Archived: High Habberley House

Updated 5 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 18, 21 and 22 January 2018 and was unannounced. On the 18 January 2018 the inspection team consisted of two inspectors, a specialist advisor who specialises in governance 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. On the 21 and 22 January the inspection consisted of two inspectors.

As part of the inspection we reviewed information we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us by law. We also spoke with the local authority about information they held about the provider.

We spoke with nine people who used the service and two relatives. We spoke with three care staff, one nurse, one domestic staff, two activities co-ordinators, the receptionist and the chef. We also spoke with the general manager, the operations manager, area manager and the regional manager.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a sample of people’s care records and medication records. We also looked at provider audits, complaints and compliments, incident and accident and the recruitment files of five nurses and three care staff.

Updated 5 April 2018

High Habberley House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. High Habberley House accommodates up to 37 people across two floors. There were 17 people who were living at the home on the day of our visit.

This inspection took place on 18, 22 and 23 January 2018. The 18 January 2018 visit date was unannounced, which means the provider did not know we were coming. The 22 and 23 January 2018 we had arranged with the provider to return to the home to conclude our inspection visit. We found the service required improvement with five breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014.

We were contacted by the provider a week after our inspection had finished. They notified us that a decision had been made to close the home. They told us this decision would be communicated with people who lived there and the staff who supported them.

Following the last inspection in July 2017, we asked the provider to complete an action plan to show what they would do and by when to improve in all of the key questions. This was because we found three breaches in regulation, for Regulation 9, Person-Centred Care, Regulation 10, Dignity and Respect and Regulation 17 Good Governance. At this inspection we found the provider continued to remain as Requires Improvement, with a continued breach of Regulation 9 Person-Centred Care, with further breaches in Regulation 12 Safe Care and Treatment, Regulation 17 Good Governance, Regulation 18 Staffing and Regulation 19 Fit and Proper Person's Employed.

There was a registered manager in place at the time of our inspection visit; however the registered manager was no longer working at the home and was in the process of de-registering with us. An operations manager had been managing the home for almost two weeks at the time of our visit. A new manager had been appointed who told us they would be applying to register with us.

A registered manager from the providers other service came to support the inspection visit. 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.

Staff recognised signs of abuse and knew how to report this. Risk assessments were not always completed properly, which meant that actions needed to keep people safe and minimise risks were not always identified and acted upon. People felt that more staff were needed to meet their needs in a timely way. The provider had recognised that further review of people’s care was required as they could not be assured there was sufficient staffing to meet people’s individual needs. People’s medicines were managed in a way that kept people safe.

Staff supported people with their consent and agreement. However staff did not always understand the importance of this. We found that where Mental Capacity Assessments had taken place these were did not clearly demonstrate how staff were to support people, or whether other health care professionals had been involved in decision making around a person’s care. We found people were supported to eat a healthy balanced diet and were given enough fluids to keep them healthy. We found that people had access to their doctor when they required them.

People told us that the provider had not listened to them, and they continued to receive care that was not always in line with their preferences. People told us that staff treated them kindly and respected their privacy. People told us that their wishes were not always met as staff did not always listen to them.

People did not always receive care that was reflective to their individual needs. Where people had specific individual needs, staff had not always recognised this to ensure their care reflected their personal preferences.

Information on how to raise complaints was provided to people, and people knew how to make a complaint if they needed to. We looked at the providers complaints over the last 12 months and found that two complaints had been received and responded to with satisfactory outcomes.

The provider had identified that their plans to improve the service were not on target, and had brought additional management resources in to support the service. The operations manager had been working at the home for less than two weeks prior to our visit. We saw the operations manager during that time had begun to make positive improvements to people’s safety. However, throughout our inspection we found other areas of concern that had not been identified by the provider, however the provider responded to these concerns promptly. People and staff felt positive about the new general manager and while they recognised there was further hard work to do, staff felt positive this would improve with the new manager’s support.

You can see what action we told the provider to take at the back of the full version of the report.