We carried out a review of the data available to us about Hazeldene on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hazeldene, you can give feedback on this service.
Hazeldene is a residential care home providing personal care to 10 people with a diagnosis of learning disabilities and associated health needs at the time of the inspection. The service can support a maximum of 10 people. It offers bedrooms and communal space over two buildings. One building is home to four people whose bedrooms are split over two floors. Two of the bedrooms are en-suite whilst the other two bedrooms share a bathroom. A communal lounge, open plan dining room and kitchen, and laundry room offer facilities to people in one of the buildings. The other building offers additional communal space with a day room, quiet room, separate dining room, lounge, laundry and communal bathrooms / kitchen catering to six people living across two floors. Each building offers a large garden that people are encouraged to utilise.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was designed so to ensure there were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People were supported by a team of staff who were dedicated to meet their needs. The service had a number of audit tools in place to measure the effectiveness and safety of the service. We found that whilst most audits were completed, the registered manager had not always reviewed these. As a result some reviews had been missed. These did not put people at risk, nevertheless illustrated that the registered manager did not always have a full overview of the service. The provider developed systems following the inspection to overcome these shortfalls.
People were supported to receive safe care and treatment from a dedicated staff team. Risks were appropriately recorded and assessed highlighting when the risk was most likely to occur, and what action to take to prevent the risk from occurring. Details were also written on what action to take should the risk occur. These were reviewed regularly. Staff received training and had a thorough understanding of their duty of care to keep people safe from risk of harm and abuse. The Commission received reportable notifications in line with requirements.
We found that medicines were administered safely. Staff medication training and competencies were up to date. Required learning was identified from accidents and near misses, with a trigger analysis being completed as required by the provider.
People were involved in all aspects of their care, as far as possible. Staff were trained and supported to ensure they had the necessary knowledge and skills to safely and effectively deliver care. The service proactively worked in partnership with external agencies, utilising their knowledge and skill to further develop staff expertise, and determine correct support for people.
People enjoyed a positive relationship with staff which was built on trust, dignity and mutual respect. People were encouraged to maintain their independence and celebrate their uniqueness. People were supported to maximise their dreams and supported to live their life the way they wished. Activities were designed around people’s preferences and promoted integration in the community.
People were supported in the least restrictive way possible. Staff ensured people were given maximum choice and control of their lives and where decisions had to be made these were in their best interest. The provider’s policies and procedures supported this practice.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. Care plans were reflective of this and key worker sessions clearly documented the drive to achieve choice and independence for all people using the service.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Rating at last inspection
The last rating for this service was good (report published on 15 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The service is required to have a registered manager. There was a registered manager in post who had been registered to manage the service since March 2015. 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.
At the last inspection the service was rated Good. At this inspection we found the service remained Good.
Why the service is rated Good:
People continued to receive safe care. There were sufficient numbers of staff to support people safely. Risk assessments were completed and reviewed regularly to enable people to receive support with the minimum of risk to their safety. Medicines were managed safely by staff who had received training and had their skills assessed regularly. Staff were aware of and had practiced emergency procedures. Recruitment procedures helped to ensure only suitable staff were employed to support people.
People continued to receive effective care. Staff received training and support to develop and maintain the skills and knowledge required to perform their role. People’s healthcare needs were monitored and advice was sought from healthcare professionals when necessary. People were helped and encouraged to learn about healthy lifestyle choices and maintain their well-being. 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 supported this practice.
The service remained caring. People had developed positive and trusting relationships with staff which they valued. Interactions between them were relaxed, supportive and appropriate. Staff protected people’s privacy and dignity and treated them with respect. People were fully involved in making decisions about their care. They were assisted by their key worker and other health and social care professionals where appropriate. People were supported to be as independent as they possibly could be. They were enabled to acquire additional skills to empower them and enhance their independence.
The service was extremely responsive. Support plans were very detailed, personalised and focused on the individual. People had been involved in creating the support plans which identified their preferences and their lifestyle choices. They provided excellent guidance for staff on how to respond to people’s needs in the way they wanted and had agreed to. People discussed their support plans regularly with their key worker and were encouraged to challenge and change them if they wished. Support plans identified people’s aspirations and staff consistently worked hard to find ways to empower people to achieve these. Some outstanding work had been undertaken with individuals to overcome challenges they faced in their lives. This had made a positive impact and given them opportunities and confidence to develop their independence further. Other people had benefitted from intense support in building family relationships despite having to overcome difficulties which threatened those relationships. People had a range of activities they could access and staff spent time assisting people to find and engage in activities they would enjoy and benefit from. Staff continuously supported people to look for and engage in activities they would enjoy and benefit from. People knew how to raise a complaint if they needed to and were confident in approaching staff about any concerns they had. When concerns had been raised they had been responded to effectively.
