Hadleigh Court, Cary Park, Torquay.Hadleigh Court in Cary Park, Torquay is a Residential home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs, dementia and mental health conditions. The last inspection date here was 9th August 2019 Contact Details:
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Link to this page: Inspection Reports:Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.
4th December 2018 - During a routine inspection
This inspection took place on the 4 and 5 December 2018. The first day of the inspection was unannounced, and started at 6:55 am to allow us to meet with the night staff, be present at the staff handover and see how duties were allocated for the day. Hadleigh Court is a ‘care home’ without nursing, operated by Babbacombe Care Limited. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. People living at Hadleigh Court were older people, many living with long term health conditions or dementia. The service accommodated up to 31 people in one adapted building, with a lift to access the rooms on the first floor. 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. 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 of the service on 12 July 2016 the service was rated as ‘good’ in all areas. On this inspection we have rated the service as good overall. The key question for well led has been rated as requires improvement. This was because we identified a number of people’s records and care plans had not been updated, or were not comprehensive enough to guide staff on how to support people consistently. We did not find people had suffered harm as a result, and staff knew people well. However, this could have left people at risk. Assessments were in place to support people with other risks, for example with pressure damage, choking risks, poor nutrition, falls and moving and positioning. We saw staff understood how to support people in ways that made use of known information about the person’s history and choices. Staff knew people well, and we saw evidence of compassionate, caring and supportive relationships in place. There were enough safely recruited staff on duty to meet people’s needs. Staff and people told us they felt they had the skills and knowledge to support people effectively and had access to senior staff for advice and support. Training plans were in place and an external training advisor visited the service every month to assist with updating staff training and management systems, policies and procedures. Systems were in place to learn from accidents or incidents and for staff supervision. People received their medicines as prescribed. People were protected from abuse. Staff understood what constituted abuse and were aware of how to report concerns about people’s wellbeing. Where people were at risk from poor nutrition or hydration this was monitored, and the service had built supportive relationships with visiting professionals such as district nurses, community mental health teams and podiatrists. People’s rights with regard to the Mental Capacity Act 2005 were well understood. Where Deprivation of liberty authorisations (DoLS) had been granted, conditions of the DoLS were well understood. This meant people’s rights were being supported. We did not identify any areas of discrimination. Hadleigh Court is a long-established care home, set in a residential area of Torquay, close to local shops and facilities. The registered manager told us they were working on developing the building and workmen were painting and refreshing décor during the inspection. Work had been undertaken on communal areas, flooring and furnishings in people’s bedrooms and the garden in the last year, but some areas were still looking tired. We have recommended the registered persons seek and follow best practice guidance on the adaptation of the premises to meet the needs of people living with dementia. During the inspection we identified concerns over the laund
12th July 2016 - During a routine inspection
Hadleigh Court is a long established care home without nursing, set in a residential area of Torquay, and providing care for up to 31 people. People living at the home were older people, many of whom were living with dementia. This unannounced inspection took place on 12 July 2016, and started at 6.30am to allow us to meet with the night staff and see how people were supported from the start of their day. It was a comprehensive inspection, and was unannounced. It followed on from a focussed inspection carried out in May 2016, and a comprehensive inspection of October 2015 where concerns had been identified. You can read the reports from our last inspections by selecting the ‘all reports’ link for Hadleigh Court care home on our website at www.cqc.org.uk. On this inspection of 12 July 2016 we looked to see that the improvements that we had seen in May 2016 had been sustained. We found that the improvements were ongoing, but those seen in May 2016 had been maintained. Quality and safety had improved, and risks were being managed with improved communication both within and outside of the home. Comprehensive training was being provided and the new staff team had been boosted with additional management and leadership support. There was a registered manager in post. A registered manager is a person who has registered with the 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. People were being protected because systems for the management and assessment of risks had been put in place. Where risks had been identified measures were taken to reduce these wherever possible. Internal and external audits were used to identify concerns, and where issues were identified, action plans showed the progress being made to resolve them. For example, new systems had been put into place to ensure the risks of cross infection were reduced. This included more regular audits, cleaning schedules and improved equipment. Cleaners understood their roles, and could demonstrate how a safe environment was kept maintained, and we found the home was