Harmonia Village

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s needs were assessed. However, information identified about people was not always included in people’s care plans and risk assessments which needed to be improved to include more information. Information about people’s preferences were also limited in places. For example, how some people liked to be cared for, what they liked to eat and drink. There was a lack of information in people’s oral health assessments which meant people’s care plans were limited for this area. This needed to be improved to ensure people’s dental health was well assessed and monitored. Other people’s care plans did include sufficient levels of information about the person’s needs.

When people’s needs were assessed best practice evidence-based tools were being used. For example, tools were used to identify people’s falls risk or the risk of skin integrity concerns.

People were supported to eat and drink. There were mini kitchens in the houses where people could access cold drinks. There was also a drinks maker in the hub and fruit juice was available. People requested or helped themselves to drinks throughout the day. People told us they were happy with the support they had to access drinks. One person said, “I can get a drink when I want.” A relative told us, “There’s always a jug of squash in his room.”

There were systems in place to support staff to work together and promote teamwork. For example, there were handover meetings and information could be shared with staff via the electronic devices staff used. Staff were positive about teamworking at the service. One staff said, “I feel we are a very good team here, if someone needs extra support to help someone, we help, it doesn’t matter if it’s in a house we are not assigned to, we help each other to support whoever needs it.”

Staff were able to tell us how they supported people to live healthier lives. For example, one staff member told us how staff were supporting one person to reduce how much they smoked. The person had reduced how much they smoked on a daily basis from being a heavy smoker to only 3 or 4 a day.

People were supported to remain active where possible. There were activities such as armchair exercise and movement to music to encourage people to get up and move. We observed staff encouraged people to get up and move to activities whilst they were in the hub.

Where people had health conditions, they were referred to specialist nurses where appropriate to help support them to manage their conditions as well as possible.

There were systems in place to routinely monitor people’s care and treatment to continuously improve it. For example, where people were at risk of constipation or needed to be supported to reposition regularly to reduce the risk of skin integrity issues.

Staff understood the importance of supporting people to maintain hydration and how to identify if there were concerns with areas such as pressure sores. However, continence care monitoring needed to be improved and there were gaps in people’s records.

We observed staff consulting people about their wishes and well-being. People told us they had day-to-day choices such as what they wanted to eat and drink and what activities they wanted to do. Staff had knowledge of the Mental Capacity Act 2015 (MCA) and they knew where to find the policy. One staff member told us, “Mental capacity can vary for every person and every decision. You start by assuming they have the ability to make a decision, for example, about what they want to eat or drink. If they can’t tell you, I can use body language and point to pictures or ask their family. I try to do what people want even if they can’t tell you what that is.” Staff understood the importance of gaining consent. One staff member told us, “I ask for their consent before I do anything, if they can’t give it to you, you assess their body language, use facial expressions and be patient. You can understand a lot from someone about the way they move their body and the expression on their face.” Where appropriate people’s mental capacity had been assessed, and best interest decisions were recorded where people needed decisions made for them.