Hawkhurst Care Centre is owned by Prime Life Limited. The home provides 24 hour personal care and accommodation for people who have mental health care needs or dementia. Hawkhurst is located in a residential area within easy reach of Blackburn town centre. The home has two lounge and dining areas connected by a conservatory. There is a passenger lift to access bedrooms on the first floor. There is a mix of single and shared rooms with three having en-suite facilities.

The service were last inspected in September when the service met all the regulations we inspected.

We undertook this inspection on 15 and 16 November 2016. This comprehensive inspection was unannounced and conducted by one inspector.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff we spoke with were aware of how to protect vulnerable people and had safeguarding policies and procedures to guide them, which included the contact details of the local authority to report to.

Recruitment procedures were robust and ensured new staff should be safe to work with vulnerable adults.

The administration of medicines was safe. Staff had been trained in the administration of medicines and had up to date policies and procedures to follow. Their competency was checked regularly.

The home was clean and tidy. There was a planned series of redecoration and people were asked how they would like their rooms decorated. The environment was maintained at a good level and homely in character. We saw there was a maintenance person to repair any faulty items of equipment.

There were systems in place to prevent the spread of infection. Staff were trained in infection control and provided with the necessary equipment and hand washing facilities to help protect their health and welfare.

Electrical and gas appliances were serviced regularly. Each person had a personal emergency evacuation plan (PEEP) and there was a business plan for any unforeseen emergencies.

People were given choices in the food they ate and told us it was good. People were encouraged to eat and drink to ensure they were hydrated and well fed.

Most staff had been trained in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The registered manager was aware of her responsibilities of how to apply for any best interest decisions under the Mental Capacity Act (2005) and followed the correct procedures using independent professionals.

New staff received induction training to provide them with the skills to care for people. Staff files and the training matrix showed staff had undertaken sufficient training to meet the needs of people and they were supervised regularly to check their competence. Supervision sessions also gave staff the opportunity to discuss their work and ask for any training they felt necessary.

We observed there were good interactions between staff and people who used the service. People told us staff were kind, knowledgeable and caring. Most staff had worked at the service for some time which meant they knew the people they cared for well.

We saw that the quality of care plans gave staff sufficient information to look after people accommodated at the care home and they were regularly reviewed. Plans of care contained people’s personal preferences so they could be treated as individuals.

Staff, people who used the service and family members all told us managers were approachable and supportive.

Meetings and supervision with staff gave them the opportunity to be involved in the running of the home and discuss their training needs.

The manager conducted sufficient audits to ensure the quality of the service provided was maintained or

This is a service that provides care for people with dementia. Some people we spoke with were not able to answer specific questions. However, we managed to speak to two people who used the service about the care provided at the home and several people in general, who were sat together in a lounge area. We also spoke with a family member and three members of staff. All the people we spoke with, who were able to reply, said they were happy and staff were, "Nice", "Wonderful" and " Excellent".

Was the service safe?

Systems were in place to make sure that managers and staff learn 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 proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications were currently required. Relevant staff had been trained to understand when an application should be made, and how to submit one. Staff told us they would react to any safeguarding incidents and the people who used the

service said they did not feel threatened by staff. Two people we spoke with said, "I feel safe here. Nobody bothers me" and "The people and staff here are very nice and I feel safe". A family member said, "I think she is very safe here. The manager is very good. I have never seen anything untoward". This meant that people were safeguarded as required.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk. However, the certification for the electrical installation should be forwarded to the registered manager when it is completed. Two people who used the service told us, "My room is very nice. I have no qualms about my room, it is always clean and tidy" and "My room is comfortable, warm and clean". A family member said, "The home is very clean and tidy but it never smells".

Was the service effective?

People's health and care needs were assessed with them if possible, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People who used the service told us, "I have lived here for a while and like it". I get very good care" and "I am very well looked after". A family member said, "I am finding the home excellent. I have been in many care homes. I am a care worker and have seen how some homes are and how they operate. Her care is good".

People's needs were taken into account with signage and the layout of the service enabling people to move around freely and safely. The premises had been sensitively adapted to meet the needs of people with physical impairments. A family member said, "I can come when I feel like. There are no restrictions to visiting. I think the staff are brilliant. They are welcoming and always ask if I want a drink". The registered manager and staff confirmed visiting was open and unrestricted.

Was the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. Two people who used the service told us, "The staff are kind" and "We are like a family".

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People who used the service or a family member were encouraged to provide as much information about their past lives and what they liked or did not. This information gave staff the knowledge to treat people as individuals.

Was the service responsive?

People completed a range of activities in and outside the service regularly. We were told by several people that they particularly enjoyed singing together with staff. Entertainers visited the home once a week. Other activities included arts and crafts, games and gardening. A family member said, "I tell them if we are going out and she is ready. She is always well presented". The family member thought this was important.

