This inspection took place on 26 January 2018 and was unannounced. This was the first inspection since the service registered with CQC in July 2016.

Hatch Mill is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Hatch Mill accommodates 48 people in one adapted building, over two floors. One floor provides residential care and the other provides nursing care to people. At the time of our inspection there were 42 people living at the home. The home supported older people, some who had physical disabilities and long term medical conditions. Some people at the home were living with dementia.

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.

We identified shortfalls in record keeping that meant that clinical risks were not always accurately monitored. Plans on how to manage risks did not always contain enough detail to guide staff. The provider took action to address this immediately following the inspection. We made a recommendation for the provider to review their systems for monitoring individual clinical risks.

Care was planned in a person-centred way and care plans were regularly reviewed. Despite the shortfalls in record keeping for some risks, most individual risks were identified and managed to keep people safe. Staff routinely involved people in their care and met their preferences and desired routines. We received a large amount of negative feedback about the quality of the food on offer; we made a recommendation about the quality of the food on offer at the home.

People were involved in the running of the home and their feedback was regularly sought. Meetings took place to provide opportunities for people to make suggestions or give feedback and the provider conducted regular surveys. People’s had consented to their care and treatment and staff had followed the guidance of the Mental Capacity Act 2005 (MCA). We made a recommendation about the documentation kept with regards to the MCA.

Staff had received training for their roles and told us that they felt supported by management. Regular supervisions and appraisals took place and the provider had systems of communication in place to enable staff to pass on important messages regarding people’s care. Staff worked alongside healthcare professionals to ensure people’s healthcare needs were met.

People received their medicines safely and in line with best practice. Nursing staff had support to maintain their clinical competencies and revalidate their registrations with the Nursing and Midwifery Council (NMC). The provider had effective systems and training in place to reduce the risk of the spread of infection and people lived in a clean home environment. The premises design was suited to the needs of the people who lived at the home.

Staff were caring and took an interest in people. Staff knew people well and found ways to improve people’s lives and enable them to develop independence. People’s wishes and preferences for end of life care were clearly documented and met. Staff provided care in a way that was respectful of people’s privacy and dignity.

The provider had links with the local community and people benefitted from fund raising work that took place. Fundraising was used to develop the home and gardens in a way that provided people with restful spaces and areas to exercise in. The provider carried out regular audits to monitor the quality of the care that people received. There was a wide range of activities taking place at the home and people to