Hascott House is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Hascott House provides accommodation and personal care for up to nine people, over the age of eighteen, who have a learning disability. The home is located in the Gleadless area of Sheffield, close to local amenities and transport links. At the time of this inspection seven people were living

at Hascott House.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People living at Hascott House told us they felt safe and they liked the staff. Some people who we could not verbally communicate with were able to express their happiness and satisfaction with the care they received by facial expression (smile) and body languages and gestures.

We found systems were in place to make sure people received their medicines safely so their health was maintained.

Staff recruitment procedures ensured people's safety was promoted.

Staff were provided with relevant training and supervision to make sure they had the right skills and knowledge to support people. Some staff said they would benefit from additional training in safeguarding vulnerable adults and the Mental Capacity Act.

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 had access to a range of health care professionals to help maintain their health. A varied diet was provided, which took into account dietary needs and preferences so people's health was promoted and choices could be respected.

A range of activities were available both inside and outside the home to provide people with leisure opportunities.

People living at the home said they could speak with staff if they had any worries or concerns and they would be listened to.

There were systems in place to monitor and improve the quality of the service provided.

Safety and maintenance checks for the premises and equipment were in place and up to date.

Further information is in the detailed findings below.

The inspection took place on 9 February, 2016 and was unannounced.

Hascott House provides accommodation and personal care for up to nine people, over the age of eighteen, who have a learning disability. The home is located in the Gleadless area of Sheffield, close to local amenities and transport links.

The service had a registered manager in post at the time of our 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.

The provider had a policy and procedure in place for safeguarding people from abuse. This included the types of abuse and how to recognise and report it. Staff we spoke with told us how they would recognise abuse and the signs they would look for.

We found there were enough staff available to meet the needs of people living at the service. Staff were available to support people as required, including supporting people on trips out in the community.

We looked at systems in place for managing medicines and found people received their medicines safely and appropriately. Medication was stored in a locked room in a locked cabinet and the temperature of the room was taken daily to ensure medicines were stored correctly.

We saw the service had a safe recruitment system in place which was used when employing staff. We looked at four staff files and found the recruitment process had been followed.

We looked at support plans and found risks associated with peoples’ care and support had been identified. However, we saw one support plan stated someone was at risk of losing weight, but there was no risk assessment in place to address this.

We looked at staff training records and saw training took place on subjects such as medication management, infection control, moving and handling, nutrition, safeguarding, and food safety. Training was completed electronically and face to face depending on the subject.

We found the service to be meeting the requirements of the MCA and DoLS. Staff training records confirmed training in this subject had taken place. We spoke with the registered manager who told us that appropriate DoLS requests had been made to the authorising body and they were waiting to hear the outcome.

People were supported to have sufficient quantities of food and drink. People were involved in menu planning, food shopping and meal preparation where possible. People decided on a weekly menu for evening meals.

We looked at peoples support plans and found that relevant healthcare professionals were involved in their care when required.

We observed staff interacting with people and found they were kind, caring and patient. Staff were supportive and involved people in their care and support. We saw staff offered choices and gave time for people to respond and they respected the person’s decision.

We looked at support plans belonging to people and found they reflected the support being offered by staff. Support plans were person centred and reflective of the person’s needs and wishes and included their likes and dislikes.

People were supported to pursue hobbies and interests and engage with the community. For example, people were involved in work programmes, church activities, shopping, and community groups.

The provider had a complaints procedure in place which was also available in an easy read version. Staff we spoke with told us that if anyone had a problem they would tell the staff or it would be raised at the residents meetings.

We saw that audits took place to monitor the quality of service provision. Any actions were identified and resolved.

People were supported to comment about the home and staff were able to suggest ways to improve the service. We saw results from an annual family survey which had been com

An adult social care inspector carried out this inspection. At the time of this inspection seven people lived at Hascott House. We observed interactions between people living at the home and staff, and were able to speak with one person to obtain their views of the support provided. In addition, we spoke with all of the staff on duty, which included the registered manager, the deputy manager, a senior care worker and a care worker about their roles and responsibilities.

We gathered evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. The summary is based on observing and speaking with people using the service, the staff supporting them and from looking at records.

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

Is the service safe?

People supported by the service told us they felt safe.

We observed, and people told us they felt their rights and dignity were respected.

