Archived: Harrias House Residential Care Home

We visited the home on the 10 April to confirm all necessary actions had been completed and to assess compliance over several key areas of the home's operation.

We considered our inspection findings to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found.

Is the service safe?

People told us they felt safe and well-cared for. Care staff received appropriate training to give them the skills they needed to provide safe and effective care. Staff showed they knew what might constitute abuse and what to do if they saw or suspected it. Care plans included the information care staff needed to identify people's needs and how they were to be safely met. There were assessments of the risks relevant to each individual who received care and support. This meant they could be identified and eliminated or managed.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted.. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people would be safeguarded as required.

Is the service effective?

People who received care and support and two health professionals we spoke with all commented very favourable about the standard of care they experienced or saw. We were told communication with the home and community health services was good, which enabled people to receive prompt and effective treatment.

Staff had a good understanding of the people they provided care and support to. They told us they received the training and supervision they needed to maintain high standards of effective care.

Care plans included the information staff needed to understand the care needs of people and also to learn something about how they wanted care and support to be provided. This meant care could be effective and specific to the individual who received it.

Is the service caring?

People told us the staff were very caring. "They couldn't do more for me" was one comment. We observed staff supporting people at mealtimes and during the day. They were patient and polite, and offered people choices without directing them as to what they should choose.

We saw the garden had been set out and equipped to enable those who wanted to walk around to be able to do so. There were raised beds which people had been able to plant-up and tend if they wanted to. Staff appeared to have the time to engage in conversation with people and to take an interest in what they were doing.

Is the service responsive?

Care plans showed people were involved in the assessment and planning of their own care. Reviews were held which enabled care to be adjusted to meet any changes in need and respond to changed circumstances. People were involved in a range of decisions about daily living. They were offered opportunities for activities if they chose, they were able to visit the community if they were able and chose to. Where people had active and engaged family or friends, they were able to contribute to decisions about care and support, where appropriate. We saw evidence staff were able to respond to emergencies if any occurred and to access community health services in response to any short or long term medical conditions which arose.

The home had policies and procedures in place to enable people to make comments or complaints and had a clear timescale for responding to either. People told us they were far more likely to approach the manager or members of the management committee if they had a concerns as they felt sure they would respond promptly and appropriately.

Is the service well-led?

The provider's management committee were involved on a voluntary basis with all aspects of the home's operation. They had responded to previous issues of non-compliance and had put in place systems and processes to achieve compliance. The manager carried out staff supervision and appraisals to support and promote good practice and high standards of care. There were a series of regular audits carried out on key areas of operation, for example, medication and infection control. This meant people were protected by systems of checks and audits from identifiable and avoidable risks to their health, safety and well-being.

There were a series of regular surveys of short-stay and permanent service users as well as surveys of friends and relatives. These were now formally summarised, with action plans drawn up to address any issues or concerns raised or suggestions for improvement to the service.

Care staff told us they felt supported by the home's manager and the home's management committee. Training had been put in place to support and develop staff. A number of staff we spoke with told us they had worked at the home for several years, and said this was, in part, because of the support they received to do their job effectively.

We found the provider had a system in place to gain the consent of people to care.

We found that staff had an understanding of people's needs and that care was planned in a safe way. One person told us, "The care is excellent."

We found that the provider worked well with health care professionals to support people's health needs.

Staff were appropriately trained to carry out their role and the provider had an adequate recruitment process. One person told us, "The staff are very caring."

We found that the provider did not have systems in place to monitor and improve the quality of service provided and did not always take into consideration comments made by people to improve the service.

We spoke with five people who live in Harrias House and with a relative. They told us they were very satisfied with the standard of care they experienced and saw. They were very positive about the staff and management. "The staff really are first class" one person told us.

When we looked at care plans we found they included an initial assessment of care needs and detailed how these were to be met. There was evidence of a process of regular review. This ensured changing needs were identified, and changes made to care delivery where indicated as necessary.

All of the staff we spoke with said there was a very good team spirit. They said they received support not only from the manager and deputy but also from the members of the management committee they came into regular contact with.

People who used the service were asked for their views about their care and treatment and they were acted on.