The inspection took place on 4 and 5 May 2016 and was unannounced.
Harker House provides care for up to 36 people. This includes a separate wing which supports people living with dementia. The building was purpose built, offering accommodation over two floors.
There was a registered manager and a deputy in place. The deputy was responsible for the day to day management of the service. 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.
People benefited from being supported by staff who were safely recruited, trained and who felt supported in their work. However, we received mixed feedback about staffing levels. People who required the assistance of more than one member of staff did not always receive the care they needed in a timely way.
Staff understood how to protect people from abuse and knew the procedure for reporting any concerns. Medicines were managed and stored safely and adherence to best practice was consistently applied. People received their medicines on time, safely and as the prescriber had intended.
Staff knew and understood the needs of people at Harker House, although they did not receive regular supervision. However staff said they were in regular communication with the deputy manager and team leaders. The management team was aware of this short fall and was arranging supervision for staff, which they said they would receive on a regular basis.
Staff told us they were happy working at Harker House. They assisted people with kindness and compassion. People’s dignity and privacy was maintained and respected.
The Care Quality Commission (CQC) is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The service was not depriving people of their liberty unlawfully and worked within the principles of the MCA. Staff’s knowledge of MCA was good and people told us staff always asked for their consent before assisting them.
People’s care plans were detailed and individualised. They contained important and relevant information to assist staff in meeting people’s needs in a way that was personalised. People and their relatives had been involved in their care assessment and care plans. People’s needs had been reviewed and people’s records were up to date.
The service had good links with community healthcare teams. People were supported to maintain good health and wellbeing. Some people had complex health needs; these people’s needs were closely monitored. The service reacted positively to changes in people’s health and social care needs.
People and staff told us there was a lack of social activities. Some people told us they felt isolated and bored at times. The issue of staffing levels was also relevant here and sometimes contributed to people not feeling socially stimulated. The service was making efforts to address this issue by planning to increase planned activities; however people did not have regular daily social stimulation throughout the day.
People were encouraged to maintain relationships with people who were important to them, and the service actively welcomed family members and visitors to the home.
There was a homely feeling to the communal areas. The home had benefited from an ongoing refurbishment programme, which had also contributed to the light and homely feel to the service.
People felt listened to and were confident that any concerns they may have would be addressed. There were systems were in place to monitor the quality of the service. Staff and the deputy manager was very committed to providing a good service for people living in the home.