there was a positive culture at Haddon Hall. Some staff told us they were not always told of events that happened at the home. However, most staff told us safety concerns were investigated and learnt from. The manager told us of the processes when incidents occurred. This involved investigating the concern, notifying relevant agencies, and analysing the concern to determine any lessons learned. The manager told us they felt it was important that lessons learned were shared with the wider staff team and told us of the various systems they had in place to ensure this was communicated.

We found the provider had improved systems and processes in place for learning. We reviewed the actions the manager had taken. For example, analysing accident and incident data and reviewing people’s care to mitigate the risk of re-occurrence. Changes to people’s care was communicated to staff using the various communication systems the provider had in place. The provider understood their responsibility around the Duty of Candour and had processes in place. The Duty of Candour is a regulation which all providers must adhere to. Under the Duty of Candour, providers must be open and transparent, and it sets out specific guidelines' providers must follow if things go wrong with care and treatment.

We were told how people were supported through transition into the service. The provider gave people support and assurances through this to ensure they felt comfortable. A relative told us, “I was impressed how thorough and accommodating Haddon Hall was in the transition period, the staff worked well to get to know my family member and how best to support them”.

We spoke with healthcare professionals who work closely with the provider. We were told there were previous concerns with the provider which had now been addressed. We were told by community health services and local commissioners that the provider had improved and there are now no concerns relating to the care being provided by Haddon Hall. The provider was working with partners to ensure continuity of care. For example, information was being regularly shared by the provider with relevant external professionals.

We reviewed the providers admission process and found key information was collected from the person, their relatives and any external professional involved in the person’s care. This enabled a positive transition into the service. The manager had developed an admission process which involved the person being welcomed and meeting staff to seek their views and preferences.

Some staff did not always consider they were given enough information about people on their admission to the home. However, most staff told us they were provided with information on people who had been recently admitted during daily handovers. Staff told us they spend time with people to learn about their needs on a person centred basis. The manager told us clinical meetings were held regularly to monitor risks to people.

People felt safe living at Haddon Hall. Relatives told us they were told of any safeguarding matters relating to their family member and communication from the home was good. A relative told us, “I know who to contact if I did have any concerns. I am confident they would listen and act on anything, as they care”.

The provider had processes in place to monitor safeguarding concerns. This demonstrated where action had been taken. For example, the provider had made referrals to healthcare professionals, the police and they had submitted statutory notifications. There was a safeguarding policy and procedure in place to protect people from abuse. The provider’s safeguarding policy stated how to raise a safeguarding alert and who to contact. Deprivation of Liberty Safeguards (DoLS) had been submitted, where appropriate. The provider was working in line with the Mental Capacity Act (MCA).

We observed staff interact with people in a kind and respectful manner. People were witnessed to be comfortable at the home and had good relationships with the staff.

The manager told us about the training in place to ensure all staff were aware of their responsibilities in respect of safeguarding people from abuse. The provider ensured systems were in place to regularly check staff’s understanding and competence of delivering care safely. The manager told us of their open door approach and how they ensured they were a visible presence in the service to assist people, staff and relatives. The manager wanted to be available to listen and action any concerns. Staff told us how they identify abuse and knew how to raise an alert. Staff told us they were confident about raising any concerns internally or externally.

People were supported to maintain their independence in a way that was safe for them. We were told how staff understood people’s needs well, including people who were living with dementia. For example, a relative told us, “Staff have invested time in getting to know my family member and they show genuine interest and value them as an individual”. People and relatives trusted staff. A person told us, “I am surrounded with people who understand and care for me”. Where people presented distress, staff was able to recognise changes in the person and offer distraction. Staff spent time with people and supported them in engaging in activities. However, 1 person felt small improvements would better their experience.

We observed staff provide support to people’s risks safely. For example, when moving and handling, staff explained the support they were providing. We saw staff were responsive to any potential risks and supported people to be safe. For example, a person was observed to be over the side of their mattress. Staff supported this person to be in a more comfortable position and safely in their bed.

