This inspection was carried out on the 18 April 2017 and was unannounced.

Haydon-Mayer is a nursing home for up to 32 older people, some of whom may be living with dementia. On the day of the inspection there were 30 people living at the service. Haydon-Mayer is located in the town of Herne Bay. It offers residential accommodation over several floors and has two communal areas together with a conservatory on the ground floor which is also used as a dining area.

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.

We carried out an unannounced comprehensive inspection of this service on 5, 7 and 8 April 2016 and Haydon-Mayer was rated ‘Requires Improvement’. There were breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014. We issued requirement notices relating to safe care and treatment, fit and proper persons employed and person centred care. We asked the provider to take action and the provider sent us an action plan. The provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements. Improvements had been made and the breaches had been met.

Staff knew how to recognise and respond to abuse. The registered manager was aware of their responsibilities regarding safeguarding and staff were confident the registered manager would act if any concerns were reported to them.

Staff completed incident forms when any accident or incident occurred. The registered manager analysed these for any trends to see if any adjustment was needed to people’s support. Risks relating to people’s health and mobility had been assessed and minimised where possible. Regular health and safety checks were undertaken to ensure the environment was safe and equipment worked as required. Regular fire drills were completed.

There was enough staff to keep people safe. Staff were checked before they started working with people to ensure they were of good character and had the necessary skills and experience to support people effectively.

Staff had the induction and training needed to carry out their roles. They had received training in people’s healthcare needs. Staff met regularly with their manager to discuss their training and development needs. They had received training in topics relating to people’s needs.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. DoLS applications had been made to the relevant supervisory body in line with guidance.

People were supported to eat and drink healthily. Staff had sought advice and guidance from a variety of healthcare professionals to ensure people received the best care possible. Staff followed guidance and advice given by health care professionals. People’s medicines were managed safely.

People and their relatives said that staff were kind and caring. Staff knew people well and their likes and dislikes formed part of their care. People were supported to dress how they wished and wear jewellery when it was important to them. People were treated with dignity and respect.

Staff were responsive to people’s needs. Detailed assessments were carried out before people moved into the service. People’s care plans were reviewed monthly by staff to ensure they reflected the care and support people needed.

People took part i

We carried out this inspection on the 5, 7 and 8 April 2016, it was unannounced.

Haydon-Mayer is a nursing home providing accommodation for up 32 older people who may have mental and physical difficulties and require nursing care. At the time of the inspection, 25 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.

Nursing staff managed and administered medicines for people. Medicines were not always administered, stored, and disposed of safely. People had not always received their medicines as prescribed.

Staff were recruited using procedures designed to protect people from unsuitable staff. However, robust recruitment checks were not always being carried out.

Person centred care planning records showed inconsistencies therefore; people may not have received care and support that met their needs.

Staff were trained to meet people’s needs. They met with management and discussed their work performance at one to one meetings and during annual appraisal, so they were supported to carry out their roles.

There were sufficient numbers of staff to meet people’s needs. Staff were available throughout the day, and responded quickly to people’s requests for help. Staff had the knowledge and skills to meet people’s needs, and attended regular training courses. Staff were supported by the registered manager and felt able to raise any concerns they had or to make suggestions to improve the service for people.

People demonstrated that they were happy at the service by smiling and chatting with staff who were supporting them and greeting the manager warmly. Staff interacted 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 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. Nursing staff carried out on-going checks of people’s health needs, and contacted other health and social care professionals for support and advice.

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 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 pos

We carried out this inspection in response to concerns that one or more of the essential standards of quality and safety were not being met, so that we could check improvements have been made. We spoke with five people and a relative, and observed care given to some people in their rooms and in one of the lounges. We found that staff engaged with people at the home, and we noticed that some people joked and laughed with their carers in a relaxed manner.

We noted that people at the home were comfortable, dressed appropriately and able to move freely around the home. Problems had been addressed with regard to the smoking area and we observed the new system working effectively.

People told us that they liked living at the home because it "was very comfortable, and one person told us she "felt well looked after by the staff". People told us that the staff were always kind and considerate. People who used the service told us that the staff had been busy but their needs had still been met.

Some of the people living in the home were unable to tell us about their experiences. We spent time with the people and observed interactions between the people and the staff. Some people using the service expressed that they were happy. They enjoyed participating in activities and the entertainment that the home provided. During our visit, children from a local school had come to sing Christmas carols with the people who use the service.

We saw that people were responsive in the company of staff. They were able to let staff know what they wanted and we saw that staff responded in a caring and positive way. During the inspection we found that there were appropriate numbers of suitable staff and staff were given the support they needed to carry out their role effectively.

People knew how to make a complaint or raise a concern and told us that staff would act on items raised and resolve them quickly.

People using the service told us that they enjoyed staying at the home. They said the staff were polite and respectful.

One person told us; “I have been here for two years, it’s a nice home, they really look after me and I feel safe. I would not wish to live anywhere else”. A relative commented; “My relative is very well looked after, they receive the best care here”

All of the people using the service that we spoke to said that they received the care and support they needed, they felt safe and they were happy at the home. They were involved in making decisions about their care and said the staff were kind and that there were enough staff on duty. One person said that they had recently moved in and had been very impressed with the home so far. They said the staff were kind and helpful and ‘could not do enough for you’.

They said the home was clean and that they were happy with their rooms and facilities.

A carer told us that there had been improvements over the past few days. They said they had made a complaint that had been listened to and act on and has been resolved.

The manager completed the Provider Compliance Assessment (PCA). This was a self assessment and gave information about how they intend to ensure that they continue to be compliant with the essential standards of quality and safety.

The inspection was carried out by one inspector over seven hours on the 21 and 22 May 2014. During this time we met and talked with people living in the home and with staff on duty. We also talked with the provider of the service over the telephone on the 22 May 2014. They helped answer our five questions; 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 is based on our observations during the inspection, speaking with people using the service, their relatives, the 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?

The service was safe. People were treated with respect and dignity by the staff. People told us that they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that unsafe practice is identified and people are protected.

Is the service effective?

The service was effective. People’s health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. We saw that where appropriate people had signed and confirmed that they had been involved in writing them and they reflected their current needs.

Visitors confirmed that they were able to see people in private and that visiting times were flexible.

Is the service caring?

The service was caring. We saw that staff interacted well with people and knew how to relate to them and how to communicate with them. People living in the home made positive comments about the staff, with remarks such as, “The staff are very helpful” and “The staff are kind and are always good to me”.

Is the service responsive?

The service was responsive. We found that the staff listened to people, and took appropriate action to deal with any concerns.

People knew how to raise a concern, if they were unhappy. Two people told us that they had raised concerns with the manager and that they were satisfied with the outcome. People can therefore be assured that their concerns would be listened to and action taken as necessary.

Records showed that the service was responsive to people’s changing needs. For example, when a person felt unwell their doctor was called.

Is the service well-led?

The service was well-led. The company and the manager had systems in place to provide ongoing monitoring of the home. This included checks for the environment, health and safety, fire safety and staff training needs.