clean, warm and comfortable. Developments were under way to make the environment more ‘friendly’ for people with dementia. Staff understood how to safeguard people from abuse. There were clear policies and procedures in place and staff had received training in how to identify abuse and what to do about it. Staff told us they were clear about what to do if they had any concerns about people’s safety or wellbeing. There were enough staff to meet people’s needs in a timely way. Additional staff had been provided at times of high need to make sure people received the care they needed in the way that they wished. We saw staff were skilled at identifying changes in people’s needs or behaviours and taking action to reduce anxieties before they increased. Staff told us they had received the training and support they needed to carry out their role, and although there had been a significant staff turnover recently, the staff team were working well together to protect and support people. Records identified the training given to staff and when updates were needed. Staff were positive about training. They told us the manager and training provider were approachable and would access any training they needed. Risks relating to the recruitment of staff were identified, and a full recruitment process was being followed for new staff. Communication systems were in place including handovers and regular staff meetings. Staff we met were enthusiastic about providing good care for people, and told us they were happy with the standards of care at the home. We saw them working well as a team. People’s care files and plans reflected people’s needs or wishes about their care and how this was to be delivered. Relatives had in many c
3rd May 2016 - During an inspection to make sure that the improvements required had been made
Hadleigh Court provides care for up to 31 people. People living at the home were older people, many of whom were living with dementia. This inspection took place on the 3 May 2016. It was an unannounced focussed inspection to follow up on a warning notice issued following an inspection on the 8 and 13 October 2015. On the inspection in October 2015 we identified concerns over a number of breaches of legislation. We issued the provider and then registered manager with a warning notice in relation to Regulation 17 (1) and (2) (a) (b) (c) and (d) of the Health and Social Care Act (Regulated Activity) Regulations 2014 (Good Governance). The provider and registered manager needed to comply with the warning notices by 15 January 2016. The provider sent us an action plan telling us what actions they had taken to improve, and worked with the local authority’s safeguarding and quality teams to improve standards at the home. The registered manager in post at the time of the inspection in 2015 had left the home and additional time was allowed to enable the service to make the changes they needed to improve. This focussed inspection was carried out to ensure the provider had met the detail of the warning notices for Regulation 17 (Good Governance). Other areas for improvement identified during the inspection of 8 and 13 October 2015 remain part of the home’s ongoing action plan, and will be looked at on the next comprehensive inspection, when we will also check to see improvements made at this time have been sustained. We found sufficient action had been taken to meet the requirements of the warning notice. There was a newly appointed registered manager in post. A registered manager is a person who has registered with the 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. People’s safety had improved. Systems for the management and assessment of risks had been strengthened and where risks had been identified measures were put into place to reduce these wherever possible. We saw that people’s well-being had improved as a result of the reduction and proper management of risks, for example the number of falls had declined. Internal and external audits had been put into place, and where issues were identified, action plans identified progress being made to resolve them. New systems had been put into place to ensure the risks of cross infection were reduced. This included more regular audits, cleaning schedules and improved equipment. Improvements had been made to the leadership and management of the home. Staff received increased guidance in their role and routines were being made more flexible to meet people’s differing needs and wishes. Communication systems had improved, including handovers and regular staff meetings. Records, policies and procedures had improved. People’s care plans reflected their needs, wishes and aspirations regarding their care in more detail, and policies and procedures had been updated. Staff recruitment processes and records had been strengthened to help protect people and provide greater assurance of their character and work performance. References had been obtained and disclosure and barring service (police) checks had been undertaken before any new staff started to work with people. Systems had been put in place to assess any risks in relation to staff recruitment and gaps in people’s employment history had been explored. Quality assurance systems and feedback had led to improvements for people. For example changes had been made to improve the environment and people were enjoying more trips out. Feedback from people living at the service or visiting was positive about the changes being made. This report only covers our findings in relation to compliance with the warning notice for Regulation 17 He
20th May 2014 - During a routine inspection
