You are here

Archived: Harbour Close Inadequate

We are carrying out a review of quality at Harbour Close. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 26 July 2016

During an inspection to make sure that the improvements required had been made

We undertook a focused inspection of Harbour Close on 26 and 28 July 2016.

At the comprehensive inspection of this service in November 2015 we found the provider was meeting all the regulations we looked at and was rated as a GOOD service.

This focused inspection was carried out to look at concerns raised by Halton Council with regard to staffing levels and leadership of the service.

This report only covers our findings in relation to the Safe, Responsive and Well-Led domains.

You can read the report from our last comprehensive inspection by selecting the 'all reports' link for Harbour Close on our website at www.cqc.org.uk.

8 -11 Harbour Close is a purpose-built care facility providing personal care and accommodation for 12 people who have physical disabilities. The service consists of four bungalows each accommodating three people. The bungalows are owned by Liverpool Housing Trust and the service is managed by Scope. The home is located in the Murdishaw area of Runcorn and is within easy access of local amenities including shops, social and educational facilities. There is also a small office located adjacent to bungalow 10 which is used by staff to store and access information.

There was no registered manager at Harbour Close. 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.

We found that since our last inspection the registered manager had left the service and the staffing levels were now a cause for concern. We were aware that concerns had been raised by Halton Council regarding the staffing and overall governance of the service.

We identified breaches of the relevant regulations in respect of person centred care, safe care and treatment, safeguarding service users from abuse and improper treatment, staffing, good governance and notifications to the Commission.

Care plans were not person centred and did not provide enough information to direct staff in the care they needed to deliver. We found that a number of agency staff were employed that had difficulties in understanding the needs of people living at the home and staff told us that they did not have time to read the care plan and risk assessments. People did not receive care that met their individual needs and preferences.

Risk assessments were out of date and did not include full details of any action taken to minimise avoidable harm. We saw some examples of unsafe practice that put people living at the home at risk of harm. We identified a number of incidents and issues that should have been referred to the local authority’s safeguarding team. These had not been referred and we had not been notified about them.

There were insufficient staff employed to safely meet the needs of people living at the home.

The registered provider was aware of many of the shortfalls in practice because the local authority had previously carried out quality monitoring visits and implemented an action plan. However, leadership and management of the home had failed to address many of the issues.

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by the Commission. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

Services placed in special measures will be inspected again within six mon

Inspection carried out on 12 and 19 November 2015

During a routine inspection

The inspection was announced and took place on 12 and 19 November 2015. The provider was given 48 hours’ notice of the inspection because staff accompany people who live in in Harbour Close on shopping trips and outings and we therefore needed to be sure that someone was available in the office. This location was last inspected in March 2013 when it was found to be compliant with all the regulations which apply to a service of this type.

8 -11 Harbour Close is a purpose-built care facility providing personal care and accommodation for 12 people who have physical disabilities. The service consists of four bungalows each accommodating three people. The bungalows are owned by Liverpool Housing Trust and the service is managed by Scope. The home is located in the Murdishaw area of Runcorn and is within easy access of local amenities including shops, social and educational facilities.

There is a registered manager at Harbour Close. 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.

We found that care was provided by a long term staff group in an environment which was friendly and homely. People who lived in Harbour Close spoke of it as their home.

Staff knew people well and positive caring relationships had been developed. People were encouraged to express their views and these were communicated to staff in a variety of ways, including; verbally, and through physical gestures or body language.

The service had a robust recruitment process in place and used a matching process to ensure that there was compatibility between people and the staff who provided them with support. We found staff to have received an appropriate induction, supervision, appraisal and training which allowed them to fulfil their roles to their maximum potential.

Staff had received all essential training and there were opportunities for them to study for additional areas of interest. All staff training was up to date. Regular supervision meetings were organised and the newly appointed coordinator was in the process of planning supervisions with staff as well as annual appraisals. Team meetings were held and staff had regular communication with each other at handover meetings which took place at the end of each shift.

Consent to care and treatment was sought in line with the requirements of the Mental Capacity Act 2005. The registered manager was seeking authorisation for people under the Deprivation of Liberty Safeguards legislation.

People were supported to have sufficient to eat and drink and to maintain a healthy diet. They also had access to healthcare professionals as and when required.

Care plans provided comprehensive information about people in a person-centred way. People’s personal histories had been recorded and their likes and dislikes were documented so that staff knew how people liked to be supported.

Complaints were dealt with in line with the provider’s policy, but there had been no formal complaints logged in the last year.

People who used the service spoke highly of the staff and services provided. Staff presented as encouraging people who used the service to make decisions and choices in their lives to maximise their independence and enhance their life skills.

The 4 bungalows were well-decorated and maintained and adapted where required. People had their own bedrooms which they could personalise as they wished.

We noted that the provider did not have a corporate quality assurance system. However we saw that the registered manager of Harbour Close had devised a quality assurance system which was used to check on the quality of staff and services provided.

Inspection carried out on 11 April 2013

During a routine inspection

The people who used the service said that they were happy living in the home and that the staff members supporting them were good. One of the people who used the service told us, �I am really happy here.�

During our inspection we saw there was good communication and understanding between the members of staff and the people who were receiving care and support from them. We observed people being supported with their daily life activities. The people we met with appeared relaxed, comfortable and at ease with the staff. It was evident staff had a good understanding of what was important to each person, for example, preferred clothes, meals and social arrangements.

We looked at support plans, risk assessments; monthly key worker notes and saw that they contained a lot of information about people and reflected the individual�s current circumstances. We found that they were being reviewed consistently.

Menus and shopping for food were planned and undertaken with the people who lived in each bungalow. This was done by discussing likes / dislikes and what people felt like eating. This provided a very flexible menu for people.

Information about the safety and quality of service provided was gathered on a continuous and ongoing basis with feedback from the people who used the service.

Inspection carried out on 11 January 2013

During a routine inspection

The 12 people currently living at Harbour Close had support plans which included information about the support they needed and how they wanted to receive it. One of the people who used the service told us, �Nothing goes in without my say so.�

The people who used the service said that they were happy living in the home and that the staff members supporting them were very good. One person said, �It�s brilliant, I love it here.�

During the visit we spoke to a visiting GP, he told us, �The care was excellent and they always address things promptly.�

During our inspection we saw there was good communication and understanding between the members of staff and the people who were receiving care and support from them. The people using the service appeared relaxed, comfortable and at ease with the staff.

We looked at support plans, risk assessments; monthly key worker notes and saw that whilst they contained a lot of information about people they did not always reflect the individual�s current circumstances. We found that they were not being reviewed consistently. Whilst the above issues are a concern to us we did not find any evidence to indicate that the needs of the people currently living at the home were not being met.

Information about the safety and quality of service provided was gathered on a continuous and ongoing basis with feedback from the people who used the service.