Harmony House Nursing Home

Harmony House Nursing Home 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. Harmony House Nursing Home accommodates up to 29 older people in an adapted building. At the time of our inspection 26 people were living in the home.

People’s experience of using this service:

People told us they felt safe, they were relaxed and familiar with the staff and each other. People were cared for by a consistent staff team who had received appropriate training to carry out their roles.

People’s dietary needs and preferences were assessed and where needed, people received support to eat and drink. Meal times were an important social event in the day for those who chose to eat together.

People received assistance to take their medicines as prescribed and were supported to access health care services.

People received care that was compassionate, respectful and responsive to their individual needs. Care plans were comprehensive, respectful, and reviewed to ensure they reflected people’s needs.

People and their relatives knew how to complain and were confident their views would be heard.

No people were receiving end of life care at the time of our inspection visit. The staff were proud of the care they provided at the end of people’s lives. The clinical lead had undertaken a comprehensive, accredited training programme run by the local hospice. They used this knowledge to develop end of life care within the home.

The previous registered manager had died unexpectedly, and their loss was felt by the staff, the people and their relatives. The nominated individual had ensured continuity of management and the quality of care people received had not been impacted.

The team shared a clear vision about the quality of care and service they aimed to provide.

More information is in detailed findings below.

Rating at last inspection:

The last inspection was comprehensive. The overall rating was Good (report published in October 2016).

Why we inspected:

This was a planned inspection based on the rating from the last inspection. The service remained rated Good overall.

Follow up:

We will monitor information received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

Harmony House provides nursing care and accommodation for up to 29 people. On the day of our inspection there were 27 older people at the home, some who were living with dementia. The home is spread over two floors with a passenger lift, communal lounge and conservatory, dining room and gardens.

The home had a 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.

People told us they felt safe living at the home, staff were kind and compassionate and the care they received was good. One person told us “I feel safe because the nice carers drop in to see if I am ok”. Another person said “This is a safe place I chose it out of three possible choices”.

There were good systems and processes in place to keep people safe. Assessments of risk had been undertaken and there were clear instructions for staff on what action to take in order to mitigate the risks. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. One member of staff said “It is our job to protect residents as they are sometimes no longer able to do that for themselves. I would report anything I did not think was right to the senior on duty or to the manager. If I thought nothing was being done I would call the safeguarding number or the CQC”. The registered manager made sure there was enough staff on duty at all times to meet people’s individual care needs. When new staff were employed at the home the registered manager followed safe recruitment practices.

The provider had arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get their medicine when they needed it. People were supported to maintain good health and had access to health care services.

Staff supported people to eat and drink and they were given time to eat at their own pace. The home met people’s nutritional needs and people reported that they had a good choice of food and drink. One person told us “We get plenty to eat here and it’s always good”. Staff were patient and polite, supported people to maintain their dignity and were respectful of their right to privacy. People had access to and could choose suitable leisure and social activities in line with their individual interests. One person told us “I love it all and really enjoy the activities especially the skittles and the musicians, I think there is plenty to do”.

People’s individual needs were assessed and care plans were developed to identify what care and support they required. People were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.

The home considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles of the MCA in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded. The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

Staff felt fully supported by management to undertake their roles. Staff were given training updates, supervision and development opportunities. For example staff were offered the opportunity to undertake additional training and development courses to increase their understanding of the needs of people. One member of staff told us “There is a lot of training here and the good thing is that we can do it in different ways. There is on line training, also worksheets you can fill in and send away to be marked or they will help you with practical training”.

There was a positive and open atmosphere at the home. People, staff and relatives found the registered manager approachable and professional. One person told us “The manager is very good, nothing is too much trouble at all. Such a nice lady”. A member of staff said “The manager is very helpful and will always try to find a solution to any problem. She always knows what is going on with every resident. We are lucky to have her as a manager”.

The registered manager and provider carried out regular audits in order to monitor the quality of the home and plan improvements. There was a system in place to manage complaints and comments. People felt able to make a complaint and were confident that any complaints would be listened to and acted on.

The people we spoke to told us they were happy with the care they received and felt involved in the planning of their care. They also told us they were happy living in Harmony House and one person who used the service told us 'they are very nice staff and if I have a complaint they listen to me and deal with it'. Another person we spoke with told us 'The staff always listen to me and the carers are wonderful'.

Staff we spoke to were happy in the roles and felt fully supported by their manager one member of staff told us 'We all work as a team and fully supported by our manager, I love coming here'.

We looked at care plans and staff records and observed levels of staff. We saw the service had enough experienced and skilled staff to meet the people's needs.

People's needs were assessed and care, treatment and support was planned and delivered in line with individual care plans. People told us they felt safe living at Harmony house. Staff members said they felt the service was safer and had improved under the new owners and manager. Staff told us they were receiving good training, support, supervision and professional development.

We found evidence that learning from incidents and accidents took place and appropriate changes were implemented. The provider and manager were making improvements to develop effective systems that regularly monitor and assess the quality of service people receive at Harmony House.