Hazel Garth 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. Accommodation is provided for up to 24 people. There were 19 people living at Hazel Garth when we inspected.

At our last inspection in February 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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At this inspection we found the service remained Good.

There were systems and processes to ensue people were safe and risks were appropriately assessed. People were supported with their medicines and staff understood safe practice around managing medicines. Staff understood how to safeguard people from harm, and there was a system for recording accidents and incidents. Premises and equipment were regularly checked for safety.

Staff completed regular training and engaged in supervision meetings. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were encouraged to lead healthy lives and there were effective links with other professionals. People enjoyed the meals and the social occasion from mealtimes.

Staff were respectful of people’s privacy and dignity and people’s independence was promoted. There was a friendly, welcoming atmosphere and people said they felt at home.

Care was person centred and people’s individual needs were promoted and respected. Care records showed individual preferences and people’s visitors were welcomed at any time.

Staff were motivated and there was open communication in the home and effective teamwork. Audits were in place and regular feedback was sought from people about the quality of the service. Documentation was securely filed and care records were being updated

Further information is in the detailed findings below

This was an unannounced inspection carried out on 24 February 2016.

We last inspected Hazel Garth in October 2013. At that inspection we found the service was meeting all the legal requirements in force at the time.

Hazel Garth provides accommodation and personal care for up to 24 people. Care is provided to older people, including people who live with dementia or a dementia related condition. At the time of inspection there were 21 people living there and this included one person who was staying for a short term break.

A registered manager was in post. They were unavailable at the time of inspection and their position was covered by the registered manager of another service. 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 said they were safe and staff were kind and approachable. People’s comments included, “Excellent care home, nothing is too much trouble for the management and staff,” “I enjoy living here,” and, “Happy to go back anytime for respite care.” People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

Systems were in place for people to receive their medicines in a safe way. People had access to health care professionals to make sure they received appropriate care and treatment. Appropriate training was provided and staff were supervised and supported.

There was a good standard of record keeping and records reflected the care provided by staff. Staff knew the people they were supporting well. People we spoke with and relatives told us staff were kind and caring and peoples’ privacy and dignity were respected. Their comments included, “The staff are great,” “We couldn’t ask for better care,” “Staff are really on the ball,” and, “Staff are all very welcoming.” There were activities and entertainment available for people

Hazel Garth was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Best interest decisions were made appropriately on behalf of people, when they were unable to give consent to their care and treatment. Food looked appetising and people received a varied menu including people who required a special diet.

A complaints procedure was available. People told us they had no need to complain but they would feel confident to speak to staff about any concerns if it was necessary.

The home had a quality assurance programme to check the quality of care provided. People had the opportunity to give their views about the service. There was regular consultation with people and/ or family members and their views were used to improve the service. The provider survey results included several comments of appreciation and these included, “Fantastic home, tons of care, a lovely place,” “I am pleased that (Name) is fortunate enough to live at Hazel Garth. They are content and all staff treat (Name) with kindness and consideration and do their utmost to ensure (Name)’s well-being. I thank you for this."

Staff and relatives said the management team were approachable. Communication was effective to ensure staff and relatives were kept up to date about any changes in people’s care and support needs and the running of the service.

We spoke with four people who lived in the home, three care staff, two assistant managers and the acting manager. We also spoke with two relatives of people who lived there.

We found people were consulted and informed about their care and encouraged to make their own decisions. Staff told us they always asked people’s consent before caring for people and respected their rights and wishes.

We saw people were happy and content and their needs were met by staff who understood their likes, dislikes, abilities and personalities. People had plenty to do and they engaged in activities of their own choice.

We saw premises were visibly clean and there were appropriate systems in place to prevent the spread of infection.

We looked at how people’s medication needs were managed and found there were procedures in place to ensure people got their medicine on time. We saw medicines were stored securely and appropriate records were maintained.

We found there were changes to management that we had not been informed about, although we saw this had not adversely affected people’s daily care and well-being. We saw there were systems for monitoring the quality of the service provision, although we noted that this had not been closely managed in recent weeks. The temporary manager gave assurance that there were plans in place to restore stability of staffing and management.

We spoke with the people who used the service. One person told us that they felt they were treated with respect by the staff. Other people told us that they ‘liked living here.’

We saw that interaction between staff and the people who used the service was warm and respectful.

We spoke with four members of staff. They told us that the service had been short of staff due to sickness but this hadn’t affected the care people received. However, the levels of sickness had been having an impact upon the morale of staff and they told us that they felt tired of having to fill in for the gaps in vacancies due to sickness.

We saw that staff received monthly supervision and appraisals had been carried out recently. The staff we spoke with told us they felt supported by the management and were able to talk to the manager if they had any problems.

The staff had training in safeguarding and we saw that there was a safeguarding and whistle blowing policy in place to support staff.

We saw that there was a corporate complaints policy and the manager told us that they hadn’t received any complaints over the past year. In the reception area there was a leaflet informing visitors to the service how they could complain.

We spoke with about six of the people who live in Hazel Garth and one of the relatives.Many of the people have lived in the area and said they are happy to be so close to their homes.

People were very positive about the care they receive. They said they liked the staff and that they treated them with respect." they are all nice here" one person said .Another person said "The staff are good to us they help us out"

People were observed being supported by staff in a kind way. Staff were clear about their

roles and the support they offer to people. Many had been working in the home for some

years.

People spoken with said they have never had any concerns during their time at the

home.