Harley House Care Home Ltd

Updated 26 March 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Harley House Care Home Ltd is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We reviewed information we had received about the service since the last inspection. We used this information to plan our inspection.

We sought feedback from the local authority and professionals who work with the service. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with eight people who used the service about their experience of the care provided. We spoke with five members of staff including the registered manager, a nurse, a laundry staff member who works as a care worker, the chef and the nominated individual, who is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We also spoke with a further four staff by telephone; the deputy manager, maintenance staff, a senior carer and a care worker, by phone.

Updated 26 March 2021

Harley House Care Home Ltd is a care home providing personal and nursing care to 28 people aged 65 and over and people with a physical disability. At the time of the inspection visit 16 people were using the service.

People’s experience of using this service and what we found

Processes were in place to protect people from avoidable harm and abuse. Staff were trained and aware of their responsibilities in relation to this and knew how to escalate any concerns they identified.

People’s safety was promoted. Potential risks to people’s safety had been assessed and care plans provided clearer guidance for staff to follow to reduce risks. Care plans and risk assessments were monitored and reviewed regularly. When accidents or incidents occurred, learning was identified to reduce the risk of them happening again.

People received their medicines as prescribed. Further improvements had been made to the management and storage of people’s medicines, and staff competency to administer medicine was checked regularly.

The provider continued to follow safe staff recruitment processes. Staff training and support had significantly improved to ensure people received effective care and support. Staff used correct techniques to support people to move safely. There were enough numbers of staff available to provide a timely response to people and provide safe care.

People lived in a well-maintained environment that promoted their safety, wellbeing and independence. Cleanliness, hygiene and infection control practices had been enhanced to ensure a good standard of cleanliness to protect people from the risk of the spread of infection.

People’s dietary needs were met and where required, staff supported people to eat and drink in a caring manner. People spoke positively about the quality and choice of meals provided to suit cultural and individual food preferences. People’s health care needs were met, and they had access to a range of healthcare support when needed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People’s capacity was assessed and any authorisations to deprive people’s liberty and best interest decisions were kept under review and monitored.

The provider's quality assurance systems and processes had been reviewed and improved to ensure they were effective and gave the registered manager and the provider a good oversight of the service. Audits and daily visual checks were carried out by the management team, which promoted everyone’s safety. The maintenance person was on site daily so any required improvement could be swiftly addressed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 6 November 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating and to follow up the breach of regulation found at the last inspection of the service on 17 September 2019. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions of Safe, Effective and Well-led which contains the requirement.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Harley House Care Home Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.