This inspection took place on 27 March 2018 and was unannounced. Hyde Lea is registered to provide personal care and accommodation for up to 18 people living with dementia. On the day of our inspection there were 16 people living at the home. The home is a large detached property set in its own grounds. The main house has kept some of the original features which add character to the building. An extension has been added to the rear of the home. There is a passenger lift to the first floor. An enclosed garden area is situated at the rear of the home and is easily accessible by ramped access. Car parking is available in the grounds at the front of the home. The home is close to local amenities, including a park and supermarket.

Hyde Lea is a ‘care home’. People in care homes receive accommodation and nursing or 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.

The home had a registered manager in place. 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 our last inspection in March 2016, we rated the service as good. At this inspection we found the service had continued to develop and strengthen a caring approach and the effectiveness and leadership of the home. People continued to receive a high standard of care.

Hyde Lea was well-led. The registered manager was supported by the provider and by a conscientious staff team who took in to account individuals wishes so each person was valued and treated equally.

Staff knew about people and what was important to them and significant events in their lives. They focused on each person rather than labelling them with them with a diagnosis or condition.

The home had sufficient staff to meet people’s needs and preferences. Staff were recruited after the provider and the registered manager had completed necessary checks to make sure they were suitable to work at the home. Staff understood their responsibilities to raise any concerns through safeguarding procedures.

The management team were proactive in driving the service forward to improve outcomes for people who used the service and their relatives. They worked in partnership with other key organisations.

Care plans provided staff with information about risks to people’s health and wellbeing. Risk assessments took into account people individual’s needs and abilities and encouraged people to maintain independence where possible.

We saw that medicines were stored safety and administered in a timely manner and as prescribed.

People were supported by staff who understood the principles of the Mental Capacity Act 2005. They gave people maximum choice and involved them in decisions about their care. Staff provided care in the least restrictive way possible.

People were supported to take part in activities, some being group activities or one to one sessions.

Residents’ and relatives’ meetings, where people could raise concerns and put forward suggestions, were held regularly. The registered manager held a ‘manager’s surgery’ on the first Monday of every month to meet with families.

Systems were in place to monitor and assess the quality of the care provided. Where improvements were needed, plans were in place to achieve these to ensure the people continued to receive high standards of care.

This unannounced inspection that took place on 16 March 2016. We last inspected Hyde Lea on 25 November 2013. At that inspection we found the service was meeting all the regulations that we inspected against.

Hyde Lea is a residential care home registered to provide personal care and accommodation

for up to 18 people living with dementia. There were 18 people using the service at the time of the inspection. The home is situated in a residential area of Bolton and is close to public transport and local amenities. Parking is available in the grounds of the home and on the road at the front of the home.

Bedroom accommodation is provided on the ground and first floor. Access to the first floor is via a passenger lift. The communal areas of lounges and the dining room are situated on the ground floor.

The home had a manager registered with the Care Quality Commission (CQC) who was present on the day 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 saw that risk assessments were in place for the safety of the building. We found the premises were safe, fire exits were clear of obstructions and window restrictors in place to all windows. This help to keep people who used the service safe.

All areas of the home were clean and well maintained. Procedures were in place to prevent and control the spread of infection.

People who used the service and relatives were complimentary about the service and care provided.

Staff had received safeguarding vulnerable adults training and knew what action to take of they suspected or witnessed abuse or poor practice. The service had a robust recruitment and selection process to protect vulnerable people from staff who were unsuitable.

There were sufficient staff available to support people safely and effectively. We saw that staff received training to enable them to do their job efficiently.

Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply.

People’s care records contained detailed information to guide staff and other professionals involved in the care people required. The care records showed that risks to people’s health and wellbeing had been identified and plans were in place to eliminate or reduce the risk.

Appropriate arrangements were in place to assess whether people were able to give consent to their care and treatment. Where appropriate family and friends were involved in a person’s post care and future goals and plans were discussed.

We found the provider was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.

Food stocks were good, people were offered a choice of meal and the meals provided were varied and nutritionally balanced.

To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided and there were systems in place for receiving, handling and responding appropriately to complaints.

We visited Hyde Lea on 25 November 2013 and found the home to be warm, clean and bright. We were told most were people up and sat in the lounges. People who used the service were seen to be well presented and we heard staff interacting with them in a friendly polite manner and respecting their dignity and privacy.

We were told most of the people who used the service had a diagnosis of dementia. This made communication difficult. Some people we spoke with were able tell us, “I enjoyed my dinner today” and “I like her” (referring to a member of staff). We observed people’s body language with staff was good and their facial expressions were positive when staff approached them.

We looked at two care records and saw they contained relevant medical and health information, personal preferences and social history. There was evidence of working with other health professionals, risk assessments and monitoring charts were seen.

We saw relevant policies and procedures were in place to quality assure the services. There was evidence staff meetings taking place. We were told any complaints or concerns raised were taken seriously and responded to accordingly.

We saw a selection of compliment cards from relatives. Some of the comments included: “Thank you for the care and compassion shown to X”, and “Thank you for your care and dignity”.

We saw relevant policies around safeguarding and we spoke with two members of staff who demonstrated an understanding of the issues. The staff with whom we spoke with were confident to report any issues they may encounter.

Staff we spoke with told us, “I have worked here for a long time, it’s great”. We spoke with two visitors who told us their relative appeared to be settling in well and the staff were very good.

Due to the varying levels of dementia of the people who used the service, views about the service were gained from visitors and relatives at the home on the day of the visit.

Some of the comments included:

“This is a marvellous place: I have no complaints at all”.

“My X is looked after very well. She always looks cared for and happy”.

" I have every confidence that my X is safe here".

“I have nothing but praise for the staff here. They do a wonderful job”.