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Archived: Harmill House Good

Inspection Summary


Overall summary & rating

Good

Updated 21 April 2015

We inspected Harmill House domiciliary care agency on 11 December 2014. The agency provides personal care and support for almost 50 people living in the community. People had a range of needs arising from old age or physical disabilities. The agency owner is also the registered manager. 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.

Staff were well trained and knew how to keep people safe. No safeguarding issues had arisen since the previous inspection. No missed calls had been reported. Where issues had arisen around medicines, staff had openly reported the issue and had prioritised the person’s safety through seeking medical advice. The manager had made changes to medication recording systems to reduce the risk of recurrence. A senior staff member completed a detailed risk assessment of the home environment in each case and staff were trained to use any relevant moving and handling equipment.

The staff had access to the information they needed to meet people’s needs in a person-centred way. Staff were very good at identifying changes in people’s wellbeing and were proactive in approaching healthcare services and family to pass on their concerns. People and their relatives were very happy with the care and support provided and felt people were safe in the care of Harmill House.

The agency had advocated effectively for people to get their needs met via healthcare services and in protecting their rights. The agency had acted beyond the usual expectations in taking steps to try to maintain the safety of one person prone to wandering off from their home. They had also taken the lead in getting medicines prescribed in an alternative form where this was beneficial to keep people safe.

Prospective staff were subject to a thorough recruitment process and the required checks were carried out to ensure they were suitable to work with vulnerable people. New staff were introduced to people before providing their support and regularly monitored to ensure they provided care to the high standards expected by the manager.

People told us staff were very good at managing the balance between people’s dignity and rights and the need for support with aspects of their care. People and relatives told us the agency was very good at communicating with them about any issues of concern. People were very happy with the consistency and continuity of care provided by the staff.

Staff had the skills and training they needed to recognise and meet people’s needs and were provided with additional or specialist training when necessary. Staff practice and competency were regularly monitored and staff were well supported in their role. The manager had a good understanding of the Mental Capacity Act 2015 and had advocated in this regard on people’s behalf where necessary. Staff provided appropriate support around nutrition and people’s health and had promptly reported concerns to health agencies when they observed changes in people’s wellbeing.

People and relatives praised the agency’s caring approach and compared it very favourably with others they had experienced. People often commented about how this agency had gone beyond what was usually expected in meeting people’s needs. Where any issues had been raised they had been promptly addressed. Relatives told us they were very confident in the ability of the agency to care for their family member. People and relatives felt the staff were very kind, caring and compassionate and looked after people’s dignity.

People were involved in planning and reviewing their care. Where they were unable to manage this or with people’s consent, the views of their family were sought. Relatives told us that the agency had been very effective in ensuring that, where necessary, other agencies were engaged to meet people’s needs. Staff felt they were given the information they needed and had sufficient time allocated to provide support to people without rushing them.

People and relatives felt the agency was approachable and the manager responded positively to any issues raised. Relatives said the agency exceeded their expectations and gave them peace of mind. They were appropriately involved and informed and felt the agency was flexible as people’s needs changed.

The manager regularly sought the views of people and their relatives through surveys and post-visit calls and any issues identified were addressed. People and relatives knew how to complain but this was rarely necessary as any concerns were responded to promptly. The agency was well managed by an experienced manager who had effective systems in place to monitor and maintain standards.

Inspection areas

Safe

Good

Updated 21 April 2015

The service was safe because staff were knowledgeable and worked safely based on clear care plans and risk assessments.

People and their relatives felt the agency kept people safe.

Staff were proactive and reported any concerns about people’s wellbeing immediately and the agency sought medical and other specialist help when necessary.

Effective

Good

Updated 21 April 2015

The service was effective because staff had the skills and knowledge to meet people’s needs and knew when to report any concerns.

Care practice was effectively monitored by the provider and people felt they or their relative were well cared for.

The agency advocated on behalf of people with external agencies, to ensure their care needs were met appropriately and in a timely way.

Caring

Good

Updated 21 April 2015

The service was caring because people’s needs were met in a gentle, patient and unhurried way with respect for their dignity and rights.

People or their relatives were involved in planning their care.

Staff met people’s needs and often went beyond the basics to provide additional support or advocacy.

Responsive

Good

Updated 21 April 2015

The service was responsive because they sought people’s wishes about their care and worked in ways that respected this.

The views of people, their relatives and staff were sought via surveys and in other ways about the quality of the service and any issues raised were addressed appropriately.

Well-led

Good

Updated 21 April 2015

The service was well led by a competent and experienced manager.

The day-to-day operation of the agency was very well monitored and the agency delivered high quality consistent care.

People and relatives felt the agency was exceptional in its performance.

The provider was open, transparent and responded in a positive way when any issues were raised.