We considered all the evidence we had gathered under the outcomes we had inspected. We used the information to answer the five questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found. The summary was based on our observations during the inspection, speaking to people using the service, staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read the full report. Is the service safe? People were treated with dignity and respect by the staff. People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported. Systems were in place to make sure that the managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve. The home had clear policies and procedures in relation to the Mental Capacity Act. Deprivation of Liberty Safeguard applications had been submitted in a timely fashion proving that the manager was protecting the vulnerable people who lived there from harm. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant that people were safeguarded as required and decisions were taken in the person's best interest. The Deputy Manager set the staff rotas, we saw they took people’s care needs into account when making decisions about numbers, qualifications, skills and experience required in the staff on duty. This helped to ensure that people’s care needs were always met. Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected. Is the service effective? People's healthcare needs were assessed with them and they were involved in writing their care plans. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said they had been involved in writing them and they reflected their current needs. Is the service caring? People were supported by kind and attentive staff. We saw that care staff showed patience and gave encouragement when supporting people. People commented, “The staff are so friendly, patient and caring”. People who used the service, their relatives, friends and other professionals involved with the service completed annual satisfaction surveys. Where shortfalls or concerns were raised these had been addressed. Randomly selected cards from relatives said "Thank you so much for all you are doing for my Mum. You treated her with respect, dignity and humour. God bless every one of you”. Another card said “There are not enough words to express our thanks and gratitude for all you did for Dad. Not only did you do him proud but our Mum as well. Your kindness will never be forgotten". People’s preferences, interests, aspirations and diverse needs had been clearly recorded in their care plans and care support had been provided in accordance with people's wishes. Is the service responsive? People regularly completed a range of daily activities within the home. There was a full time activities organiser, day trips in the mini bus and external entertainers employed. Everyone within the home was able to choose their level of involvement.
People knew how to make a complaint if they were unhappy. No one we spoke to felt the need to make a complaint as they were very happy with the service they received. We looked at how complaints had been dealt with and found that the responses had been open, thorough and timely. People could therefore be assured that complaints were investigated and action was taken as necessary. Is the service well-led? The service worked well with other agencies and services to make sure that people received their care in a joined up way. The service had a quality assurance system. Records seen by us showed that identified shortfalls had been addressed promptly. As a result the quality of the service was continually improving. Staff told us they were clear about their roles and responsibilities.
18th June 2013 - During a routine inspection
At the time of our inspection 26 people lived at Hadleigh Court. We spoke with five people who lived at the home and a relative of a person who lived there. We also spoke with three care workers, the manager, the owner, the cook and three health professionals. People told us that they were treated respectfully by care workers and that they were offered choices in relation to their daily care and their activities at the home. People who lived the home, their relatives and visiting health professionals were positive about the care delivered at Hadleigh Court. Comments included “The service here is very good, very flexible.” People's needs had been assessed and their care had been planned and delivered in line with those assessments. Care plans had been regularly reviewed and updated. We observed organised activities which took place at the home. People told us that they enjoyed a range of different activities such as quizzes, games, music and gentle exercise classes. We saw evidence that Disclosure Barring Service (DBS) checks and reference checks had been completed on care workers at the home prior to employment. We looked at the quality assurance systems in place to monitor the quality of care delivered. We saw that the provider monitored the service and responded to feedback effectively.
11th March 2013 - During a routine inspection
Hadleigh Court was last inspected by the Care Quality Commission (CQC) in March 2012. We found minor improvements were required in relation to the environment, care records and privacy and dignity for people in the home. At this inspection we found that these improvements had been made. People told us they were happy at the home. One person said “I feel safer now I am here and I have company all the time”. We found that people's needs were met in a respectful and discreet manner. Care workers were able to tell us how they respected people’s preferences even though their dementia might mean that the person was no longer aware of their previous preferences. We saw that care plans contained details of people's physical needs and directions for care workers on how to meet these needs. We saw these needs had been met. People told us they felt safe at the home and care workers were aware of the procedures to be followed if they suspected abuse was occurring. People were very complimentary about the stable group of care workers. One person said “They are all as good as gold.” We found that there were enough care workers on duty to meet the needs of the people who lived at the home. The home was well managed. People, staff and visitors all spoke highly of the manager and provider. Records reflected the management of the home. They were well maintained and securely stored.
