Archived: Harbour House

At the previous inspection on 5 and 6 May 2016 we found four breaches of our regulations, an overall rating of requires improvement was given at that inspection. The breaches of regulation related to some practices for the storage and administration of medicines; some aspects of recruitment were incomplete because decisions about the employment of some staff were not recorded; some quality assurance checks were not fully effective and where the service had a legal obligation to notify the Commission of certain decisions and events, notification was not always made. We issued requirement actions for these breaches and the provider wrote to us telling us how and when the required improvements would be made. At this inspection we found the provider had met the previous requirement actions and addressed all of the breaches of regulation.

The service did not require a registered manager as the provider manages this service and another owned by her locally. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 provider was present throughout the inspection.

Three people lived at the service; we met and spoke with each of them. People told us that they liked living at the service, they were happy, they thought the staff were good at their jobs, were kind and cared about the people they supported.

There were safe processes for the storage and management of medicines. Recruitment processes were in place to protect people and ensure staff employed were suitable for their roles. Staff felt supported and listened to and received appropriate supervision. Staff had appropriate training and experience to support people well.

Quality assurance and management oversight of the service was effective, all statutory notifications required by the Commission were made when needed.

Staffing was sufficient and flexible to meet people’s needs. Staff knew how to keep people safe from harm, they were trained to recognise and report abuse, risks were appropriately assessed.

Staff were aware of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and applied these principles correctly.

People had personalised records detailing their care and support, including well developed support plans for their emotional and behavioural needs.

People were supported to access routine and specialist health care appointments. People told us staff showed concern when they were unwell and took appropriate action.

People enjoyed their meals, they were involved in deciding what they wanted to eat and went shopping to buy groceries. Some people helped to prepare meals.

Staff were caring and responsive to people’s needs and interactions between staff and people were warm, friendly, respectful and often made with shared humour.

Staff spent time engaging people in communication and activities suitable to their needs.

People felt comfortable about complaining, but did not have any concerns. People, relatives and visiting professionals had opportunities to provide feedback about the service provided both informally and formally. Feedback received had been reviewed and acted upon.

The provider had a set of values forming their philosophy of care. This included treating everyone as an individual, working together as an inclusive team and respecting each other. Staff were aware of these and they were followed through into practice.

Harbour House provides accommodation and personal care for up to four people who have learning disabilities, some health conditions and some complex and challenging behavioural needs.

Accommodation is arranged over three floors and each person had their own bedroom. Bath and shower facilities were shared. The service benefitted from a small enclosed back garden.

Three people lived at the service and we were able to meet and speak with each of them. People told us that they liked living at the service, they were happy, they liked the staff and the staff were kind. They thought the home provided a relaxed and comfortable living environment, which didn’t feel crowded.

The service did not require a registered manager as the provider manages this service and another owned by her locally. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 provider was present during the inspection.

At this inspection we found improvement was required in some areas where some regulations were not being met.

Some practices for the administration of medicines did not promote proper and safe management. This was because procedures intended to ensure the correct storage temperatures of medicines were not followed and one person picked up a pill they found on the floor.

Aspects of recruitment processes were incomplete because decisions about the employment of some staff were not recorded.

Quality assurance checks were not fully effective because they had not identified some of the shortfalls we found.

Where the service had a legal obligation to notify the Commission of certain decisions and events, notification was not made.

Staff were aware of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and applied these principles correctly.

People were supported by enthusiastic staff who received regular training and appropriate supervision. There were enough staff to meet people’s needs.

People had personalised records detailing their care and support, including well developed support plans for their emotional and behavioural needs.

People were supported to access routine and specialist health care appointments. People told us staff showed concern when they were unwell and took appropriate action.

People enjoyed their meals, they were involved in deciding what they wanted to eat and went shopping to buy groceries.

Staff were caring and responsive to people’s needs and interactions between staff and people were warm, friendly and respectful.

Staff spent time engaging people in communication and activities suitable for their current needs.

People felt comfortable in complaining, but did not have any concerns. People, relatives and visiting professionals had opportunities to provide feedback about the service provided both informally and formally. Feedback received had been reviewed and acted upon.

The provider had a set of values forming their philosophy of care. This included treating everyone as an individual, working together as an inclusive team and respecting each other. Staff were aware of these and they were followed through into practice.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Care records showed that people were supported and encouraged to make decisions about their lives. We observed consent people sought when staff worked with people and information was held on records gaining consent. When people's needs changed, we found that records had been updated to reflect this.

Food was prepared for people living at Harbour House, with some input from them. We saw that menus were planned each week with people and that shopping took place alongside staff. People were able to have food and drink as they wished though meal times were at set times.

Medicines were stored correctly and administered in line with the home's procedure. Staff were trained in medication management and records were kept clearly and concisely. Medication was well organised.

Staff employed had a wide range of training and experience. There were sufficient staff members that were qualified and skilled to care for the people living at Harbour House and back-up systems in place so that people would always have this support.

In our discussions with staff they demonstrated a thorough knowledge of the people living at the service. This was confirmed by the record keeping.

Care records showed that people had been supported and involved to make decisions about their lives, including their care and daily activities.

Staff spoken with demonstrated good understanding of how to safeguard people from harm and how to report concerns if they had any. We saw that staff had a comprehensive training schedule and supervision and day to day support was in place.

Records showed the provider regularly assessed and monitored the quality of the service. We saw that people and their representatives were asked their views about the home and information from involved professionals were sought.