Archived: Harbour Close

At the comprehensive inspection of this service in November 2015 we found the provider was meeting all the regulations we looked at and was rated as a GOOD service.

This focused inspection was carried out to look at concerns raised by Halton Council with regard to staffing levels and leadership of the service.

This report only covers our findings in relation to the Safe, Responsive and Well-Led domains.

You can read the report from our last comprehensive inspection by selecting the 'all reports' link for Harbour Close on our website at www.cqc.org.uk.

8 -11 Harbour Close is a purpose-built care facility providing personal care and accommodation for 12 people who have physical disabilities. The service consists of four bungalows each accommodating three people. The bungalows are owned by Liverpool Housing Trust and the service is managed by Scope. The home is located in the Murdishaw area of Runcorn and is within easy access of local amenities including shops, social and educational facilities. There is also a small office located adjacent to bungalow 10 which is used by staff to store and access information.

There was no registered manager at Harbour Close. 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 found that since our last inspection the registered manager had left the service and the staffing levels were now a cause for concern. We were aware that concerns had been raised by Halton Council regarding the staffing and overall governance of the service.

We identified breaches of the relevant regulations in respect of person centred care, safe care and treatment, safeguarding service users from abuse and improper treatment, staffing, good governance and notifications to the Commission.

Care plans were not person centred and did not provide enough information to direct staff in the care they needed to deliver. We found that a number of agency staff were employed that had difficulties in understanding the needs of people living at the home and staff told us that they did not have time to read the care plan and risk assessments. People did not receive care that met their individual needs and preferences.

Risk assessments were out of date and did not include full details of any action taken to minimise avoidable harm. We saw some examples of unsafe practice that put people living at the home at risk of harm. We identified a number of incidents and issues that should have been referred to the local authority’s safeguarding team. These had not been referred and we had not been notified about them.

There were insufficient staff employed to safely meet the needs of people living at the home.

The registered provider was aware of many of the shortfalls in practice because the local authority had previously carried out quality monitoring visits and implemented an action plan. However, leadership and management of the home had failed to address many of the issues.

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by the Commission. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.

During our inspection we saw there was good communication and understanding between the members of staff and the people who were receiving care and support from them. We observed people being supported with their daily life activities. The people we met with appeared relaxed, comfortable and at ease with the staff. It was evident staff had a good understanding of what was important to each person, for example, preferred clothes, meals and social arrangements.

We looked at support plans, risk assessments; monthly key worker notes and saw that they contained a lot of information about people and reflected the individual's current circumstances. We found that they were being reviewed consistently.

Menus and shopping for food were planned and undertaken with the people who lived in each bungalow. This was done by discussing likes / dislikes and what people felt like eating. This provided a very flexible menu for people.

Information about the safety and quality of service provided was gathered on a continuous and ongoing basis with feedback from the people who used the service.

The people who used the service said that they were happy living in the home and that the staff members supporting them were very good. One person said, 'It's brilliant, I love it here.'

During the visit we spoke to a visiting GP, he told us, 'The care was excellent and they always address things promptly.'

During our inspection we saw there was good communication and understanding between the members of staff and the people who were receiving care and support from them. The people using the service appeared relaxed, comfortable and at ease with the staff.

We looked at support plans, risk assessments; monthly key worker notes and saw that whilst they contained a lot of information about people they did not always reflect the individual's current circumstances. We found that they were not being reviewed consistently. Whilst the above issues are a concern to us we did not find any evidence to indicate that the needs of the people currently living at the home were not being met.

Information about the safety and quality of service provided was gathered on a continuous and ongoing basis with feedback from the people who used the service.