16th March 2012 - During a routine inspection
We carried out an unannounced visit to Hadleigh Court on the 16 March 2012. We met and spoke with eight people living at the service. We also spoke with two relatives, four care and ancillary staff, the registered manager and a senior manager. People living here told us they were happy with the care and support they received and that their privacy and dignity was respected by staff. The people we spoke with told us that they felt safe living at the home and that they knew who to speak to if they were unhappy about something. None of the people we spoke to had any concerns about the way they were treated at the home. People told us, “The staff are lovely. Always polite…”, “The staff are marvellous…”, “Staff are helpful and polite”, “The staff are pretty good. Just got to ask and they do it” and “The staff are kind and polite”. There was a relaxed friendly atmosphere at the home. We saw that a number of people enjoyed the activities provided and people told us about the friendships they had developed since moving to the home. Relatives spoken with told us they were happy with the level of care and support provided to their family members. One relative told us, “It is very caring and homely here…” another relative said, “You couldn’t ask for more friendly staff”. The staff we spoke with told us that they were well supported. They said that they had a good range of information and training to help them care for people living at the home. We found that to ensure the home remained welcoming, comfortable and safe for people; parts of the environment were in need of refurbishment.
1st January 1970 - During a routine inspection
This inspection took place over two days on the 8 and 13 October 2015. The first day of the inspection was unannounced and took place at 6am to enable us to meet with the night staff and see people being supported in the early morning. The second day was announced. The inspection was bought forward due to concerns shared with the Care Quality Commission (CQC). At the time of the inspection the concerns were being investigated by the local authority safeguarding team.
Hadleigh Court is a long established care home providing care and accommodation for up to 31 people. 28 people were living at the home at the time of the inspection. Most of the people living at the service were older people, many of whom were living with a significant dementia, some of whom were also physically frail. Some people were younger and living with long term health conditions.
There was a registered manager in post at the service at the time of the inspection. 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.
We identified concerns about a lack of leadership and effective governance of the home. This meant systems had not been put in place to ensure people’s care could be delivered effectively and safely. Changes in people’s needs were not being identified and medical and professional advice was not always being sought at an early enough stage to prevent ill health or deterioration in people’s condition. Where people were having falls or other accidents action was not taken to analyse the incident and take actions to help prevent them happening again. This meant care was not always safe.
Records kept were not fit for purpose; many were out of date and there were no audits of practice being carried out to enable the provider to judge the quality of the services provided or take action to address shortfalls. Notifications had not been sent to CQC as required by law. Care plans were not personalised to each individual and did not contain sufficient detailed information to assist staff to provide care in a manner that was safe and respected people’s wishes. Medicines were not always being stored safely, although staff understood how people should be given their medicines and people told us that they received the medicines they needed at the right time.
Staff did not always have the skills, training or support they needed to do their job, and there were not always enough staff available to help people get the care they wanted when they wanted it. This meant sometimes care was task based rather than being based on people’s wishes and preferences. Staff recruitment practices were not robust, which meant that people could have been placed at risk by being cared for by staff who could be unsuitable. Concerns were expressed by agencies supporting the home that their recommendations were not being implemented consistently to improve people’s care.
Concerns raised were not always being fully investigated or addressed robustly and safeguarding practice including staff training in how to protect people was not up to date. Staff understood how people expressed their wishes and consent, but had not received training in how to protect people’s rights under the Mental Capacity Act 2005.
The design of the premises did not reflect best practice in dementia care, but improvements were being made, both to the building and to support better control of infection and improve cleanliness. However, risks presented by the premises had not been audited or managed properly and the premises had not always been properly adapted to meet people’s changing needs.
We saw many examples of positive and supportive care being delivered from staff, but we also saw instances where staff did not recognise that people’s needs were not being met, or care did not respect people’s dignity. Staff respected people’s confidentiality and celebrated successes and special events with people, and the home had a good programme of activities for people to follow which were provided one to one or in groups. People told us they enjoyed their meals and people’s dietary needs were respected.
People told us they were happy at the home. People’s relatives were positive about the care their relation received. They told us they felt involved with people’s care and were free to visit at any time.
Where concerns were identified to the provider at this inspection we saw they were quick to take action to make improvements.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
We have made a recommendation about sufficient staff being available to support person centred care.
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