About the service:

Haddon Court provides accommodation and personal care for 33 older people who live with dementia. At the time of our inspection the home had 32 people living there. The home is situated close to the promenade and transport routes. Accommodation is provided on three levels and all bedrooms provide single occupancy. There are three lounge areas and a large dining room.

People’s experience of using this service:

People and relatives consistently commented they felt safe and comfortable at Haddon Court. A relative commented, “It's a really good home, I would have no hesitation recommending it to anyone else.” Staff had training relevant to protecting people from abuse and poor practice and were able to describe their responsibilities.

The registered manager completed risk assessments aimed at minimising the risk of injury or unsafe care. They had a variety of systems intended to reduce accidents and regularly audited environmental and fire safety to maintain everyone’s welfare.

The provider assessed and monitored staffing levels to ensure they continued to meet people’s changing needs. A relative stated, “There seems to be enough staff.” The provider had a range of training to support staff in their roles.

The registered manager had multiple systems to ensure the safety of medication procedures. Staff demonstrated they understood their responsibilities and people said they received their medicines as prescribed.

Staff monitored and documented changes in people’s health and understood their responsibilities. People and relatives said staff were prompt in referring them to other healthcare professionals.

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. One person said, “They never try to force me into anything.”

Staff closely monitored how much each person ate and care records contained extensive information about their food likes/dislikes. People confirmed they enjoyed their meals. One person commented, “The meals are alright and I have a good appetite.”

We observed staff had a kind approach that focused on maintaining people’s dignity and valuing their individuality. One person commented, “The staff are smashing, they could not be any better.” The management team worked hard to ensure they valued people’s human rights.

Care records were personalised to the individual’s needs and support planning was aimed at assisting them to retain their self-determination. One person commented, “The staff here helped me become independent.”

People and relatives said the management team was approachable and visible at Haddon Court. One person stated, “Yes, I see the manager and the owner around the home.” The management team regularly completed a range of audits to assess the quality of care delivery. The registered manager told us the provider was ‘hands on’ in their approach and worked closely with staff. They added, “[The provider] is very involved in the home, the residents' wellbeing and making sure everyone is safe.”

Rating at last inspection: At the last inspection the service was rated good (published 16 November 2016).

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

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 issues or concerns are identified we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection visit at Haddon Court was undertaken on 16 and 18 November 2016 and was unannounced.

Haddon Court provides care and support for a maximum of 33 people who live with dementia. At the time of our inspection there were 33 people living at the home. Haddon Court is situated in a residential area of Blackpool close to the promenade. All bedrooms offer single room accommodation and there are communal lounges, dining areas and gardens for people’s use. Accommodation is provided over three floors with lift access for individuals with limited mobility.

A registered manager was in place. 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.

At the last inspection on 29 August 2015, we rated the service as Requires Improvement. We made recommendations for the provider to improve people’s safety and welfare. These related to recruitment documentation and employee background checks, varied meals and menu options, the provision of dementia-friendly mealtimes and medication recordkeeping.

During this inspection, we found the provider had completed the necessary improvements and people who lived at Haddon Court experienced a good service. For example, they implemented new recruitment procedures to protect people from unsuitable personnel. A staff member told us, “My recruitment was very good. It was very professional.”

Additionally, we saw the management team had improved their medication procedures. For instance, we reviewed a sample of medication charts and associated risk assessments and found staff completed them correctly. Enhanced audits checked processes to safeguard people from unsafe management of their medicines.

Furthermore, the provider had enhanced people’s experiences at mealtimes. For example, they encouraged people who were friends with others who lived at the home to sit together. The provider used an external agency to implement a ‘scent delivery system’ that produced pleasant food aromas to increase people’s appetite. Those who lived at the home and their relatives told us they enjoyed their meals and had a varied diet.

The new ‘scent delivery system’ also provided a relaxation scent in another part of the home to reduce people’s anxiety. This was an excellent way of enhancing people’s experiences of living at Haddon Court. Additionally, people and their relatives told us staff were kind and courteous in the provision of good standards of care. A relative said, “The staff and [the registered manager] treat people as their own, like their grandfather. I love that.”

The registered manager ensured staff had information about reporting concerns and had training to protect individuals from abuse or harm. They had suitable arrangements to reduce the risk of inappropriate or unsafe care. People told us they felt safe and comfortable whilst living at Haddon Court. A relative said, “We feel relieved because [our relative] is in a safe place.”

The provider utilised a staffing model to check enough staff were consistently available to meet people’s complex requirements. They additionally provided a range of training, including refresher guidance, to underpin staff understanding and experience. One person told us, “I find the carers here understand me. That’s a help in itself because I feel confident in their abilities.”

We discussed the Mental Capacity Act (MCA) and associated Deprivation of Liberty Safeguards (DoLS) with staff who demonstrated a good awareness of related principles. Care files we looked at held evidence people or their representatives had signed their consent to care and support.

Staff agreed care planning with individuals who lived at the home and involved them in every aspect of their support at Had

The inspection visit at Haddon Court Limited was undertaken on 29 July 2015 and was unannounced.

Haddon Court Limited provides care and support for a maximum of 33 people who live with dementia. At the time of our inspection there were 31 people living at the home. Haddon Court Limited is situated in a residential area of Blackpool. There are ensuite facilities and lift access to all floors. A number of lounges are available so people can choose where to relax.

A registered manager was not in place. 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 provider was in the process of registering a manager that had been recently recruited.