The service continued to be well-led. There was an open culture that promoted empowerment for people living at the service. Staff were valued and supported by the registered manager and provider. They were given appropriate responsibility which was monitored and checked by the registered manager. The provider was clear on the value base it expected from staff. They responded to this and worked to maintain those values at all times. A system to monitor, maintain and improve the quality of the service was in place. The provider had a clear commitment to driving up quality by seeking views from people who use the service, their relatives and other professional stakeholders. People were involved at every level of the organisation in providing opinions on the service which were used to make improvements and address concerns. Links with the local community were maintained and new opportunities sought consistently.
Further information is in the detailed findings below.
The inspection took place on 28 November 2014 and 4 December 2014 and was unannounced.
Hazeldene is a care home without nursing for up to ten people with a learning disability. At the time of the first day of the inspection nine people were living at Hazeldene and on the second day eight people were living there as one person had moved to another service. This move had been carefully planned with the person and their family. The people living at Hazeldene had a range of support needs. Some people could not communicate verbally, some needed support with personal care and engaging in activities whilst others needed support if they became distressed or anxious. Most of the people living at Hazeldene required support from staff when they were away from the service.
The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of the inspection the manager was not registered with CQC. They had recently been appointed and were in the process of submitting their application to become a registered manager.
Hazeldene had not had a permanent manager in post since the previous manager deregistered in September 2014. A number of interim managers had managed the day to day running of the service. Some relatives and professionals told us they had not received information promptly during this time and felt they were not aware of what was happening in the service. A member of staff commented that sometimes change took a long time to implement as communication with senior management was not always regular.
People using the service, their relatives and local authority commissioners told us they were happy with the support and care provided at the service. Support was focussed on individuals and designed to meet the specific needs and preferences of people living in the service. There were systems in place to manage risks to people. Staff were aware of how to keep people safe by reporting concerns promptly through procedures they understood well. The provider had robust recruitment procedures in place to ensure only staff of suitable character were employed.
People who could not make specific decisions for themselves had their legal rights protected. A best interests meeting involving relatives and healthcare professionals had been held for one person and a decision made in accordance with the principles of the Mental Capacity Act 2005. The MCA provides the legal framework for acting and making decisions on behalf of individuals who lack the mental capacity to make particular decisions for themselves.
Staff were trained appropriately to meet people’s needs. New staff received induction, training and support from experienced members of staff. Staff felt well supported by the manager and said they were listened to if they raised concerns.
People were involved in planning and reviewing their support. People were encouraged to be as independent as possible and they worked toward agreed goals to achieve this. There was a full programme of activities planned and tailored to the individual needs and preferences of people living at Hazeldene. People maintained links with the community through inviting their friends and relatives into the service, visiting local places of worship, garden centres, coffee shops and the day care centre. Entertainment and activities were also provided by community musicians who visited the service. The manager and staff were aware of the risk of social isolation and worked hard to involve people and avoid isolation.
People and their relatives told us that staff treated them with kindness and respect. The manager and provider monitored the quality of the service regularly. Feedback was encouraged from people, visitors and stakeholders which was discussed and used to improve and make changes to the service.
People’s needs were reviewed regularly and up to date information was communicated to staff. Healthcare professionals spoke positively about the way the staff worked with them to meet the needs of people living at Hazeldene.
Care plans were person-centred and regularly reviewed to ensure that people's changing needs were met. People told us that the staff team were 'fantastic' and one person said, 'They always listen to me if I'm worried about something.' A relative we spoke with said, 'The manager and staff are very good. Since he went there his confidence has improved so much, you wouldn't think it was the same person.'
Medication was given safely and discreetly, in a room set aside for this purpose and was accurately recorded. Staff knew what medicines people were taking, the reasons for taking them and any potential side effects.
People were protected from the risk of inappropriate or unsafe care because the service had a thorough recruitment and selection process. Staff we spoke with confirmed that references and other security checks had been completed before they begun to work at the home.
The provider operated systems which regularly assessed and monitored the quality of the service people experienced. We saw a range of audits which identified areas for improvement and associated action plans to achieve this.
We were told that independence and individuality were promoted within the home. People living there were supported and enabled to do things for themselves. They were encouraged to express their views using their preferred individual communication styles and to participate in making decisions relating to their care and treatment.
We looked at a range of records, spoke with the manager, the assistant manager and two support staff in private. We saw the communal areas of the home, some people's bedrooms and spent time observing interactions between staff and people living in the home.