About the service Harley House Care Home is a care home providing personal and nursing care to up to 28 people aged 65 and over. At the time of the inspection 22 people were using the service.
People’s experience of using this service and what we found
The service does not have a manager registered with Care Quality Commission (CQQ). The manager had begun the process to apply to be the registered manager.
The provider’s quality assurance systems was not effective. There was lack of systems and oversight of staff training, competencies, spot checks, management of medicines and the environment. The shortfalls we found had not been identified through the internal checks and audits. Although the manager was responsive and managed to address some issues further action was needed.
People felt safe and were protected from abuse. Risks associated to people’s health, safety and welfare were assessed, managed and monitored. Care plans provided clear guidance for staff to follow to meet people’s needs. Further checks were needed to monitor staff used equipment correctly to meet people’s needs.
Some people and staff felt staffing numbers could be better, but no one had expressed concerns to the manager about this. Staff recruitment procedures were followed, and all necessary pre-employment checks were carried out. Staff received regular support and supervisions.
People told us they lived in a clean and safe environment, which was homely and welcoming. Further improvements to the signage and adaptations could improve people’s sense of wellbeing with clear signage to access different areas of the home.
People were provided with enough to eat and drink. Observations of the dining experience was positive. People’s cultural and dietary requirements were met. People received their medicines as prescribed. People’s health care needs were met, and they had access a wide range of healthcare support. Procedures were followed to ensure people had the opportunity to express their wishes in relation to end of life care.
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.
People received care from kind and caring staff and had developed good relationships with them. People’s privacy and dignity was maintained. A relative described the care home and staff as, “It [the care home] has a good feel about it and it is humane.”
People received care that was responsive to their needs. People were involved in the planning and reviewing of their care. Care plans reflected people’s likes, dislikes and preferences and people’s diverse needs were captured so staff knew how people wished to be supported.
The service ensured people’s social, cultural and religious needs were met. Daily and monthly activities of interest was organised. People’s relatives and friends were welcome to visit anytime. The service had maintained links with the wider community.
People knew how to complain and raise concerns and were listened to. People had opportunities to express their views about the service.
We identified a breach in relation to the governance and management oversight of the quality of care, medicines management, staff training and competency, the environment and effectiveness of audits and checks. More information is in the full report.
Why we inspected
This was a planned inspection based on the previous rating.
Rating at last inspection
The last rating for this service was outstanding (published 6 January 2017). The overall rating for the service has changed to requires improvement. 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 on our website at www.cqc.org.uk.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.