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Inspection Summary


Overall summary & rating

Outstanding

Updated 17 January 2019

Harleston House is a residential care home that provides care for up to 39 older people. Some people using the service were living with dementia. At the time of this unannounced inspection of 12 November 2018, there were 38 people who used the service. This service was registered on 7 December 2010.

At our last inspection on 20 April 2016, we rated caring as outstanding and the service overall as good. At this inspection we found that the service had continued to develop and improve, with caring, responsive and well led now rated outstanding. The overall rating for the service is outstanding.

A registered manager was in post at the time of our inspection. 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.

People were at the heart of the service; receiving outstanding care that was personalised to them, taking account of their individual needs and wishes. Without exception people, relatives and professionals were full of praise about Harleston House. They were extremely complimentary about the approach of the staff and the management team, describing them as incredibly kind, compassionate and respectful towards them. People and relatives shared numerous examples of how compassionate and dedicated staff repeatedly went the extra mile to ensure they were extremely satisfied with all aspects of their care. This included taking the time to ensure every small detail of the care provided met the person's individual needs and wishes to provide a positive outcome for the person. Everybody we spoke with said that they would highly recommend the service.

Harleston House was exceptionally well led. There was dynamic and effective leadership within the service. The service was organised and extremely well run, with an open, transparent and empowering culture. Morale in the service was extremely high, at all levels within the service.

Staff were proud to work at Harleston House and were remarkably motivated and enthusiastic about delivering high quality care. The registered manager led by example and was passionate and committed to ensuring people received tailored care to meet their diverse needs. They were visible and hands on in the home, supported by a management team that demonstrated a holistic approach to achieving positive outcomes for people through person centred care. The registered manager had clear oversight of how the home was meeting people’s physical, emotional and social needs. They effectively demonstrated how their robust quality assurance systems had sustained continual development and improvement at the home.

All the staff continued to be extremely compassionate, attentive and caring in their interactions with people. They consistently promoted and encouraged people’s independence and treated them with the utmost dignity and respect. Staff understood the importance of obtaining consent when providing care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Ensuring people received care and support tailored to meet their individual needs to enhance their quality of life was integral to the ethos of the home. Staff demonstrated an enhanced understanding about people’s choices, views and preferences and acted on what they said. An enabling and supportive culture focused on meeting the diverse needs of people had been established and was clearly documented in people’s care records.

The staff and management team were exceptionally responsive to meeting people’s needs. People were actively involved in contributing to the planning of their care and support. This was regularly reviewed an

Inspection areas

Safe

Good

Updated 17 January 2019

The service was safe.

Established systems protected people from the risk of abuse and harm.

Risks had been assessed and were regularly reviewed with guidance provided to staff on how to manage risks and keep people safe.

There were sufficient numbers of staff who had been recruited safely and who had the skills to meet people�s needs.

People�s medicines continued to be managed safely.

People were protected from the risk of infection.

Effective

Good

Updated 17 January 2019

The service was effective.

Staff had the skills, knowledge and experience to meet people�s needs fully.

People�s nutritional needs were assessed and they were supported to maintain a balanced diet.

The staff worked well as a team and with other organisations involved in people�s care to provide a consistent service.

People were supported to have access to health professionals where needed.

The home had been adapted and designed to meet people�s needs.

Staff acted in accordance with the Mental Capacity Act 2005 and ensured people's rights were respected and upheld.

Caring

Outstanding

Updated 17 January 2019

The service continued to be exceptionally caring.

Without exception feedback from people and relatives about the approach of all the staff was extremely complimentary.

Staff were consistently kind, caring and compassionate. They promoted people�s independence and treated people with dignity and respect.

People�s views on their care was encouraged and they were offered choice and had control over their care.

Staff understood how people wanted to be supported and had a thorough understanding of each person's likes, dislikes and preferences.

People could have friends and family visit without restriction.

Responsive

Outstanding

Updated 17 January 2019

The service was exceptionally responsive.

People were at the heart of the service and received exceptional care that was personalised and tailored to meet their individual needs and wishes.

People were actively involved in contributing to the planning of their care and support. This was regularly reviewed and amended to meet changing needs.

People were encouraged and enabled to pursue their hobbies, individual interests and to participate in activities of their choice and enjoy a quality of life.

People knew how to complain and share their experiences. Their views and opinions were actively sought, valued and listened to. Feedback about the home was extremely complimentary.

Concerns and complaints were thoroughly investigated, responded to and used to improve the quality of the home.

People�s preferences about their end of life care were documented.

Well-led

Outstanding

Updated 17 January 2019

The service was outstandingly well-led.

Dynamic leadership was demonstrated at all levels. The registered manager promoted the highest standards of care and support for people; delivered by an extremely passionate and highly motivated workforce.

People and relatives expressed confidence in the management team. The registered manager was visible and accessible in the home.

There was an open and transparent culture at the home. All the staff described being well supported by the registered manager and were clear on their roles and responsibilities.

Effective systems and procedures had been implemented to continually monitor and improve the quality and safety of the service provided.

The management team worked effectively in partnership with other stake holders to improve the lives of people they cared and supported.