Archived: Harefield Hall

There was a registered manager in post. 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. The registered manager was also the owner and registered provider of Harefield Hall. For the purpose of the report we will refer to the registered manager.

People were ‘very happy’ living at the home and we received positive comments about their views and experiences throughout our visit. People told us they felt safe because the staff were “Caring and enjoyed what they did”. The registered manager listened to people and staff to ensure there were enough staff to meet people's needs. They demonstrated their responsibilities in recognising changing circumstances within the service to help ensure that staffing levels and skill mix was effective.

Staff had the knowledge and skills they needed to carry out their roles effectively. They enjoyed attending training sessions and sharing what they had learnt with colleagues. The registered manager and deputy supported staff at all times.

People and their relatives felt staff were caring and kind. Comments included, “I love coming here to visit the staff are so pleasant”, “My relative is treated with good humour, patience and kindness” and, “The care is without question excellent”. Staff had a good awareness of individuals' needs and treated people in a warm and respectful manner. The registered manager and staff were knowledgeable about people's lives before they started using the service. Every effort was made to enhance this knowledge so that their life experiences remained meaningful.

People received appropriate care and support because there were effective systems in place to assess, plan, implement, monitor and evaluate people's needs. People were involved throughout these processes. This ensured their needs were clearly identified and the support they received was meaningful and personalised. Regular monitoring and reviews meant that referrals had been made to appropriate health and social care professionals and where necessary care and support had been changed to accurately reflect people's needs. People experienced a lifestyle which met their individual expectations, capacity and preferences.

Staff demonstrated a genuine passion and commitment for the roles they performed and individual responsibilities. It was important to them those living at the service felt ‘valued and happy’. One staff member recently wrote in a questionnaire, “I enjoy the variety, making people smile and feeling like I have made a difference”.

Staff embraced new initiatives with the support of the registered manager and deputy. They continued to look at the needs of people who used the service and ways to improve these so that people felt able to make positive changes. In a survey completed in February 2016, people wrote, “Don’t change a thing, it’s a success. You should be proud of yourselves”, “I am pleased to say Harefield Hall and the staff are first class” and, “If only all homes were run like Harefield Hall”.

Below is a summary of what we found. The summary is based on our observations during the inspection, seeking experience and views from people who used the service, their relatives, and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe and 'in good hands'. The home had policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. No applications had needed to be submitted this year. Relevant staff had been trained to understand when an application should be made, and how to submit one. There were effective systems in place where people did not have capacity and best interest decisions were made through a multi-agency approach.

People were safe from the risks of mismanagement of medicines, because policies and procedures were in place and followed by staff. They had been trained and supervised appropriately to ensure they were competent to administer medicines.

The service was clean and hygienic. Appropriate guidance, equipment and facilities were in place for staff so that people were safe and protected from the risks associated with cross infection.

Is the service effective?

People's health and welfare was protected and promoted because the service sought expertise and support from other health and social care services that people required in order to meet their needs effectively.

People received appropriate care and support because there were effective systems in place to assess, plan, implement, monitor and evaluate people's needs. People were involved throughout these processes. This ensured their needs were clearly identified and the support they received was meaningful and person centred.

Is the service caring?

We saw that staff had a good awareness of individuals' needs and treated people in a warm and respectful manner. We saw people were receiving care and support in a sensitive way during our visit. The manager, deputy manager and staff were knowledgeable about people's lives before they moved into the home. Every effort was made to enhance this knowledge so that their life experiences remained meaningful.

There was a constant interaction between staff and people in the home; everyone was relaxed, happy and comfortable in each other's company. People were positive about their experiences. Comments included "They are all lovely and very kind", "It's like being at home but with a very big caring family" and "The home is quite unique and wonderful, I am very well looked after'.

Is the service responsive?

Systems were in place to make sure that the manager, deputy manager and staff learnt from significant events including accidents and incidents. Audits helped determine why a particular incident may have happened and what further action was required to help prevent reoccurrence.

People using the service and their relatives completed surveys throughout the year. Where shortfalls or concerns were raised these were addressed promptly.

Is the service well-led?

The manager, deputy manager and staff continued to look at the needs of people who used the service and ways to improve these for people. One way they had achieved this was through monthly 'residents' meetings. This meant that people had been empowered to make positive changes.

The manager had looked at ways that staff would feel valued and be able to effect positive change and equally feel supported. Their ideas and experiences were being sought through newly developed surveys so that weaknesses within the service could be actioned and strengths would be recognised and celebrated.

People shared with us their experiences about living in the home and we spoke with six people at length. Everyone expressed positive comments.

We also looked at surveys that had been completed by people in October 2012 and visitor surveys that were completed in February 2013.

We spent time in various parts of the home, including communal areas and individual bedrooms so that we could observe the direct care, attention and support that people who lived at the home received. There was a constant interaction between staff and people in the home. People were relaxed, happy and comfortable in each other's company.

People looked well and were happy when we visited. People were spending time in the lounge with visitors, some were enjoying the privacy of being in their own rooms and people were walking freely around parts of the home and the grounds.

We spent time in various parts of the home, including communal areas and individual bedrooms so that we could observe the direct care, attention and support that people who lived at the home received.

People were positive about their experiences. Comments included, 'I have settled very well and so far it has been very positive', 'The staff are lovely and they make time to come and talk with me' and 'I have made some new friends and I like to meet up with them during the day. My room is lovely and I enjoy being on my own sometimes'.