This inspection took place on 31 August 2016 and was unannounced.

Hazelford Residential Home Residential Home is owned and managed by A N I Health Care Services Limited. It is situated in the village of Bleasby in Nottinghamshire and offers accommodation for to up to 36 older men or woman. At the time of inspection 24 people were using the service.

The service had a registered manager. 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 who used the service and staff at Hazelford Residential Home knew who to report any concerns to if they felt they or others had been the victim of abuse. People’s care records showed that any risk to their safety had been identified and measures were put in place to reduce these risks. There were enough staff with the right skills and experience to meet people’s needs. Medicines were stored, administered and handled safely.

People were supported by staff who had received the training they needed to support people effectively. People had consented to the care that they received. People’s rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly.

People spoke positively about the food they received. They were able to have choice in what they ate at each meal and received support to eat if required. People had regular access to their GP and also other health care professionals when required.

People were supported by staff who were caring and treated them with kindness, respect and dignity. Staff encouraged people to remain independent wherever possible and where people showed signs of distress or discomfort, staff responded to them quickly. There were no restrictions on friends and relatives visiting their family members.

Staff were always on hand to respond to people’s needs and a range of activities were available to those that wished to join in. Care plans were written with the involvement of each person and their family. They were reviewed regularly to ensure staff responded appropriately to any change in need a person may have. A complaints procedure was in place and people felt comfortable in making a complaint if needed.

The atmosphere within the home was warm and friendly. People living in the home were asked for their opinions with regard to the service that they received, which meant that their views informed decisions to improve the service. Staff understood the values and aims of the service and spoke highly of the registered manager. The registered manager had clear processes in place to check on the quality of the service and to ensure that any improvements identified were made and sustained

Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with four people who used the service and two relatives and asked them for their views. We also spoke with four care workers, one of whom was the senior on duty. We looked at some of the records held in the service including the care files for three people and observed the support people who used the service received from staff.

We carried out a responsive inspection following the receipt of some concerning information from an anonymous source. Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

We found systems designed to keep people safe were not followed. One person who had recently sustained an injury following a fall had a risk assessment and care plan associated with preventing falls. These had not been reviewed or updated following this recent fall.

Is the service effective?

We found staff were not effective at meeting the care and welfare needs of people who used the service. Documentation did not accurately show what support people had received.

Is the service caring?

We found staff spoke with people in a sensitive and caring manner. A person who used the service told us, “They look after me fine.”

Is the service responsive?

We found records made did not show staff responded appropriately to the care and welfare needs of people who used the service.

Is the service well-led

There was no evidence to show that monitoring forms used were checked or reviewed to ensure people were receiving the care they required.

Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with six people who used the service and asked them for their views. We also spoke with four care workers, the cook and the deputy and home managers. We also looked at some of the records held in the service including the care files for three people and observed the support people who used the service received from staff.

We found people were supported to make decisions about their care. People’s individual characteristics were respected and their privacy and dignity were promoted. A member of staff told us, “We don’t do things the fastest way, we encourage people to do things themselves, like wash their own face and put their deodorant on.“

We found people were encouraged to have sufficient food and drink to promote their well-being. A person told us, “We get more than enough, we had fresh salmon the other day and we always have a pudding.” Another person told us how staff took the time to help people to eat their meals when they had difficulty doing so themselves.

We found people had their medication when they needed it and this was administered safely. A person told us, “They have never run out of my medicine. I always have it.”

We found the provider had taken the appropriate steps to safeguard the health, safety and welfare of people when concerns were raised at the number of staff on duty. A person who used the service told us, “I thought they had been a little bit short staffed recently, but things are better now.”

We found the provider assessed and monitored the quality of the service. A person who used the service told us, “I think the home is very well run, everything they do for you is for your own good. I don’t think I would get better attention anywhere else.”

This visit was carried out to check the provider had complied with the actions we had set following our last visit. In order to do this we inspected some records and discussed these with senior staff.

We found the provider had complied with the actions we set.

During the inspection we spent some time observing care practices and spoke with five people who used the service and asked them for their views. We looked at the care records for four people who used the service.

People expressed their views and were involved in making decisions about their care and treatment. People who used the service told us they were able to do what they wanted. One of them said, “We are able to do what we want to do.” Another person said, “They give us choices and treat us with respect.”

People who used the service were given appropriate information and support regarding their care or treatment. One person who used the service told us, “We have talked about the care I want” and another said, “I went through my care plan. I should think I signed it (the care plan) in the past.” We were also told, “I get the care I want there is nothing I would change” and “If you need anything they will explain it to you.”

People were supported in promoting their independence and community involvement. We saw tables in the dining room were nicely set with condiments and flowers. Breakfast tables had preserves and other items so people could help themselves. One person who used the service told us, “I am fairly able, I don’t need some of the help so they let me do what I can myself.”

Care and treatment was planned and delivered in a way that ensured people’s safety and welfare. One person who used the service told us, “They are really good if you don’t feel well.” Another person told us, “I’ve often said I don’t think you could get a better place” and someone else said, “There is nothing to worry about in this place, it’s a nice place. It’s as good as any other home.”

One person who used the service told us, “I feel safe here, nobody comes in the middle of the night and there are always staff around.” Another person said, “I feel safe here. If you need any help they (the staff) are always there to help you.” We were also told by a third person, “I like it here they (the staff) are good to you.”

One person told us, “I think they (the staff) know what they are doing, I suppose they must be trained.” Another person told us, “They (the staff) are very good at coping with us.”

We asked people who used the service if they knew about the records kept in the home. One person told us, “I haven’t asked them about records” and another person said, “They keep details of who they can get in touch with and details like that.”

A person who used the service told us they had not seen their care plans. They were happy that their dignity was respected. Another person told us they had not seen their care plans; however, they were happy their privacy and dignity were respected. A person told us that staff explained what was going to happen and that they could say whether it was ok or not for staff to carry out the care.

A person told us they felt well looked after and that they received a quick response from staff. They could get help day or night from staff and were very happy with the home. Another person told us they felt safe and staff were kind. They also said, “It sometimes takes a good while to get staff to help.”

People told us the environment was clean and well maintained, however, one person told us that two toilets on the ground floor were regularly unclean. People told us staff were well trained to meet their needs. A person told us there were no meetings where people who used services discussed their experiences of living at the service. People told us they had not been asked to complete a survey on their views of living at the service. They also told us the manager was always available to receive comments from people who lived at the service.