The inspection took place on 25 June 2018 and was unannounced. At the last inspection we rated the home overall as ‘Good’ with a request to the provider to make improvements within the ‘Responsive’ section. At this inspection we found some improvements had been made, however further improvements were required in the ‘safe’ and ‘well-led’ sections of the report.

Haddon Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home has accommodation set over three floors. Each floor has access to dining areas and small and large lounge or relaxation spaces. Each room has an ensuite; there are also large communal bathrooms with adapted baths on each floor. There is a small gym and a dining area which can be used by people and their relatives. The garden is access with areas of seating and a circular pathway to support people to navigate around the landscaped flowerbeds. The upper floors also had access to the outside on large balconies with seating.

The service was registered to provide accommodation for up to 75 people. At the time of our inspection 60 people were using the service.

Haddon Hall has a registered manager. 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.

There was not always enough staff to support people’s needs. Medicine was not always managed safety to meet peoples prescribed needs. Risk assessments had not always been completed and behaviour plans were not completed to support a consistent approach. When audits had been completed they did not reflected actions which required completion. New systems had not been checked to ensure staff had the knowledge to use them effectively.

People enjoyed living at the home. It was well maintained and any risk to infection was managed. Staff showed knowledge about people’s needs and they had established relationships with people. Dignity and respect for people was maintained.

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. Their views were considered and improvements developed from these meetings and connections.

Staff understood how to protect people from harm and when required people were supported with their health care needs. Nutritional needs had been considered and dietary needs met.

Activities and areas of interest were on offer, which linked traditional things with new initiatives. The community had also been encouraged to link with the home and partnerships had been developed.

Complaints had been responded to and the registered manager understood their role in relation to notifications. We saw the rating was displayed at the home and on the provider’s website.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of the report.

This inspection was unannounced and took place on 16 March 2016. It was the first inspection of the service since initial registration under the HSCA 2008.

Haddon Hall Care Home provides accommodation, nursing and personal care for up to 75 older adults, including people living with dementia. At the time of our visit, there were 53 people living at the service, including 19 people receiving nursing care. There was a registered manager at this service. 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.

People felt safe and relatives felt people were safely supported. Staff usually responded promptly to provide people with the assistance they needed to support them safely. Arrangements for staff planning and deployment, helped to mitigate risks to people’s safety from their increased numbers and needs and ensure people’s safe supervision.

The provider’s arrangements helped to protect people from harm and abuse. Staff understood their role and responsibilities to recognise and respond to any suspected or witnessed harm and abuse of a person receiving care. Staff were recruited and monitored in a way that promoted safe care and practice.

Known risks to people’s safety associated with their health needs, medicines and their environment, were assessed before they received care and regularly reviewed. People’s care was planned and delivered in a way took account of this. People received care in an environment that was clean and well maintained. This helped to ensure that people received safe care and treatment.

People and relatives were happy with the care provided and felt that people’s health needs were being met. People’s care plans were sufficient to inform people’s care. Staff referred to and followed instructions from external health professionals for people’s care when required.

Staff received the training they needed to perform their role and responsibilities for people’s care and they were conversant with people’s health needs and related care requirements. Staff training and development needs and opportunities were regularly reviewed and sought to help ensure a consistent and thoughtful approach to effective care.

Staff understood and followed the Mental Capacity Act 2005, to obtain people’s consent or appropriate authorisation for their care.

People received effective nutrition and they were supported to do this by staff who understood and followed their dietary needs and preferences.

People received care from staff who were motivated in their role, respectful, kind and caring. Staff understood and promoted people’s independence, involvement, rights and choices in their care and also the appropriate involvement of their relatives.

Care was not consistently personalised and staff did not always provide people’s care in a timely manner. Staff did not always respond promptly when people needed assistance or to support their independence.

A range of aids, adaptations and adjustments helped to support people living with dementia or sensory and physical disabilities. Further improvements were planned to enhance people’s access to information.

People were supported to engage with others and in home life. This was done in a way that helped to promote people’s participation and inclusion in home life and the extended community.

People and relatives were asked for their views about the care provided and informed how to make a complaint or raise any concerns. These were listened to, taken seriously and acted on and used to make improvements for people’s care when required.

The service was well managed and led and people, relatives and staff were confident in this. The provider’s record keeping and governance arrangements helpe