About the service:

Haddon House is a small residential care home registered to provide personal care and support for up to six people under the age of 65 who have mental health issues, learning disabilities or autism. At the time of the inspection there were five people living in the home.

The care service had not originally been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. The home had been registered before such guidance was produced. The guidance focussed on values including choice, promotion of independence and inclusion so that people with learning disabilities and autism using a service can live as ordinary a life as any citizen. However, it was clear that people living in Haddon House were given such choices and their independence and participation within the local community had been and was continuing to be encouraged and enabled.

People’s experience of using this service:

People were supported to keep safe in the home. People continued to be protected against the risk of abuse, neglect and discrimination.

People continued to receive care and support that was personalised to meet their individual needs. The systems in place to identify and assess potential risks continued to be used to help manage known risks related to people’s support needs and daily lives. Staff were clear about action they would take to keep people safe from the risk of harm.

People were supported to maintain good health and good nutrition by staff who displayed kindness and respect as they provided support. People received their medication as prescribed.

People continued to be supported by adequate numbers of staff who were well trained and focussed on helping people who lived in the home. Safe recruitment of staff ensured that people were supported by staff of good character.

Relationships between staff and people who used the home were positive, respectful and supportive. Staff ensured that people were supported to make choices as agreed and maintain a good level of independence in line with their abilities and wishes. People’s diverse needs were recognised and access to activities was supported and enabled by staff.

The provider continued to use their audit systems and processes to check and ensure that people were being supported to receive good quality care.

The home continued to meet the characteristics of a rating of good in all areas. More information about the inspection is in the full report.

Rating at last inspection:

The home was rated Good at the last inspection (report published in August 2016).

Why we inspected:

This was a planned unannounced inspection based on the previous rating.

Follow up:

We will continue to monitor the home through information we receive.

This inspection took place on 7 July 2016 and was unannounced. The inspection team consisted of one inspector and a Specialist Advisor who had expert knowledge in relation to mental health.

Haddon house is a care home without nursing for up to six people who have mental health support needs. At the time of the visit five people were using the service. The home had a registered manager who we met at the inspection. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People and staff told us they felt people were safe in the home. Staff were aware of the need to keep people safe and they knew how to report allegations or suspicions of poor practice.

People were protected from possible errors in relation to their medication because the arrangements for the storage, administration and recording of medication were good and there were systems for checking that medication had been administered to people in the correct way. Checks on the environment and general safety were available for us to see on the day of our visit.

People had opportunities to participate in a range of activities in the home and community, but staff respected people’s wishes when they wanted to be alone and have privacy.

People’s relatives and friends were encouraged to visit and made welcome by staff.

Staff regularly asked people how they wanted to be supported and what they wanted to do. People were treated with dignity and respect. Staff understood the needs of the people who used the service and how they liked to be supported. We saw that staff communicated well with people and with each other.

Staff were appropriately trained, skilled and supervised and they received opportunities to further develop their skills.

The registered manager and staff we spoke with understood the principles of protecting the legal and civil rights of people using the service.

People were supported to have their mental and physical healthcare needs met and were encouraged to maintain a healthy lifestyle. The registered manager sought and took advice from relevant health professionals when needed.

People were provided with a good choice of food in sufficient quantities and were supported to eat meals which met their nutritional needs and suited their preferences.

The registered manager had provided effective leadership to ensure staff were well motivated and enthusiastic.

The registered manager and provider assessed and monitored the quality of care consistently through observation and regular audits of events and practice.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

At our last inspection in March 2013 we found improvements were needed in the storage, recording and checking of medicines. At this inspection we found that the provider had updated their procedures and made all the appropriate improvements for the security of medicines. We observed a medicine being administered and recorded in line with these procedures. Medicines were administered in a safe way. We spoke with three out of the four people who were living in the home and found they were involved in developing their own care plan and making decisions about their day to day life.

Amongst the comments we received and saw were: "Thanks for all the help, I will miss you all, but it is time to move on" and “They (the staff) are good ones.” Comments from external visitors included: "Staff work in the best interest of the person" and "Staff gave good emotional support." People received caring support that was effective and assisted them to move on.

We saw good interactions between staff and people living in the home. There were sufficient staff to meet the needs of people in a timely way. People and staff were complimentary about the new manager. We saw that they had reviewed several systems in the home and had plans to continue improvement. The home was being well led.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activity at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

We spoke with three people that lived in the home and they were all happy with the support they had received. People told us about their leisure activities and work experience and how they were supported to become as independent as possible. They told us that care staff available when they needed them.

We looked at two people's care records and these provided staff with good information about how people's care needs, risks to their health were to be met. Care staff had enough information to be able to identify when a person's physical and mental health needs were changing. People's care and health was reviewed regularly. Where restrictions were in place to maintain a person or other people's safety this was in accordance with legal requirements.

People were not always assisted appropriately to receive their 'when required' medicines. Improvements were needed on the recording, auditing and storage of medicines.

Staff were recruited appropriately.

New systems had recently been put in place these included: a staff forum to discuss ideas new ideas, the opening of concerns care-line where people and could leave a message for senior staff and further checks on the quality of the service provided.

People told us that they were being well supported by staff and that they were happy with their accommodation.

We saw that people who were living in the home were encouraged to be as independent as possible and they were making decisions about their care and support and the way in which they wished to live. We saw that care staff treated people with respect.

We spoke with one person and asked about their experience of living at the home.

We asked if they could get up when they chose to and we were told, “I get myself up.”

We asked what time they go to bed and they said, “When I feel like it.”

We found that the health needs of people were being promoted to ensure that they remained healthy. This was reflected in the care files that we reviewed during our visit to the home.