About the service:

Hurstwood View is registered to provide residential and nursing care for up to 55 older people. Accommodation was provided over two floors. The ground floor (Ashdown Walk) provided nursing care for people whilst the upper floor (Deer View Walk) provided care and support for people who lived with dementia. People required a range of help and support in relation to their nursing, dementia and care needs. There were 55 people living at the home at the time of the inspection.

People’s experience of using this service:

The service met characteristics of Good in all areas.

People, relatives and other stakeholders told us the quality of care and support was good. People told us, “It’s my home now, took a while to get used to it, but now I love it here,” and “Couldn’t be cared for better anywhere, excellent.”

• People told us they were safe. Comments included, “I’m able to be independent because staff support me so well, I’m safe here,” and “Very safe, I get my medicines on time and they monitor my health really well.”

• There were safeguarding systems and processes that protected people from harm. Staff knew the signs of abuse and what to do if they suspected it. One staff member said, “We receive training in safeguarding, I wouldn’t hesitate to raise a safeguarding if our residents were at risk.”

• There were sufficient staff to meet people’s individual needs: all of whom had passed robust recruitment procedures that ensured they were suitable for the role.

• There were systems in place to monitor people's safety and promote their health and wellbeing, these included health and social risk assessments and care plans. The provider ensured that when things went wrong, these incidents and accidents were recorded and lessons were learned.

• Medicines were managed safely. Medicine documentation and relevant policies followed best practice guidelines to ensure people received their medicines safely.

• Staff received appropriate training and support to enable them to perform their roles effectively. People told us, “Staff know their stuff, look after me really well,” and “They are really well trained, I have to have help to get up and they do it so nicely.”

• People’s nutritional needs were monitored and reviewed. People had a choice of meals provided and staff knew people’s likes and dislikes. People gave positive feedback about the food. Comments included, “Plenty of choice and always tasty,” and “Homemade meals and cakes, I’ve put on weight since I have lived here.”

• The environment was comfortable and was adapted to meet people's needs. One person said, “It’s so beautiful here, warm, cosy and the views are lovely.”

• People and relatives told us staff were ‘kind’ and ‘caring’. They could express their views about the service and provide feedback. One person said, “A fantastic group of staff, everyone is wonderful, its calm and we can have a laugh.”

• People's care was personalised to their individual needs. There was sufficient detail in people's care documentation that enabled staff to provide responsive care.

• The service provided a variety of activities in line with people's interests and encouraged people's involvement. People, relatives and social care professionals told us staff engagement and interaction had a positive effect on people's quality of life. People told us they had been involved in choosing activities they enjoyed and people were excited about the plans for the spring gardening.

• Management and staff demonstrated a good understanding of and response to people's diverse needs.

• People told us that the service was well-led and that the registered manager was “Approachable and very kind,” and “Runs the place well.”

• The service had processes in place to measure, document, improve and evaluate the quality of care.

• Referrals were made appropriately to outside agencies when required. For example, GP visits, community nurses and speech and language therapists (SALT). Notifications had be

Hurstwood View is registered to provide residential and nursing care for up to 55 older people. Accommodation was provided over two floors. People required a range of help and support in relation to their nursing, dementia and care needs. The home is purpose built with large communal areas and a large reception area at the main reception where people and visitors could sit and have drinks and snacks throughout the day. There is a passenger lift to assist people to access all areas of the building. The ground floor (Ashdown Walk) provided nursing care for people. Whilst the upper floor (Deer View Walk) provided care and support for people with dementia.

There were 48 people living at the home at the time of the inspection.

This was an unannounced inspection which took place on 12 and 13 April 2016.

Hurstwood View did not have a registered manager. 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.

The previous registered manager had recently left and de-registered. Interim management cover had been put in place and support was being provided by the operations and regional manager. A new manager had been recruited and was due to start work the week following the inspection. The regional manager told us that the newly appointed manager would be registering with CQC as soon as they had completed their initial induction and training.

The operations and regional manager were in day to day charge of the home, supported by the deputy manager, registered nurses and senior care staff. People and staff spoke highly of the management of the home. Staff told us that they felt supported and knew that there was always someone available to help them when needed. We received positive feedback regarding the nursing and care staff from relatives, visitors and people living at Hurstwood View.

