Hanningfield Retirement Home is a ‘care home’. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Hanningfield is registered to provide accommodation and personal care for a maximum of 39 people. The home specialises in providing care to older people, people who are frail and some people living with dementia. At the time of our inspection there were 38 people living in the service. Hanningfield is located in Sittingbourne and is arranged over two floors.

There was a registered manager at the service. 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.

People were protected from abuse. Staff received regular safeguarding training, knew how to identify potential signs of abuse and knew how to report concerns. Risks to people and the environment were assessed and minimised. Risks associated with people’s care had been identified and appropriate risk assessments were in place. There were sufficient numbers of staff to keep people safe and meet their needs. People received their medicines when they needed them from staff who had been trained and competency checked. People were protected by the prevention and control of infection. Accidents and incidents were reported by staff in line with the provider’s policy, and the registered manager took steps to ensure that lessons were learned when things went wrong.

Staff received the training and skills they needed to meet people's needs. Staff were recruited safely. Staff didn’t always feel confident in their roles as training was not always kept up to date. People’s needs were assessed and their care was delivered in line with current legislation. People were supported to eat and drink enough to maintain a balanced diet. People told us they enjoyed their meals. Staff worked together across organisations to help deliver effective care, support and treatment. Staff were knowledgeable about the Mental Capacity Act, knew how to seek consent for care and knew the process to help those who lacked capacity to make decisions. People’s needs were met by the adaptation, design and decoration of the service.

People were treated with kindness, respect and compassion. We saw staff listening to people, answering questions and taking an interest in what people were saying. People were supported to express their views and be actively involved in making decisions about their care and support. People's privacy, dignity and independence were respected and promoted.

People told us they were not always supported to take part in activities that interested or were appropriate to them. Activities provided by the volunteer were group based, and not always tailored to individual interests. We have made a recommendation about this. Other aspects of people’s care was provided in a personalised way. People were encouraged to maintain relationships with those who mattered to them. Family members and friends were welcomed into the service. People told us they were confident to raise complaints and concerns about the support they received. People were supported at the end of their life to have a comfortable, dignified and pain-free death. Staff worked closely with the palliative care team and the local hospice.

Governance systems were not always effective in ensuring that shortfalls in service delivery were identified and rectified. Audits had not been effective in identifying all of issues we identified at this inspection. The registered manager had an oversight of and reviewed the daily culture in the service, including the attitudes, values and behaviour of staff. Ma

We carried out this inspection on the 27 October 2015, it was unannounced.

Hanningfield Retirement Home is a privately owned care home providing accommodation and personal care for up to 39 older people, some of whom are living with dementia. The premises are a large detached property providing accommodation over two floors with a passenger lift and two chair lifts for access to upper floors. At the time of the inspection, 39 people lived at the service.

The service had a registered manager. 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.

There were sufficient numbers of staff to meet people’s needs. Staff were recruited using procedures designed to protect people from unsuitable staff. Staff had the knowledge and skills to meet people’s needs, and attended regular training courses. Staff met with the management team and discussed their work performance at one to one meetings and during annual appraisal, so they were supported to carry out their roles. Staff were supported by the registered manager and felt able to raise any concerns they had or to make suggestions to improve the service to people.

People said they were happy at the service. Staff were available throughout the day, and responded quickly to people’s requests for help. Staff communicated well with people, and supported them when they needed it.

People were protected against the risk of abuse. People told us they felt safe. Staff recognised the signs of abuse or neglect and what to look out for. Both the registered providers, registered manager and staff understood their role and responsibilities to report any concerns and were confident in doing so.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood when an application should be made. They were aware of the Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The service was meeting the requirements of the Deprivation of Liberty Safeguards.

There were risk assessments in place for the environment, and for each person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. There were systems in place to review accidents and incidents and make any relevant improvements as a result.

People and their relatives were involved in planning their own care, and staff supported them in making arrangements to meet their health needs. Staff contacted other health and social care professionals for support and advice.

Medicines were administered, stored, and disposed of safely. People received their medicines as prescribed.

People were provided with a diet that met their needs and wishes. Menus offered variety and choice. People said they liked the food. Staff respected people and we saw several instances of a kindly touch or a joke and conversation as drinks or the lunch was served.

Staff encouraged people to undertake activities and supported them to become more independent. Staff spent time engaging people in conversations, and spoke to them politely and respectfully.

The registered providers and the registered manager investigated and responded to people’s complaints. People knew how to raise any concerns and relatives were confident that the registered manager dealt with them appropriately and resolved them where possible.

There were systems in place to obtain people’s views about the service. These included formal and informal meetings; events; questionnaires; and daily contact with the registered manager and staff.

The registered providers and registered manager regularly assessed and monitored the quality of care to ensure standards were met and maintained. The registered providers and registered manager understood the requirements of their registration with the Care Quality Commission.

We carried out this inspection over six hours. During this time, we met the majority of the 38 people who lived at the home and spoke with eight people in detail. We spoke with three relatives and five staff members. The manager was available throughout the inspection. The summary describes what people who used the service, and the staff told us, what we observed and the records we looked at.

