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Harpers Villas Care Centre Requires improvement

We are carrying out a review of quality at Harpers Villas Care Centre. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 30 October 2018

We undertook our comprehensive inspection of Harper Villas on 17 and 22 August 2018. The first day of the inspection was unannounced, the second announced. We previously inspected the service on 12 January 2017 and the rating after this inspection was ‘good’. At this latest inspection we found there were areas where the provider needed to improve the service. We rated the service as ‘Requires Improvement’ at this inspection.

Harper Villas is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Harper Villas accommodates a maximum of 26 older people that may have dementia. People live in one building that was adapted to meet the needs of people living there. There were 23 people living at the home at the time of our inspection. The provider was also offering day care provision, this not an activity that is regulated by CQC. There were no additional staff employed to provide care for people attending for day-care.

The service has a registered manager who 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 2008 and associated Regulations about how the service is run.

Our inspection was prompted following by concerns from local authority commissioners, which had led to several safeguarding alerts.

This is the first time the service has been rated Requires Improvement

We found areas where the provider was in breach of regulations. We found the provider’s systems for governance were not always effective in identifying and addressing risks to people promptly and needed improvement. In addition, the provider had not notified us of allegations of abuse as required by the law. You can see what action we told the provider to take at the back of the full version of the report.

We have also made recommendations. We have recommended that the provider considers how they could improve the environment for people living with dementia in line with national recognised guidance. We have also recommended that the provider improves people’s access to information in a way that consistently reflects their individual communication needs and in accordance with the Accessible Information Standard.

Despite the lack of notification to CQC of allegations of abuse, staff demonstrated a good understanding of safeguarding procedures. Following local authority visits, several risks to people were identified. Audits in place had failed to identify some risks to people that had not been assessed by the provider. People were satisfied with how their medicines were managed, but there were areas were medicines management could be safer. We found there was not sufficient staff available at night to ensure the provider was able to follow their fire procedure. The provider has stated more night staff will be employed. There was an impact on staff time during day time hours due to the additional dependency levels of people attending for day-care. We saw prospective staff were subject to checks prior to their employment.

People’s consent was sought consistently by staff and the registered manager had made applications to the local authority for any restrictions that may be a deprivation of a person’s liberty. People were supported by staff on a day to day basis to have maximum choice and control of their and we saw staff supported them in the least restrictive way possible; the policies in the service supported this practice but some systems did not. Some care plans were agreed by people’s relatives and it was not clear whether these relatives were legally able to make these decisions.

People were confident in staff

Inspection areas

Safe

Requires improvement

Updated 30 October 2018

The service was not always safe.

Risks to people, when identified were not consistently addressed.

Allegations of potential abuse had not consistently been identified and reported, this despite staff having a good understanding of safeguarding procedures.

Risks to people were not consistently identified by the provider, or when identified acted upon.

People were satisfied with how their medicines were managed, but there was scope to make medicines management safer.

The provider had not ensured staffing levels reflected their dependency tool and there was not always sufficient staff to ensure people were safe at night if there was a fire.

Checks were carried out on prospective staff before they were employed.

Effective

Requires improvement

Updated 30 October 2018

The service was not always effective

People living with dementia would benefit from improvement to the environment.

People’s right to consent was sought by staff and any restrictions where people lacked capacity were referred to the appropriate local authority, although it was not always clear who could make decisions on behalf of people lacking capacity.

People were confident staff were trained to meet their needs.

People were confident they could access external healthcare when needed despite some concerns about delayed healthcare.

People had a choice of food and drinks were made available frequently.

Caring

Good

Updated 30 October 2018

The service was caring

People were supported by staff who were kind, caring and respectful. People were treated with dignity and respect and staff had positive relationships with people. People's independence and privacy was promoted.

People were supported by staff to express their views and make choices regarding their daily living.

Responsive

Requires improvement

Updated 30 October 2018

The service was not always responsive

People did not always have access to information that was accessible and considered their individual communication needs. Some people’s care plans reflected their needs, wishes and preferences, although this was not consistent, despite staff having a good awareness of these.

People had access to some leisure opportunities, although this was dependent on the time staff had available to offer these.

People’s needs likes, dislikes and personal preferences were understood and known to staff.

People could raise complaints and these were responded to by the provider.

Well-led

Requires improvement

Updated 30 October 2018

The service was not always well led

We found the systems for governance were at times overly complex and ineffective in addressing all risks to people promptly and maintaining the quality of the service.

We had not received notifications related to allegations of abuse as required by the law.

People and their relatives were satisfied with the service they received and felt the management and staff were approachable and would listen to them.

Staff told us they were well supported and liked working at the home.