Care delivery was supported by clear up to date care documentation which was personalised and regularly reviewed. Staff felt that training provided was effective and ensured they were able to provide the best care for people. Care plans and risk assessments had been completed to ensure people received appropriate care. These had been written using information sought from the person or their relatives/ next of kin if appropriate. This meant information was person centred and reflected people’s personal choices and preferences.

Medicine documentation and relevant policies were in place. These followed best practice guidelines to ensure people received their medicines safely. Regular auditing, checks and staff competencies were carried out to ensure high standards were maintained.

There were clear organisational systems in place to assess the quality of the service. Maintenance for example water, electric and gas had taken place. All equipment and services to the building had been checked and maintained regularly. Fire evacuation plans and procedure information was in place in event of an emergency evacuation.

There was a programme of supervision and appraisals taking place for staff. Staffing levels were reviewed regularly with on-going recruitment to reduce the high level of agency staff currently required. Staff received training which they felt was effective and supported them in providing safe care for people. Robust recruitment checks were completed before staff began work.

People’s mental health and capacity were assessed and reviewed with pertinent information in care files to inform staff of people’s individual needs.

People were encouraged to remain as independent as possible and supported to participate in daily activities. Staff demonstrated a clear understanding on how to recognise and report abuse and treated people with respect and dignity. P

Hurstwood View is a care home which provides personal care, nursing care and care and support for people living with dementia for  up to 55 people. At the time of our visit there were 37 people  living at the home.

The service had good systems in place to keep people safe. There were clear systems in place around protecting people from abuse. There was an up to date safeguarding vulnerable people policy in place. The policies gave guidance to staff on what abuse was, and how to report it.

Assessments of the risk to people from a number of foreseeable hazards had been developed and reviewed to minimise the risk of people coming to harm. 

We found that the systems to protect people who could not make decisions for themselves were not consistently followed. We saw some good examples where choices had been made for people in their best interests. However we saw two examples where decisions had been made but no formal recording of the best interest decision process had been documented. This meant that there was no record of who had been involved in the decision, or when that decision should be reviewed. This was a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 Consent to Care and Treatment.  

People that used the service and their family members that we spoke with all agreed that the people were supported by kind and caring staff.  All of the people were very happy with the standard of care provided by the service. They also told us that the care met their individual needs. A person who used the service told us, “I’ve nothing to complain about. I have lots of visitors and the District Nurse visits regularly.” A relative told us, “I have been involved in all of the assessments and subsequent reviews with my family member.”

The staff we spoke with were able to talk in depth about the people, their likes, dislikes and interests. The details we saw in the care plans highlighted people’s personal preferences so that staff would know what people wanted from the service. Staff knew people’s religious, personal and social needs and preferences from reading their care plans. When we spoke to people and then looked at the records, we saw that their preferences had been recorded. 

The service had a registered manager in place and they provided good leadership and support to the staff. They were involved in the day to day monitoring of the standards of care and support that were provided to the people that lived there. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider. The registered manager was not in the home for most of our visit, but we did meet with them at the end of the day. The service ran smoothly in their absence. Staff understood their roles and responsibilities and people received a good standard of care.

We reviewed a selection of records such as care plans, risk assessments, supervision records and medication administration records during this visit. We saw that these were all up to date and completed fully.

The provider completed regular audits of its practices and records to ensure the required standards were met. People who used the service and staff had the opportunity to feedback about what they thought of the service. The registered manager ensured appropriate action was taken if a need to improve was highlighted.

On the day of our visit there were 31 people living in the home ten of whom were receiving care for their memory problems in the Memory Lane community. We saw many people being visited by their relatives throughout the day and the environment appeared comfortable and welcoming and the atmosphere was friendly and relaxed.

People told us that they had been involved in making decisions about their care and were treated with dignity and respect and encouraged to be as independent as possible.

They said they felt well cared for and safe and told us that they were looked after by capable, caring and cheerful staff.

We found there were effective systems in place for medicine management which helped to protect people from harm and that appropriate action was taken in order to improve the process if required.

We saw that staff had been recruited and selected appropriately and had received induction training to ensure they had the appropriate skills to provide safe care and support for people using the service.

Systems were in place to monitor the quality of the service and the provider was responsive when issues were raised and lessons were learnt from incidents.Feedback was sought from people who used the service and all concerned were confident that any issues would be addressed by the management.

We found that some records were not up to date and did not provide the full range of information required by staff when caring for people who used the service.