This unannounced inspection took place on 07 June 2017. Hallgarth Care Home provides accommodation and care for up to 45 older people and younger adults. The service is situated in the centre of the town of Cottingham, East Yorkshire. The service has on-site parking for visitors. At the time of the inspection 41 people lived at the service.

At the last inspection on 11 November 2014, the service was rated ‘Good’. At this inspection we found the service remained Good.

People had received their medicines as prescribed and staff had been trained in the safe management of medicines. However, we found areas that required improvement in the medication administration records and audit systems. The registered manager and the registered provider took immediate action to make the required improvement soon after the inspection. Medicines were stored securely to ensure they were safe. There were risk assessments which identified risks to people and management plans had been put in place to ensure people’s health and well-being were maintained.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People’s consent to various aspects of their care was considered and where required DoLS authorisations had been sought from the local authority. However, improvements were required to the documentation relating to mental capacity assessments. The registered manager took action immediately after the inspection and made the required improvements to the documentation.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Recruitment checks were carried out to ensure suitable people were employed to work at the home. Our observations and discussions with staff and people who lived at the home confirmed sufficient staff were on duty. Risk assessments had been developed to minimise the potential risk of harm to people who lived at the home. These had been kept under review and were relevant to the care and support people required. Actions had been taken to minimise the risk of people attempting to leave the building unsafely through windows. We noted the systems for protecting people from scalding from hot water needed improving. The registered manager took immediate action to correct this.

Care plans were in place detailing how people wished to be supported. People who received support, or where appropriate their relatives, were involved in decisions and consented to their care. People’s independence was promoted.

We observed regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. Comments from people who lived at the home were all positive about the quality of meals provided. One person said, “The food here is the best.” We found people had access to healthcare professionals and their healthcare needs were met.

People who lived at the home told us they were encouraged to participate in activities of their choice and a range of activities that had been organised. We observed the activities coordinator engaging people and offering a range of activities. People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered manager used a variety of methods to assess and monitor the quality of care at Hallgarth Care Home. These included, regular internal audits of the service, surveys and staff and resident meetings to seek the views of people about the quality of care being provided.

The inspection of Hallgarth Care Home took place on Tuesday 11 November 2014 and it was unannounced.  We last inspected the service in May 2013 when we found there was a breach of regulation 12 on cleanliness and infection control.  In September 2013 the provider had improved in this area.  Audits had been carried out, cleaning schedules completed (the shower chair was clean) and hoist slings stored safely.  There was no longer a breach of regulation 12.

The service provided care for 45 older people and younger adults, some of whom may have had a dementia related condition.  There were single occupancy bedrooms, some with en-suite toilet.  Bathrooms were shared.  There was a large dining room and two lounges with small sitting areas in other parts of the building.  At the time of our visit there were 43 people using the service.

It was a requirement of registration that this type of service had a registered manager in post.  There was a registered manager in post who had been registered and working at Hallgarth for the past six years.   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 we spoke with told us they felt safe living at Hallgarth and that staff treated them well.  Staff had good knowledge of how to keep people safe because of training in safeguarding people from harm.  There were systems in place to ensure any concerns or allegations of harm were investigated by the local authority safeguarding team.

Risks to people were well managed, the premises were well maintained and there were emergency plans available to staff should a crisis arise.

Staffing levels were determined by people’s needs and staff were deployed to meet people’s needs based on when people required the most help.  Staff were safely recruited in line with regulation 21.  People received their medication safely because management of medicines was safe.

We found that staff were trained to provide the care people needed.  Staff were regularly supervised, supported to provide the best care their skills would allow and rewarded for their performance.  They understood the requirements of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards when these applied to the people they cared for.

Staff knew the importance of obtaining consent from people to support them and they had knowledge of people’s nutritional requirements, choices and needs.  People’s health care needs were effectively understood, monitored and addressed when required.  There was effective communication between the organisation and the registered manager and between the registered manager and staff.

The registered manager expected staff to have and demonstrate caring values in their daily work.  People and relatives told us staff were kind and caring.  We observed staff approaching people professionally but compassionately and they were sensitive to people’s demeanour.

Care plans contained the information staff needed to support people well.  People had been assessed and plans had been put in place to tell staff how best to support them.  This was in the way people chose and wanted to be supported.

We saw that activities were facilitated by staff and enjoyed by people that used the service.

Complaints were positively addressed.  People told us they could speak up any time about anything and were confident they would be listened to and their concerns would be resolved.

We found there was an open and pro-active culture within the service, based on a need to learn from mistakes and improve on performance.  The registered manager led by example and instilled values in the staff that put people’s welfare at the forefront of the service.

Opportunities were taken by the management to seek people, relative and staff views about the service.  These views were quality monitored, assessed, analysed and used to inform future improvements in practice and care delivery.

We visited Hallgarth Care Home on 1 October 2013 as part of a responsive follow up inspection. The purpose of the visit was to check that improvements the provider said they would make following our inspection in May 2013 had been made.

We found the provider had made improvements with regard to cleanliness and infection control. One regular visitor to the home told us “It is tip top and always smells beautiful”.

People told us that staff discussed their care and treatment with them and that they were involved in the reviews of their care. One visitor said “My parent has a care plan and it has been discussed with both of us”.

We found people were being looked after by friendly, supportive staff within a warm and homely environment. Care was risk assessed and records were up to date. Relatives told us that communication between the staff and people was “Excellent” and “The staff let you know if anything happens such as a fall”.

People told us “We get our medicine on time and when we need it” and we found that appropriate arrangements were in place in relation to recording, handling and safely administering medicines to people who used the service.

We had a few minor concerns about infection control practices, which were discussed with the registered manager for the service and recorded in this report.

Staff received training to ensure that their skills and knowledge remained up to date and the manager regularly supervised their work practice.

The provider had a quality assurance system in place and people’s views and opinions of the service were listened to and acted on where necessary.