Haddon House is a residential and nursing care home for 30 people with dementia. The home is situated in the small town of Ilkeston, an area in Derbyshire. At the last inspection, the service was rated Good. This inspection was unannounced and we found 27 people were using the service. At this inspection we found the service remained Good.

People continued to receive safe care. People were consistently protected from the risk of harm and received their prescribed medicines safely. Staffs were appropriately recruited and there were enough staff to provide care and support to people to meet their needs.

The care that people received continued to be kind and considerate. People were supported to maintain good health and nutrition Training was made accessible to support staff with their ongoing professional development. We saw supervisions were provided to give staff guidance in their roles.

There was an open culture at the home and people had developed positive relationships with the staff. Care plans provided detailed personalised information to enable staff to provide consistent care and support in line with people’s personal preferences. People knew how to raise a concern or make a complaint and the provider had responded to any complaints in line with their policy.

The registered manager understood their role and ensured we received appropriate information in a timely manner about events at the service. Audits had been completed to identify measures to maintain people’s safety and to drive improvements within the home. The home participated in new initiatives which provided opportunities to the staff and the development of ideas.

Further information is in the detailed findings below

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. This included observing care, speaking to staff and reviewing records.

We found that provider had in place processes to ensure that staff at the home were recruited safely.

We found that the provider had put systems in place to monitor the administration of medicines but that people were not protected from the risk associated with the unsafe storage of medicines and nutritional supplements.

We used a number of different methods to help us understand the experiences of people using the service, because the most of the people using the service had complex needs which meant they were not able to tell us their experiences. We spoke to the relatives of two people, who told us that they found the care at the home to be “excellent”.

We found that people or their relatives understood the care and treatment they received. People able to express their views and their relatives told us they were satisfied with the care and treatment they received.

We found that staff asked people or their relatives for consent before they received any care or treatment and the provider acted in accordance with their wishes.

People we spoke to and their relatives told us that staff were caring and thoughtful in their approach and we found that there were enough qualified and skilled staff available to meet peoples needs.

Although the provider had safe systems in place for the storage of medication we found that that people were not always protected against the risks associated with medicines because the provider did not have appropriate arrangements in place for the safe administration of medicines.

We found that care and staff records were kept securely.

People able to share their views with us said they were happy with the care and support they received from staff. One person told us “I enjoy it here”. Another person said “I like the food”.

This inspection was unannounced and took place on 16 November 2015. The service was registered to provide residential and nursing care for up to 30 older people with dementia. At the time of our inspection 29 people were using the service.

There was a registered manager in post. 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 and relatives we spoke with told us they felt the service was safe and the provider took appropriate steps to keep people from avoidable harm. Risk assessments had been completed to ensure people had been protected and to provide guidance to staff. People received their medicines at the right time and in a dignified way. There was a process which ensured this was completed safety. People’s health was monitored and when necessary health care professionals support was requested and guidance provided by them which was then followed by the staff.

There were sufficient staff to support people’s needs and they received training that provided them with the knowledge and skills to provide the care required. People had been supported to make decisions and where they lacked capacity to make decisions, people were protected under the Mental Capacity Act 2005. Where appropriate a referral had been made to the local authority to request an assessment in relation to the Deprivation of Liberty Safeguards (DoLS).

The service had a choice of meals and people could decide where they wished to have their meals. People were encourage to be independent, however if necessary support was available to ensure they were able eat their meal.

People we spoke to told us they received care which was compassionate and respectful. Consent was sort when people were offered support to maintain their daily routine.

There was stimulation available and people were encouraged to join an activity which reflected their own interests and hobbies. We observed the staff used the care records to reflect a personal approach to ensure people received the care in the way they wished.

The provider had a notice board which provided a broad range of information about the service,registlation requirements along with any forthcoming events. There was a complaints procedure and any cpmplaints that had been received, had been dealt with efficiently.

The manager was approachable and knew the people within the home and was able to provide clear guidance to the staff on how to support people. There were regular audits on a range of areas to ensure the quality of the care was maintained and where required improved.