Systems were in place to make sure 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.

We found that risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

The home had policies and procedures in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant people would be safeguarded as required.

Policies and procedures were in place in relation to the safe management of medication. Staff that administered medication had been provided with training in the safe handling of medication. This meant that people’s health and safety was promoted.

At our previous inspection we identified some concerns as some areas of the home were in need of maintenance and posed potential tripping hazards to people. We found some improvements had been made to the condition of individual and communal areas so that they were safe. We found that some areas of the home remained in need of refurbishment. These improvements were identified within the home's maintenance plan and were due to take place following planned reconstruction to an identified area of the home.

Is the service effective?

People’s health and care needs were assessed with them and their representatives, and they were involved in writing their plans of care. Specialist needs had been identified in care plans where required.

Staff were provided with training to ensure they had the skills to meet people’s needs. Staff were provided with formal individual supervision and appraisals at an appropriate frequency to ensure they were adequately supported and their performance was appraised. The manager was accessible to staff for advice and support.

Is the service caring?

We were able to verbally communicate with one person and asked them for their opinions about the support provided. Feedback was positive, for example, “they (staff) are good, they are kind" and “I am happy here". Interactions between people living at the home and staff were kind, patient and respectful. All of the people living at Hascott House appeared content and happy.

When speaking with staff it was clear that they genuinely cared for the people they supported and had a detailed knowledge of the person’s interests, personality and support needs.

People’s preferences and interests had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People’s individual choices regarding how they spent their day were supported by staff.

People spoken with said they had no worries about living at Hascott House. Information on how to make a complaint was provided to people and staff were aware of the procedure to support people if they wanted to make a complaint. We found appropriate procedures were in place to respond to and record any complaints received. People could be assured that systems were in place to investigate complaints and take action as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system in place. At our previous inspection we identified some concerns as the systems in place did not cover all aspects of the running of the home and staff were not formally asked their opinion of the service. We found that improvements had been made to the quality assurance systems to ensure that all areas of the home were audited, and staff were asked their opinion. Records seen by us showed that if shortfalls were identified they were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

People were able to decide how they wanted to live their lives and staff at the home enabled and guided them to achieve their goals. One person said, “I know what I need to do. I mostly get on with it. Sometimes staff prompt me. Staff are nice and helpful here.”

We observed instances where staff were discussing the risks, benefits and alternative choices with people who used the service to help them understand and make their decisions.

We saw and heard evidence that there was no ‘one size fits all’ approach to care here. It was very clear that every effort was made to tailor care to the person’s needs.

People who used the service attended day centres and other services as part of their living arrangements. Staff gave them support and made necessary contacts to maintain continuity of support.

There were effective systems in place to reduce the risk and spread of infection.

The provider did not make suitable arrangements for the maintenance of the building to ensure it remained fit for purpose. People said parts of the home looked “Dark and unloved.” Regular maintenance was not carried out in a timely manner.

People were protected from unsafe or unsuitable equipment.

The provider’s system for monitoring the quality of service that people received was not satisfactory. Staff said, “No one listens to us.” The provider had not ensured staff were kept informed of the outcome of incidents or complaints so that they were involved in the changes.

We were unable to gain the views of all the people who were at the home when we visited due to their complex needs. Therefore we also observed how support was provided and spoke with staff to help us understand their experiences.

We saw that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People told us, and we saw, they decided things and staff respected these decisions.

People's needs were assessed and care and treatment had been planned and delivered as they preferred. We saw people were involved in a variety of social activities in the community and also carried out day to day living skills. One person told us, “I am happy here, I don’t want to move. I do everything I want to do and I’m always busy going places.”

The premises were generally in a good condition, were clean and fresh. The people we spoke with said they were happy with their rooms and the home’s general facilities.

People received the support they needed in a timely manner because there was sufficient staff on duty to meet their needs. Staff had received training and support to assist them to do their job properly. However appraisals of their work had not been carried out regularly.

We saw the complaints procedure was available to people who used and visited the service. The people we spoke with told us they had no complaints but felt comfortable taking any concerns to staff.

People who lived at Hascott House said that they liked living there. They said that the care workers were friendly and the service was homely. They told us that they knew the manager and their key workers. They also said that staff members were approachable and supportive.