The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People were supported in an environment that was safe, clean and hygienic. Equipment at the home had been well maintained and serviced regularly. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available at the home or by telephone during the evenings. The manager was assessing people who no longer had the capacity to make decisions to make sure they were not unlawfully deprived of their liberty of freedom.

There were evacuation and emergency contingency plans in place

Is the service effective?

People were fully involved in their assessment of needs and care planning. This meant that their views were taken in consideration and that all care and support was planned with their consent. The relatives and representatives of the people who used the service were involved in the care planning process with their consent. People’s care was reviewed regularly, and adjustments were made make sure they remained comfortable, safe and as independent as possible.

Almost everyone we spoke with said that they would not hesitate to raise concerns with the manager or staff. There was a complaints procedure on display, but was in quite small font size, so may be hard for people to read easily.

Is the service caring?

People were relaxed and happy in the company of staff. We observed that everyone looked pleased and relaxed to see the manager or person escorting us. People were confident to speak about the service provided. There were monthly meetings where people could meet and voice their opinion about the service to the manager. The manager also spoke with each person who lived in the home every working day. A visiting relative told us “My relative felt a bit isolated upstairs, so we spoke to the manager, and as soon as it was possible, a room on the ground floor was provided”.

Is the service responsive?

Records showed that the manager and their team worked together to keep people’s health and support plans up to date. Records confirmed that medical professionals had been consulted without delay and that recommended actions had been implemented and appropriately recorded. The service learned from incidents and accidents and ensured that risks of re-occurrence were minimised. Relatives told us that they knew where they could post compliments or complaints, and that they would not hesitate to raise “little niggles”. All said that they found the manager and team easy to speak with and that they were ‘quick to sort out problems’.

Is the service well led?

The people we spoke with said that the home was ‘very well led’. Several people said, “I have no complaints, and if I did, I would say so”. We spoke with three relatives and they all confirmed that they were extremely happy with the service provided. One said “I cannot speak highly enough about the staff and management team”.

A scheduled inspection was undertaken on 26 June 2013 and at that time the service was judged to be compliant with Outcomes 2, 4, 9, 12 and 16.

We carried out an inspection visit on 4 September 2013 in response to some concerns raised anonymously by a member of the public. The concerns were in relation to care and welfare of people, and inadequate staff training. In accordance with information sharing policies we contacted Social Services and discussed the concerns raised.

We visited the service unannounced and commenced the visit at 06.30, as this enabled us to speak with the night staff on duty. During the visit we spoke with the providers, the manager, members of staff, people that used the service and a district nurse who told us she visited the service regularly.

We found that people experienced effective, safe and appropriate care, treatment and support that met their needs and protected their rights.

There were enough qualified, skilled and experienced staff on duty at the time of the visit to meet the needs of the people that used the service.

During our inspection we spoke to people who used the service, two relatives of people that used the service, management and staff.

People told us that they were happy with the support they received, that the staff looked after them well. People said they liked the food, there was a choice of menu and that they chose where to eat. People said they knew who to speak to should they have any concerns, but said they had no complaints.

Comments from people that used the service included “The staff are good' and “The staff are kind people”. One person said “This is the best home by far for miles and miles”. Comments about the food provided included “The food is very good and the variety of vegetarian food is good”, “The food is lovely” and “Happy with the meals”.

Two compliance actions had been made at the inspection visit dated 11 December 2012 as we found that people were not always protected from the risks of unsafe or inappropriate care and treatment as not all records were accurate, and some staff records did not contain all relevant information. At this visit we found that action had been taken to address these issues.

We found that care staff were appropriately recruited, trained and supervised so that they could meet people’s individual care needs.

Care records seen showed that the person was supported with their care in a way that was individual and in accordance with their wishes.

We carried out a scheduled inspection to the service on 26 June 2012 and at that time the service was judged to be compliant with Outcomes 1, 4, 7, 14 and 16.

We carried out a responsive review of the service on the 11 December 2012, as we had been told anonymously about issues of concern in relation to the care and welfare of people. We visited the service unannounced and started the visit at 06.30am. During the visit we spoke with the providers, the manager, members of staff, people that used the service and a relative of a person that used the service.

The relative of a person that used the service told us that “Overall it was a good service with a very nice team of staff”. He said that he could visit at any time and felt able to mention any concerns to the management, who listened and took appropriate action to resolve any issues raised.

Two of the people that used the service told us “The staff are very good, they are kind and friendly”. They said that the staff asked them in the morning if they were ready to get up, and would come back later if they asked them to.

We found overall that the service was compliant with Regulations 9 and 19. However we found the service to be non-compliant with Regulations 20 and 21 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

Where areas of non-compliance have been identified during inspection they are being followed up and we will report on any action when it is complete.

People said they liked living at Hanningfield Retirement Home. People said there were different activities to do and that they could join in with activities if they wanted to. They said they were happy with the support they received, that the staff looked after them well. People said they liked the food, there was a choice of menu and that they chose where to eat. They said that the home was always kept clean and smelled fresh. People said they knew who to speak to should they have any concerns, but said they had no complaints.