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Inspection carried out on 25 February 2019

During a routine inspection

About the service:

Harper House is a residential care home which provides accommodation and personal care for up to five people with a learning disability and/or autistic spectrum disorder.

People’s experience of using this service:

• There was a calm and relaxed atmosphere in the home. People were familiar and comfortable in staff presence and we heard animated conversation and laughter throughout our inspection.

• People had lived at the home a long time and relatives told us they were happy with the care and support their family member received.

• Information about people’s care needs and wishes were detailed in person centred support plans which were regularly reviewed and updated when there had been a change in people’s needs.

• 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 place supported this practice.

• The staff worked closely with other health professionals so people’s health and well-being was maintained.

• There were gaps in environmental risk assessments completed as the fire risk assessment had not been completed in line with required timeframes and by a competent person as dictated by legislation. This was a legitimate oversight and the provider did everything they could to remedy this whilst the inspection was ongoing and got a fire risk assessor to visit the home whilst we were on site.

• All other safety certificates and required risk assessments were in place.

• Systems continued to be maintained to help ensure the safety and protection of people who used the service. This included the safe management and administration of people’s medicines, effective recruitment and training processes.

• The home had consistent management and oversight by a registered manager who was an integral part of the care provided.

• Opportunities were provided for people who used the service, their relatives and staff to feedback their views and experiences. Relatives told us they had no cause to complain but indicated they would have no hesitation in raising a concerns with the registered manager and felt it would be sorted promptly.

• People engaged with the registered manager throughout the inspection and people’s relatives told us the registered manager was well known to them and their family member and they had confidence in their leadership.

• Relatives told us they would recommend the home to others looking for this type of care setting.

Rating at last inspection: Good and the last report was published 29 January 2016. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

At this inspection we found the evidence continued to support the rating of Good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

Why we inspected: This was a planned inspection based on the previous rating for the home.

Follow up:

We will continue to monitor information and intelligence we receive about the home to ensure good quality care continues to be provided. We will return to re-inspect the home in line with our inspection timescales for Good services. However, if we receive any information of concern, we may inspect sooner.

Inspection carried out on 29 January 2016

During a routine inspection

This inspection took place on 29 January 2016, was unannounced and was carried out by one inspector. The provider is registered to provide accommodation and personal care for up to five people. People lived with a learning disability, autism and some people have additional sensory impairments. On the day of our inspection five people lived at the home.

At our last inspection in October 2013, the provider was meeting all the regulations we assessed.

There was a registered manager in post and she was present during 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 and associated Regulations about how the service is run.

People felt safe using the service and risks to their safety had been identified. Staff knew how to support people safely and had training in how to recognise and report abuse.

People were supported to take part in everyday living tasks and to do the things that they enjoyed. The risks associated with these activities were well managed so that people could undertake these safely and without any restrictions.

People had their medicines when they needed them and staff were trained to do this safely.

The staffing arrangements were flexible and ensured that people had the support they needed to meet their needs and pursue their interests.

Staff had received a full induction, appropriate training and support and were knowledgeable about the needs of people.

People were asked for their permission before staff provided care and support so that people were able to consent to their care. Where people were unable to consent to their care because they did not have the mental capacity to do this decisions were made in their best interests. Staff had worked in people’s individual best interests but needed to ensure they considered potential impacts on other people.

We saw people were supported to remain healthy and well. People liked the meals and had been involved in choosing their meals and the times they preferred to eat these.

People had positive and meaningful relationships with staff who they had known for many years. We saw staff were attentive and caring towards people. Staff used people's preferred communication to ensure their individual choices were fully respected. Staff promoted and protected people's dignity and privacy while they supported people with their needs.

People's care plans described their needs and abilities and people had contributed to these. Staff supported people to follow their own daily routines and interests. Staff had supported people to express their views on the care provided and this had led to their care being tailored to meet their needs.

There was a complaints policy in place and staff were aware how they could support people to communicate if they were unhappy about something. We saw that people had named family or representatives to advocate for them.

Regular checks had been undertaken to maintain the quality of the service.  The registered manager had actively looked at ways to benefit the lives of people living at the home.  They had organised staffing to accommodate people’s lifestyles and choices. Staff had the support and training to be able to provide a service that was based on promoting people’s quality of life. This meant that people were benefiting from a service that was continually looking at how it could provide better care for people.

Inspection carried out on 2 October 2013

During a routine inspection

During our inspection we spoke with two people, two relatives, the registered manager and four members of staff.

People at the home were consulted and offered choices about the things they wanted to do. We saw care and support being given in ways that supported the independence of people and respected their privacy and dignity. A person we spoke with said, “I really like it here.”

Staff we spoke with knew about the individual care needs of the people they were supporting and were able to describe in detail what those needs were. We witnessed care and support being delivered appropriately and people told us they received good care.

People were protected from abuse. Staff knew how to recognise potential or actual abuse and how and who to report it to.

Staff, were very enthusiastic about the work they did and of the care they provided. One of them said, “I love working here.” Staff were well trained and supported by management in order to carry out their roles.

There were robust quality assurance processes and systems in place to monitor and improve the service. Regular meetings were held so that people could be consulted about the things they liked or disliked.

Inspection carried out on 12 November 2012

During a routine inspection

At the time of the inspeciton visit, the five people who live at Harper House were all in the lounge on the morning of the inspection having their morning coffee and tea. They were relaxed and happily chatting between themselves. The talk was of going out to get some personal items from the shops and the money they had to make these purchases, their activities at their new day centre and some family members contact visits. The new day activity centre was making the people who attended very happy and they spoke about what they liked. The registered manager arrived and all the people who used the service were very excited and happy to see her..

The staff on duty discussed the likes and dislikes of the people using the service and how they understand what they are communicating. The supervisor described a typical day with the duties which needed to be undertaken for the benefit of both the people living there and the home environment. The supervisor talked about her development since starting in her post and how she works with her staff team to ensure they are well trained and have the information they need to do their jobs. The other care worker on duty was relatively new in post. She discussed her induction and training, stating how much she enjoyed her new job.

The register manager discussed the development work which had been undertaken to ensure the welfare of the people was ensured. This was all demonstrated through recent examples.

Inspection carried out on 26 March 2012

During a routine inspection

There were five people living there on the day we visited. We spoke with three people and five staff. We observed how staff supported all the people who lived there. We looked at two people's records, staff training records and a sample of audits completed at the home.

One person said " I like living here, it's gorgeous." Another person told us, " I like it here, I've been living here for years. It's a good place, I might be worse off if I moved to another place."

We saw and people told us that they could choose what they did, how they spent their time and what they ate and drank. People told us that they went shopping with staff for their personal items, like clothes and toiletries, and chose what they wanted.

We saw that people were encouraged to be as independent as possible and seemed to enjoy helping with jobs around the home. One person said, "I make my own coffee."

People were supported by staff to attend the health appointments they needed and they had regular health checks to ensure their well being.

People and staff spoke about how the closure of their days centres had meant they had less activities and spent less time meeting their friends. The provider had set up a day centre on two days a week to help reduce the negative impact of this. People had been to the centre that day and said they had a good time. People were also supported by staff to visit other places they wanted to and to go out in the local community.

Staff had the training and support they needed to help them to support the people living there to meet their needs and safeguard them from harm.

People told us they would talk to staff if they were unhappy and they thought they would be listened to. One person said, "If I had any problems I would talk to the staff or to the manager."

Reports under our old system of regulation (including those from before CQC was created)