Harlow Hall

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always have a proactive and positive culture of safety. Accidents and incidents were not always holistically reviewed to ensure trends and themes were identified. This meant there was a risk appropriate steps would not be taken to identify potential areas of improvement. However, the registered manager told us that although a formal review of accidents and incidents had not been completed, lessons had been learnt. They told us due to the number of incidents resulting from people’s anxiety and distressed behaviour they had recognised the need to assess people’s needs differently prior to them moving into the home. As a result, they now assessed people’s mental health support needs in greater detail and looked more closely at whether these needs could be met prior to people moving to the home.

Records showed staff reported accidents and incidents which were individually reviewed by the registered manager. This helped to ensure the correct action had been taken so risks were minimised going forward. Staff told us they understood the need to report concerns in a timely way, providing as much detail as possible. One staff member told us, “I write all the details down if I witness anything. We can discuss in handover and team meetings."

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. People told us they felt supported to see healthcare professionals and staff would provide support for appointments should they need this. One person told us, “I’ve got an appointment to go to hospital and they’ll organise me getting there and go with me.”

Records showed referrals were made to relevant services as required, and any guidance provided was followed. This included referrals to the community mental health team, Speech and Language Therapy and community nursing services. The provider had also ensured joint working practices were in place where possible to support people’s health conditions. For example, staff had been trained and assessed to provide specific injections to people which had reduced the demands on community nurses several days each week.

The provider worked with people to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People told us that they felt safe living at Harlow Hall. One person told us, “It’s a nice happy place. There are no problems at all.”

Records showed that safeguarding concerns were reported appropriately. The provider was working alongside the local authority safeguarding team to ensure processes to manage risks were in place and monitored. Staff received safeguarding training and demonstrated an understanding of the different types of safeguarding, reporting procedures and the whistle-blowing policy.

The provider understood their responsibilities under the Mental Capacity Act 2005 in ensuring Deprivation of Liberty safeguards (DoLS) applications were submitted as required. A register of DoLS applications was maintained and records showed these were comprehensively completed.

The provider did not always work well with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them, although records did not always reflect the support people required. For example, there had been incidents where one person had gone into other people’s rooms without invitation. Risk management systems had been implemented, such as sensors on doors and, where appropriate, access to people’s rooms were being limited. However, despite these systems being in place and staff being aware of them, there was no risk assessment in place and no reference to this within the person’s care plan. We spoke with the registered manager about this, who assured us changes to the person’s care records would be made.

In other areas, we found the provider had systems in place to monitor risks to people’s safety and well-being. These included the support people required should they be at risk of falls, guidance for staff on how to support people during times of heightened emotions and how to ensure the environment was safe. Staff were aware of how to reassure people and provide their care safely.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People lived in a safe environment. Systems were in place to report maintenance issues and these were resolved quickly. The servicing of equipment such as lifts, hoists and fire systems was completed at the required intervals and detailed records maintained. Regular checks of equipment were recorded in order to ensure this was safe for people to use.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. People told us they felt there were sufficient staff available, and they did not have to wait for their care. One person told us, “I’m more than happy. I ring the bell, and they come and listen to what I want to say.” A second person told us, “There are (enough staff). They can take longer to come if they’re busy with another person, but they’re very good, and they say they’ll be with me in a few minutes.” Staff also confirmed they felt there were enough staff available, and they did not feel rushed.

Staff received an induction and training to support them in their roles and told us they felt this was useful. One staff member said, “I had the training and the introductions and then had two weeks of shadowing. I could read care plans and get to know the residents.” The registered manager confirmed that whilst the shadowing period for new staff was two weeks, this could be extended if staff felt they needed more time.

There were robust and safe recruitment practices to make sure that all staff were suitable for their roles. Disclosure and Barring Service (DBS) checks were carried out. These provide information, including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. People and their relatives told us they felt the home was cleaned to a high standard. They confirmed that staff followed safe hygiene practices such as wearing personal protective equipment (PPE) when supporting their care. Housekeeping staff followed clear systems to minimise the risk of cross contamination. We observed staff had access to PPE and had completed infection prevention and control training.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. During our inspection we identified a number of medicines stock checks did not match with the electronic system. The provider investigated these concerns and provided a detailed investigation report. This showed the errors had occurred due to administrative mistakes and that people had received their medicines as required. In addition, it was difficult to confirm that time critical medicines were administered within the correct time range. The provider again ensured these concerns were reviewed, and staff received additional training. Whilst the provider took prompt action to resolve these concerns, they had not been identified on their internal monitoring systems. In other areas we found medicines were managed well. People told us they felt staff supported them with their medicines safely. One person said, “They give me my medication properly.” People and relatives also confirmed staff supported them to have pain relief when required. Medicines were safely stored, and staff were observed to follow the set processes when administering medicines. Staff had completed medicines competency assessments prior to administering medicines.