At the last inspection on 29/01/2014, we found the provider was meeting all the requirements of the regulations inspected.

During this inspection, people who lived at the home and their representatives told us they felt safe. We observed staff were respectful and caring towards individuals and had a good understanding of how to protect them against abuse. One staff member told us, “Safeguarding means keeping people safe in the environment they live in, keeping them safe from the potential harm from others, staff or other residents”.

Risk assessments were in place to protect people from the potential risks of receiving care and support. A relative told us, “It must be a difficult home to work in with so many people who have dementia. However, they monitor people really well to protect residents from others who have challenging behaviours.” Accidents and incidents were acted upon to ensure the reoccurrence of events was minimised.

People’s medicines were managed safely and staff were appropriately trained and guided. However, we noted staff had not always followed national guidelines on associated record-keeping. For example, hand-written entries were not signed by two staff to ensure information was correct.

We have made a recommendation about the management of medication records.

Staffing levels were adequate to ensure people’s safety was maintained and their requirements were met in a timely manner. We found staff were effectively trained and supervised in order to carry out their responsibilities. Although staff were safely and appropriately recruited, we noted the management team had not always followed national guidelines about correct recruitment procedures. Interview question responses and gaps in staff employment were not always evidenced.

We have made a recommendation about the appropriate recruitment of employees.

People were supported to maintain their nutritional requirements and were monitored against the risks of malnutrition. However, we observed the provision of meals was not always dementia-friendly or a social occasion. Although people were given an alternative meal if they did not like what was provided on the day, a rolling programme of menus was not present. This meant meal choices was not evidenced and a varied, planned menu was not in place to maximise choice for people.

We have made a recommendation about effective nutritional support for people who live at the home and to ensure the provision of dementia-friendly mealtimes.

Staff and the management team demonstrated a very good understanding and practice of the Mental Capacity Act and associated Deprivation of Liberty Safeguards. A member of the management team told us, “As we are a dementia care home, we have managed DoLS processes, within the MCA, in a staged and contained way. This is so that our residents are safe and well-supported.” There was evidence that people had consented to and were involved in their care. People were supported by staff who consistently demonstrated respect and compassion in their duties.

We found the home was well-managed and there was an open working culture. People, their representatives and staff were supported to comment about the quality of their care. The provider had a hands-on, caring approach and led the service well by having an oversight of working practices through monitoring and audit processes.

On the day of our visit we spoke with the manager, district nurses, relatives, staff and residents. We also had responses from external agencies including social services .This helped us to gain a balanced overview of what people experienced living at Haddon Court..

Some people had limited verbal communication and understanding and were unable to hold a conversation with us because of their dementia condition. To help us understand their experiences of living in the home we observed the care they received and the interaction by staff.

During our inspection we used a method called Short Observational Framework for Inspection (SOFI). This involved observing staff interactions with the people in their care. SOFI helps us assess and understand whether people who use services were receiving good quality care that meets their individual needs. We observed staff being responsive and attentive. This confirmed people who required support with their personal care or meals were being treated with respect and dignity.

We looked at care planning, meal arrangements and recruitment of staff records. We also talked with residents about the home. Comments were positive and included, “The staff are all wonderful.” Also, “I cannot fault anyone who works here the food is good and the care excellent.”

There were a range of audits and systems in place to monitor the quality of the service being provided.

We spoke with a range of people about the home. They included the manager, staff, relatives and people who lived at the home. We also had responses from external agencies including social services. This helped us to gain a balanced overview of what people experienced living at Haddon court.

During our inspection we spoke with some people and observed staff delivering personal care support. We saw people were treated with respect and dignity. We were told the staff team provided sensitive and flexible personal care support and they felt well cared for. The people we spoke with said they had no concerns about their relatives care.

We reviewed records and observed practices, which included those related to medication, meals and general care. We saw sufficient numbers of staff were on duty to be responsive to the needs of the people in their care.

People told us that the home was "A safe place, with a good atmosphere. The staff are very caring and patient".

"There are lots of activities and it's very family orientated".

"I am the final decision-maker in my husband's care. They fully involve me and will contact me to update me to changes".

People told us they could express their views about the care they received and were involved in decision making about their lifestyles. Family members said they were involved in choosing the home with their relatives and providing information about life histories and care needs.

We spoke to people living at the home about their experiences living in the home and were told the staff team provided flexible personal care and support and they were well cared for. They told us routines were flexible and they could get up and go to bed when they wished. They said the standard of food was very good and the activities organised kept them entertained.

“The staff are busy and hard working but always have time to sit and talk to you”.

“I enjoy the activities and entertainers. We have plenty to keep us occupied, memory tests and the likes. My memory is poor and they remind me when I ask them questions about things I forget”.

“I feel tired and am going to have a nap after my breakfast. I enjoyed my breakfast, I love cereal and toast, and it’s what I have at home. I got up early and now I feel tired”.

“I knew the manager before they managed this home and had trust and confidence in them. I looked around the home and it was so calm, clean and cared for I decided this was the right place for my wife”.

Pastoral visitors who visit the home on a weekly basis told us that they were involved in the activities and were always welcomed and invited to social events. A visitor said, “We have been helping with some memory activities and looking at old tin advertising signs and pictures of old Blackpool. We visit weekly and are privileged to be involved in the life of residents. This home is their home and they are treated with dignity and respect and cared for. We are invited to all the social events and always welcomed”.