The inspection visit at Hatherlow House was undertaken on 20 September 2016 and was announced. 48 hours’ notice of the inspection was given to ensure people who accessed the service, staff and visitors were available to talk with us.

Hatherlow provides personal care assistance for people who live in their own apartments situated within a large, three-story building. The office is on site and there are communal lounge areas and a dining area facilitated by external caterers. The service supports younger and older adults who live with dementia. Staff provided care packages and were onsite 24 hours-a-day to maintain people’s safety and welfare. At the time of our inspection, Hatherlow was supporting 29 people.

A registered manager was not in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. However, the previous manager only left in August 2016 and we saw evidence the new manager had almost completed their application to register.

At the last inspection on 01 May 2014, we found the provider was meeting the requirements of the regulations.

During this inspection, people and their relatives told us they felt safe and secure at Hatherlow. One person said, “It always smells nice and feels safe and secure.” Staff received safeguarding training and knew who to raise concerns with to protect people from abuse or poor practice.

The manager verified staff had a full employment history and obtained recruitment checks before employing them. Rotas we looked at confirmed staffing levels were sufficient to meet people’s urgent needs and their agreed care packages. We found staff had training and regular supervision to develop their skills. A staff member confirmed, “Training is very thorough and it needed to be. I wouldn’t want to be cared for by someone who wasn’t well trained.”

Suitable arrangements were in place to ensure people received their medicines when they were required. The manager provided medication training to underpin their knowledge and competency testing to review their abilities. One person told us, “The staff are very good. They check me having my medication.”

Staff files evidenced employees received relevant training in the principles of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards. People said the manager and staff discussed care with them and supported them with a collaborative approach. One person stated, “We were given choices and made any decisions with their help. The staff never took control.”

People could cook for themselves, access the dining area or be assisted by staff as part of their care packages. We found care files included care planning and risk assessment to safeguard people against the risks of malnutrition.

People and their relatives told us their care packages were personalised to their needs. The manager had recorded each person’s life histories and their preferences about their support requirements.

We found staff were friendly and caring when they engaged with people. A relative stated, “I’m always hearing [my relative] giggle away with them in the bathroom.” The manager provided staff with personalised care training to assist people to maintain their independence.

We found the provider supported the new manager to undertake their role and responsibilities. Staff, people and relatives told us the new manager was supportive and approachable. The management team met with people and provided opportunities for them to comment about the quality of their care. The manager completed audits to ensure their continued safety and welfare.

We carried out this inspection on the 1 May 2014. We did not announce our inspection prior to our visit. We set out to answer our five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service told us they were treated with respect and dignity by staff. People told us they felt safe and that if they had any concerns they would raise these with staff or with the manager. People got the support they needed when they needed it and risks to people’s safety were identified and managed.

Is the service effective?

People received the care and support they required to meet their needs and maintain their health and welfare. People who lived at the service were included in making decisions about how the service was run. People's care and support had been reviewed and care plans regularly updated. Staff had been provided with up to date training in a range of topics including manual handling.

Is the service caring?

People who lived at the service and their relatives told us staff were caring and respectful. People were supported by attentive staff who were readily available to support them. We saw that staff showed warmth and familiarity in their one to one interactions with the people who used the service.

Is the service responsive?

People who lived at the service were listened to and their views were acted upon. People were asked to give feedback on their experience of the service. The registered manager did this, through the use of surveys and meetings. People’s feedback was then used to make improvements to the service.

Is the service well-led?

During our inspection we looked at the quality assurance systems currently in place at Hatherlow House. We found that the provider had put in place both internal and external audits designed to monitor the quality of the service. We saw records which confirmed that the provider had an effective system in place to take account of comments or complaints relating to the service.