Haxby Hall is owned by City of York Council and provides accommodation for up to 49 older people who have personal care needs, some of which may be assessed as high dependency needs. There is a six bedded safe unit for people with dementia care needs, which includes two respite beds for individuals requiring a short stay there. The service is purpose built, and is sited close to the local amenities in Haxby. There is some parking on site. Written information about the service can be obtained by contacting the home directly.Our inspection team was made up of two inspectors, and a specialist nurse. In relation to infection prevention and control management. They helped answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People told us they felt safe at Haxby Hall. They trusted the staff who worked there and supported them. They told us the staff were kind and friendly.
We found people were kept safe because the service took action to manage and report safeguarding incidents promptly and effectively.
We saw people's privacy and dignity rights were respected and their independence was promoted. This helped to make sure their human rights were protected.
The service understands that people have the right to take risks, as long as they understand the implications of that risk. People's mental capacity was considered when risk was assessed, though records relating to this assessment could be improved.
The service overall was kept clean, though some hygiene practices could be better monitored. This would better help to protect people from the risks associated with the spread of infection.
We found some risk management processes could be improved to better demonstrate that the service was keeping people safe whilst promoting their health and wellbeing.
Is the service effective?
People were included in decisions about their care and the support they wanted. We found their care records overall reflected their preferences and choices and dietary likes and dislikes.
We observed that there were good interactions between the staff and people, with friendly and supportive care practices being used to assist people in their daily lives.
Whilst people's independence and self-worth was promoted, some people told us they would like more help with some aspects of their day to day lives.
People were offered meals that were varied and nutritious. One person told us 'The quality of food is excellent.' A range of snacks and drinks were readily available and offered to people; to ensure individuals received enough to eat and drink. Whilst people were assessed for the risk of becoming malnourished, this assessment process was not always robust.
Is the service caring?
People told us they were treated with kindness and compassion. Their comments included 'I'm very happy with my care. There's always someone here to help you.' Another said 'The care is great and the staff are lovely.' Despite these comments we saw some instances where staff relied on people to ask for help. Two people said 'The staff don't clean our hearing aids. We wish they would.'
People overall told us they received good care and we saw the service liaised with healthcare professionals for advice and guidance, to ensure people received appropriate care.
Whilst people overall were satisfied with their care we noted some peoples' care records did not always contain up to date information about their care needs. This meant those people were at greater risk of receiving inappropriate, unsafe care. We told the provider to take urgent action and to send us information within two working days, to show that those people's care had been properly reviewed.
Is the service responsive?
People told us they attended meetings where they could talk about how the service was being run.
The service had a complaints policy and people spoken with told us they thought any concerns raised with senior staff would be taken seriously and sorted out. However, people we spoke with raised a number of 'niggles' with us about the service, which the provider was unaware of. This indicated systems in place to enable and encourage people to raise concerns may need improving.
People were consulted about the care and support they needed. This included asking about people's preferences and choices, so that these could be met, wherever possible. Whilst people's care needs were reviewed each month, this review did not always include a discussion with the individual. This meant people did not always have the opportunity to say whether their care and support needs were still being met.
Is the service well led?
People were involved and included in annual reviews about their care, so they could say what was working well and what could be improved. Residents meetings were held, where people had an opportunity to give their views about how the service was operating. Better records would help to show whether actions taken as a result of comments made, had brought about improvements.
The service had an 'open door policy' where staff were encouraged to voice their concerns and opinions to senior staff. Staff meetings were held so that information could be shared and staff could provide feedback about how the service was being run.
The provider had a line management structure, and senior managers visited the service regularly to provide support and to monitor how the service was being run.
Whilst some information about the service was gathered each month there needed to be more robust reviews, analyses and records about this information. This would enable the provider to demonstrate that risks to people's health, safety and wellbeing were well managed and effective. We have asked the provider to take action to improve the way the service is assessing and monitoring the quality of service provided.