Was 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 good quality assurance system. Records seen by us showed that identified shortfalls were addressed promptly and as a result the quality of the service was continually 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. All three staff members thought they worked well as a team, management were responsive and they enjoyed their jobs. This helped to ensure that people received a good quality service at all times.

This is a care home for people with dementia or mental health problems and some people could not communicate their thoughts on the quality of care. We spent some time in the lounge observing people being cared for and talked to two people in particular who were able to give us their views. They said, "The care is good and I am happy here" and "I like living here but there is no place like home". All other people who were able to answer said they were satisfied with life at this care home. We observed that staff treated people with compassion.

The Registered Manager had recently sent out quality assurance surveys. We looked at the results and they told us that the replies were very positive around the attitude and knowledge of staff, the environment, meals and quality of service. Two family members thought there could be more activities. There were many positive comments which included, "Staff are caring and compassionate", "A real home from home. Staff are all lovely and work really hard to ensure all residents have the best quality of life possible. I am extremely grateful for all they do", "The care individuals receive at Hawkhurst is excellent, there is always an air of calm and it is one large family" and "Excellent lovely people who give 100% into looking after my family and others". Family members thought their relatives were well cared for.

People who used the service said food was good, that they had choices at mealtimes and there was plenty to eat and drink.

People told us that staff were "Welcoming" and "Courteous" and visits could be taken in private which enabled visitors to socialise with people who used the service.

Staff gave a good account of what they thought privacy, independence and choice entailed to help people who used the service preserve their dignity.

People were involved in care planning if they wished and made comments such as, "I am very happy with the care given to my relative", "Excellent care" and "Very caring staff". All 12 people who returned a survey form thought the care was good.

A visitor told us, "I have never seen staff appear anything other than pleasant to the people who live here. Certainly not threatening or abusive" and staff were aware and had been trained to protect vulnerable adults.

People told us, "All carers, especially senior care staff know their patients inside out", "Any information I need is instantly given" and "Very caring staff". A visitor said, "The staff are always approachable and willing to help. Staff appear to know what they are doing". Staff were robustly recruited to ensure they were suitable for the tasks they performed.

Twelve people returned survey forms and this told us the home was always clean, the decor was good, the quality of service was excellent and the first impression people got when entering the home was excellent. Comments included, "All residents seem content", "We had an excellent birthday and Christmas party" and "Staff are always very helpful and friendly. They always make me a brew". A visitor said, "My friend always says it is very nice here. I think it is a good home". People thought the quality of service provided was good.

Twelve people who returned survey forms said staff knowledge was excellent. A visitor said, "There seems to be enough staff and they have a good manner. There always seems to be a staff member if she needs help". People thought there were sufficient, skilled staff to meet the needs of their relatives.

The service is registered to provide personal care for 26 older people who may have a mental health condition or dementia. On the day of the inspection 22 people resided within the home.

We last inspected this service in April 2014 when the service met all the regulations we inspected.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People who used the service said they felt safe at this care home. Staff had been trained in safeguarding topics and were aware of the need to report any suspected issues of abuse.

Recruitment procedures were robust and ensured new staff should be safe to work with vulnerable adults.

We found the ordering, storage, administration and disposal of medication was safe.

There were systems in place to prevent the spread of infection. Staff were trained in infection control and provided with the necessary equipment and hand washing facilities to help protect their health and welfare.

People told us the food served at the home was good and they were offered choices about what they ate. We saw there was a good supply and choice of food.

New staff received induction training to provide them with the skills to care for people. All staff were well trained and supervised regularly to check their competence. Supervision sessions also gave staff the opportunity to discuss their work and ask for any training they felt necessary.

The registered manager was aware of her responsibilities of how to apply for any best interest decisions under the Mental Capacity Act (2005) and followed the correct procedures using independent professionals.

There were systems to repair or replace any broken equipment and electrical and gas appliances were serviced regularly. Each person had an individual emergency evacuation plan and there was a business plan for any unforeseen emergencies.

The home was warm, clean, well decorated and fresh smelling. The garden was accessible for people with mobility problems and safe for people with dementia to use in good weather.

There was a very good end of life plan to ensure people’s wishes could be met at this difficult time.

We observed there was a good interaction between staff and people who used the service. There was some good natured banter exchanged during the day and people who used the service and staff appeared to be relaxed during the inspection.

We observed that staff were caring and protected people’s privacy and dignity when they gave personal care.

We saw that the quality of care plans gave staff sufficient information to look after people accommodated at the care home. We also noted that where possible people who used the service (or sometimes a family member) signed their agreement to the care to be given. This meant their wishes and choices were taken into account.

We saw that people who used the service were able to attend meetings or they were asked to complete quality assurance questionnaires. Some people needed the assistance of their family members to complete this for them. In this way people were able to have a say in how the home was run.

Policies and procedures were updated regularly and management audits helped managers check on the quality of the service.