The manager told us how they involved people and their representatives in the planning of their care. This started from the pre-assessment process. People had the choice to fully review their care plans every 6 or 12 months. Staff told us that they spend time getting to know people individually. A staff member told us, “When we know the things that matter, we will do everything we can to ensure this is upheld and met”.

We reviewed peoples care plans and we found they provided staff with guidance on how to mitigate people’s known risks. Care plans had been developed with people and their relatives and were regularly reviewed and updated. People’s health was regularly monitored with concerns timely identified, monitored and actions taken. For example, where people had lost weight, referrals were made for dietitian input.

Staff told us that the environment was safe. They felt that there was adequate equipment and facilities in place to keep people safe and free from harm. Leaders told us that suitable equipment was in place and where any equipment is damaged, this would be repaired.

The provider undertook safety checks of the environment, our observations found some minor issues. For example, a chair that had been positioned in front of a fire exit. We raised this with the provider and prompt action was taken. On our second site visit, this had been removed. The environment was safe and well maintained. Each person’s bedroom was personalised.

People who we spoke with told us the environment was safe, and they felt the home was secure. People’s specialist equipment was accessible to them so that they could mobilise safely. People and relatives shared that the home had appropriate adjustments in place to enable people’s independence and keep people safe. For example, having handrails on both sides of corridors. The provider had made the home a positive environment. One relative told us, “The atmosphere in the home is lovely and homely”.

Although systems were in place to maintain a safe environment, the provider did not always have plans for when the maintenance person was not at work. For example, fire alarm testing had not been completed for several weeks. A detailed business contingency plan had been developed to ensure staff were aware of actions they needed to take in the event of an emergency.

Not all staff felt there was adequate staffing levels at the home, mostly during the night. However, most staff felt this had improved, and the home was not reliant on agency workers. Staff felt they received enough training to do their jobs effectively.

During the site visit we observed there were safe staffing levels. We observed staff to respond to people in a timely manner. We saw staff were kind and caring in their nature when speaking with people. Staff carried out tasks safely. For example, moving and positioning people in line with best practice.

The provider had systems in place to ensure adequate staffing within the home. There was an allocations list which the provider had assigned staff to key roles to ensure people’s needs were met and to drive efficiency within the staff team. The proper monitored staffs training to ensure compliance with mandatory training.

Feedback from people and relatives told us they were confident in the staff at the home. We were told how staff received training in caring for people living with dementia. A relative told us, “The staff are well trained in understanding dementia, and they are very patient”. The provider had improved call bell wait times and most people told us their care needs were responded too in a timely manner. A person told us, “If I use the call bell the staff are very quick to respond”.

We were told the home was clean and infection prevention control was managed well within the home. A relative told us, “The home is spotless. My family member is always clean and tidy and in their own clothes”.

The provider had up to date infection prevention and control (IPC) policy in place. Leaders regularly completed IPC audits and where improvements were identified, action was taken.

The provider told us all staff received ongoing training in infection prevention control. Some staff received additional training, specific to their role. For example, housekeeping staff received training on cleaning products and sanitation. The home trainer completed observations of staff, to ensure control measures were followed.

We observed the service to be clean and odour free. Infection prevention and control measures were seen in place and staff followed the providers policy. Housekeeping staff were observed cleaning throughout the day and a resident of the day system was in operation to ensure deep cleaning regularly took place.

Staff involved in handling medicines had received training and were assessed as competent to support people with their medicines. Medicines were recorded on an electronic system and records showed people had received their medicines as prescribed. The provider had a good relationship with their local GP, who visited the home regularly. Robust systems were in place to monitor medicine administration, these were effective in identifying discrepancies.

We were told there had been some concerns with medicines stock and obtaining this in a timely manner. The provider had responded proactively, by working with external and internal colleagues to solve this. Staff and leaders told us people’s preferences in relation to medicines administration are respected and they understood and acknowledged people’s rights to refuse medicines.

People told us they were given their prescribed medicines safely. We were told people and their relatives were involved in their medicines, and they were informed of any changes. A relative told us, “I am confident and trust the staff. They are aware of any medical changes and act on them. If my family member presents any different, the staff contact the GP”.