The unannounced inspection took place on 19 December 2016. We last inspected the service in July 2014 when it was found to be meeting the regulations we assessed.

Lord Hardy Court provides mainly respite and intermediate care for up to 60 older people, including those living with dementia. It also supports a small number of people on a permanent basis. The home consists of four units, and is located in the Rotherham suburb of Rawmarsh. At the time of our inspection there were 51 people using the service.

The service did not have a registered manager in post at the time of our inspection. However, the acting manager told us they had begun the process to register with us to become the registered manager for the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The home was clean and generally well decorated, with a relaxed and friendly atmosphere. People we spoke with made positive comments about how staff delivered care and said they were happy with the way the home was managed, as well as the facilities available. We saw staff supported people in a caring, responsive and friendly manner, while including them in decision making. People were encouraged to be as independent as possible, while taking into consideration their abilities and any risks associated with their care.

People told us they felt the home was a safe place to live and work. Systems were in place to protect people from the risk of harm. Staff were knowledgeable about safeguarding people from abuse, and were able to explain the procedures to follow should there be any concerns of this kind. Assessments identified any potential risks to people, such as falls, and care files contained management plans to reduce these risks.

Medicines were stored safely and procedures were in place to ensure they were administered correctly. We found the temperatures of fridges and medication storerooms were within acceptable limits; however these had not been consistently recorded on each unit to ensure temperatures remained within the safe limits for storing medication. We saw people either managed their own medication, or were assisted by staff who had been trained to carry out this role.

Overall there was enough skilled and experienced staff on duty to meet the needs of the people living at the home at the time of our inspection. The recruitment process was robust and helped the employer make safer recruitment decisions when employing new staff. Staff had received a structured induction into how the home operated and their job role at the beginning of their employment. They had access to a varied training programme and periodic support sessions to help them meet the needs of the people who used the service, while developing their knowledge and skills.

People were provided with a choice of healthy food and drink ensuring their nutritional needs were met. Specialist diets were provided if needed and the people we spoke with said they were happy with the meals provided. However, we saw that on the unit for people living with dementia, some people had to wait for assistance to eat their lunch. The manager told us they were addressing this.

People’s needs had been assessed before they stayed at the home. If someone was admitted at short notice staff had collated as much information as possible prior to, and on admission. We saw people had been involved in planning their care, as well as on-going reviews. Care plans reflected people’s needs and preferences and had been updated regularly to ensure they reflected people’s changing needs. However, we noted that new information had not been incorporated into one person’s risk assessment and best interest documentation in another file was incomplete.

The home did not have a dedicated activity co-ordinator to facilitate a structured programme of activities. We found

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

Lord Hardy Court is a 60 bedded residential care home for older people with care and support needs, including those living with dementia. Accommodation is divided into four separate units, with facilities including a hair salon, a cafeteria and a ballroom. It is located close to Rotherham town centre.  When we inspected the service in August 2013 we found no concerns.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

This inspection was unannounced. During the visit we spoke with 17 people who used the service and 12 friends and family members, who were visiting at the time.

At this inspection we saw there were systems to make sure people were protected from the risk of harm. Staff knew about safeguarding and we saw concerns reported had been dealt with appropriately, which helped to keep people safe.   

People we spoke with told us staff were very nice and easy to talk to. They and their relatives and friends also told us they felt involved in their care and support.

Staff were following the principles of the Mental Capacity Act 2005 for people who lacked capacity to make a decision and the registered manager had previously made applications under the Mental Capacity Act Deprivation of Liberty Safeguards for authorisation in the case of one person whose liberty had been restricted.

There were enough skilled and experienced staff and there was a programme of training, supervision and appraisal to support staff to meet people’s needs.

Staff were aware of people’s nutritional needs and made sure they supported people to have a healthy diet, with choices of a good variety of food and drink.

People had individual personal plans that were centred on their needs and preferences and had a good level of information, which explained how to meet each person’s needs.  

There were activities available and this was an area the team were working on improving.  Additionally, a local business was funding work to the garden, which would make it safer, more accessible, and more ‘dementia friendly’.

We saw that staff were respectful and made sure people’s privacy and dignity was maintained.

People said they felt comfortable to raise any concerns with staff. The service learned from incidents and from people’s feedback and used this as an opportunity for improvement.

Staff told us the management team were very supportive and approachable and the team had supported each other through staffing changes a recent restructure had brought.

Staff consistently spoke to people in a respectful and kind manner, and took additional time where necessary to ensure that people’s dignity was upheld by explaining their care options to them, and providing discreet support.

We asked people about their experience of being cared for at Lord Hardy Court, and their views were all positive. One person said: “They [the staff] are lovely, I can’t fault them.” Another person said that staff knew all their needs. One person who was using the service at the time of the inspection told us: “They are very good.” Another person said they were very happy with the care they were receiving.

There were resources available to all staff in relation to safeguarding, including an information guide that was on display throughout the home. We checked team meeting minutes and saw that safeguarding issues were discussed in team meetings. Staff we spoke with understood their responsibilities in relation to safeguarding and whistleblowing.

The provider was undertaking a comprehensive restructure of the way they provide care and staff the home. Staff said despite a current reorganisation of the service, the manager of the home was particularly supportive. They added that their manager made sure they were given information about the changes in a timely way.

Audits were regularly undertaken, looking at a range of aspects of service delivery. Where audits identified areas for improvement, action plans were devised and implemented.

People experienced care delivered in an unhurried and patient manner, delivered by staff who understood people’s needs well.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

The facilities throughout the home were clean and well maintained with appropriate floor and surface coverings. Detailed hand washing procedure information was displayed over the sinks and there were hand washing facilities available for staff and visitors within each of the four units.

Appropriate checks had been undertaken before staff began work, and there were effective recruitment and selection processes in place.

Staff we spoke with could describe the complaints procedure and were confident in their knowledge of how to raise concerns or make a complaint. The provider had information available to staff about how to recognise and deal with complaints.

On this occasion we did not ask people who used the service about their experiences, but when we inspected the service in February 2012 people we spoke with were positive about their experience of receiving care at Lord Hardy Court. One person told us that she had used other similar services and that “this is the only one I’ve been comfortable in”. One person told us “it’s very nice here, I’m quite happy”. We spoke with one person who told us that they had recently had a physical health problem that had improved due to the actions of staff at Lord Hardy Court.

People we spoke with were positive about their experience of receiving care at Lord Hardy Court. One person told us that she had used other similar services and that “this is the only one I’ve been comfortable in”. One person told us “it’s very nice here, I’m quite happy”. We spoke with one person who told us that they had recently had a physical health problem that had improved due to the actions of staff at Lord Hardy Court.