Rating at last inspection: Good (report published 12 July 2016).

About the service: Yohden Hall Care Complex is a nursing and residential care home that can accommodate 77 people. Care is provided for older people, some of whom are living with dementia and people with learning disabilities. At the time of this inspection there were 62 people living at the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

People’s experience of using this service: Everyone we spoke with told us Yohden Hall Care Complex was a homely place to reside and visit, that staff were kind and caring and people were treated with respect. People said staff knew them very well and could anticipate their needs and that support was delivered in a timely way. People and their relatives described high levels of satisfaction with the service which impacted positively on their overall wellbeing.

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 involved in their day to day lives and were empowered to make their own choices about where they spent their time. Their independence was promoted and staff actively ensured people maintained links with their friends and family. Where people required support at the end of their life, this was carried out with compassion and dignity.

The environment supported people to have time on their own and time with other people if they chose this. Cleanliness and health and safety were well managed. The environment was safe and people had access to appropriate equipment where needed.

Staff recruitment was safe. There was enough staff on duty at the right time to enable people to receive care in a timely way. Staff had appropriate skills and knowledge to deliver care and support in a person-centred way. Staff understood how to keep people safe and used information following accidents and incidents to reduce the likelihood of future harm.

People's health was well managed and staff had positive links with professionals which promoted their wellbeing. In addition, people had opportunity to access a wide range of activities, including access to the local community.

People were observed to have good relationships with the staff team. The manager and senior team worked well to lead the staff team in their roles and ensure people received a good service. People, their relatives and staff all felt confident raising concerns and ideas. All feedback was used to make continuous improvements to the service.

A full description of our findings can be found in the sections below.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 2 and 3 June 2016 and was unannounced. This meant the staff and the registered provider did not know we would be visiting. The home had a registered manager in place. A registered manager is a person who has registered with 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.

Yohden Hall Care Complex was last inspected by CQC on 29 August 2013 and was compliant with the regulations in force at the time.

Yohden Hall Care Complex is a care home with nursing that is registered to provide care for up to 77 people and the majority of the bedrooms were en-suite. On the day of our inspection there were 68 people using the service. The home is located in Blackhall near Hartlepool and is owned and run by Countrywide Care Homes Limited.

Accommodation is provided at ground and first floor levels. The Hall provides care for general residential and general nursing service users. The Lodge provides care for service users with dementia type illnesses. The Court provides care for service users with learning disabilities. Facilities included several lounges and dining rooms, communal bathrooms, shower rooms and toilets, hairdressing rooms, treatment rooms, a communal bar and several communal gardens. The general reception was large and spacious with a comfortable seated area.

We saw that entry to the premises was controlled by key-pad entry and all visitors were required to sign in. This meant the registered provider had appropriate security measures in place to ensure the safety of the people who used the service.

People who used the service and their relatives were complimentary about the standard of care at Yohden Hall Care Complex. We saw staff supporting and helping to maintain people’s independence. People were encouraged to care for themselves where possible. Staff treated people with dignity and respect.

The registered provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. There were sufficient numbers of staff on duty in order to meet the needs of people using the service.

Training records were up to date and staff received supervisions and appraisals, which meant that staff were properly supported to provide care to people who used the service.

The layout of the building provided adequate space for people with walking aids or wheelchairs to mobilise safely around the home and was suitably designed for people with dementia type conditions.

The service was working within the principles of the Mental Capacity Act 2005 and any conditions on authorisations to deprive a person of their liberty were being met. All the care records we looked at contained evidence of consent.

People were protected against the risks associated with the unsafe use and management of medicines.

People had access to food and drink throughout the day and we saw staff supporting people at meal times when required.

People who used the service had access to a range of activities in the home.

All the care records we looked at showed people’s needs were assessed. Care plans and risk assessments were in place when required and daily records were up to date. Care plans were written in a person centred way and were reviewed regularly.

We saw staff used a range of assessment tools and kept clear records about how care was to be delivered and people who used the service had access to healthcare services and received ongoing healthcare support.

The registered provider had a complaints policy and procedure in place and complaints were fully investigated.

The registered provider had a robust quality assurance system in place and gathered information about the quality of their service from a variety of sources.

We spoke with 16 people who used the service and six relatives or friends of people during the inspection. We also spoke with the registered manager and staff who worked at Yohden Hall Care Complex.

People were asked for their consent before they received any care or treatment. The staff we spoke with understood the need for people to consent to the care they provided. It was evident that people were asked about their choices and staff were careful to make sure what they asked was understood.

People told us they were happy with the care and support they received. One relative told us “I find care here is very good, in fact I find the place uplifting, and I never leave feeling sad. Staff are really pleasant and caring.”

There was enough equipment to promote the independence and comfort of people who used the service. We saw equipment was stored safely and securely throughout the home.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. One relative told us “The staff know everything about them” and “They (the staff) understand them here.” Other comments about the staff and people’s experience of them included “The staff are very pleasant and will do anything you ask” and “Staff are really pleasant and caring.”

The provider had an effective system to regularly assess and monitor the quality of service that people received. We found systems were in place to capture feedback from people who used the services, their relatives and representatives.

This inspection was a themed inspection focussing on dignity and nutrition. People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by a professional medical practitioner and an expert by experience, “people who have experience of using services and who can provide that perspective”.

The SOFI (Short Observational Framework for Inspection) tool was not used on this inspection as people were able to talk to us about the care and treatment they received.

During this themed inspection visit, we spoke to ten people who used the service and four relatives. This is what they told us: People who used the service said they were given appropriate information and support regarding their care or treatment. Each person had a written contract and a statement of their terms and conditions with the provider. No-one had moved into the home without having had their personal needs assessed.

All had been assured by the senior staff their assessed needs would be met at the service. People told us they had been involved and had contributed to the pre-admission assessment. People told us their privacy and dignity was upheld by staff working in the home.

The ten people we spoke with on the day of the inspection all said they had a choice of at least two hot meals each day. People said portion sizes were good. They said they never felt hungry or thirsty.

Four people told us “We always get plenty to eat and drink and lots of snacks and drinks between meals.” All said the meals were excellent.

Another person told us “I can have my meals in my room if I don’t feel like going to the dining room. When I do this staff respect my wishes and privacy”.

People told us staff listened to them and they always respected their dignity and promoted choice and independence.

All the people we spoke with told us they felt safe and well cared for living at Yohden Care Complex. One person said "I feel very safe living here, when I lived on my own I was very nervous and worried all of the time", and other people confirmed they didn't feel at risk within the home. People were also clear about how and who to report any concerns about their safety to.

People told us they were well supported by the staff team and were happy with the care, treatment and support they received.

Relatives we spoke with told us the care their family members received was excellent. They told us staff kept them fully informed about their family members wellbeing and support needs. One relative described the home as five star.

We did not speak with any service users during this visit.