Hays House Nursing Home

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People had choice, control and freedom over their lives and were not subject to unlawful or excessive restrictions.

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

Staff supported people in line with this guidance. People were supported to be independent, access the community and live the life they wished. Staff received specialist training in learning disabilities, autism in line with recognised code of practice.

Staff had a good understanding of safeguarding and had received a range of training suitable to people’s needs. Staff had been recruited safely and received regular supervision and support. Comments from staff included, “[Manager] is great, they are really kind and welcoming,” “The directors play a pivotal role in running [the service], they have a positive presence” and “There is support and development available to progress within the staff structure.” Staff undertook regular health and safety checks such as fire evacuations and temperature checks of water. The service was clean and staff told us there was a good stock of personal protective equipment (PPE) available.

People’s needs were assessed prior to them moving to the service. Staff monitored people’s health and wellbeing, enabling them to achieve positive outcomes. People’s capacity was assessed and best interest decisions were conducted where people lacked capacity. Staff always asked for people’s consent and respected people’s choices. For example, we observed staff seeking people’s permission before providing support and explaining what they intended to do. Staff offered people choices about their day-to-day care and support, including where they wished to spend their time and what activities they wanted to participate in. People’s decisions were respected, and staff adapted their support in line with people’s preferences and wishes.

Staff consistently engaged with people to review and discuss their care and treatment, recognising people were decision makers in their own care. Staff comments included, “We try to make people independent with decisions and general day to day choices as much as possible” and “As a home, we are really focused on choice and control for people when it comes to activities.” The provider was keen to engage with external stakeholders, for example they had staff who shadowed nurses in a hospital environment and had recently become a ‘veteran friendly’ care home.

People’s care was person centred. For example, people with a diagnosis of dementia were shown information in alternative formats.

Health and safety was managed well and in accordance with best practice guidance.

Feedback about the manager and leaders was positive. Comments included, “The directors have a presence in the service and are supportive, they know everyone” and, “We all get on as a team and work really closely together, the registered manager has worked hard to develop a unique culture of trust and acceptance here.”

Risks associated with people’s care and treatment had not always been fully assessed. For example, where people were prescribed paraffin-based emollients, the associated fire safety risks had not been considered. In addition, for people prescribed anticoagulant medicines, the increased risk of harm from falls had not been assessed or reflected within their risk management plans.