Harwood Court Care Home

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 under the new provider. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The management and staff team had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

When things went wrong, there was evidence of lessons learned and of this information being shared with the staff team. Discussions took place in daily team huddles and regular larger staff meetings to ensure best practice would be followed in the future. The management team had oversight of any safety concerns. Staff told us they felt confident to speak up if anything went wrong, so that it could be corrected accordingly.

The staff 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. One person who lived at the home told us, “I have had several strokes, and staff were so helpful in arranging health services for me.”

Initial assessments informed the development of people’s care plans. Care records showed people had access to a range of health and social care professionals, as needed, including nurse practitioners, GPs, district nurses and podiatrists.

Policies and procedures were in place to ensure a consistency of approach in the management of risk. There was an overall understanding of risk management within the staff team. Care plans contained detailed information on how to support people accordingly and reflected both the physical and mental health needs of people. Staff told us they knew people well and had a good understanding of people’s needs. For example, A person with complex medical issues experienced multiple AE attendances earlier in the year. Following review by a specialist team and development of a clear management plan, staff in collaboration with the GP surgery and the person created an Emergency Health Care Plan (EHCP) aimed at avoiding further hospital admissions. The EHCP included agreed observation parameters, early testing, and prompt contact with the GP or Community Response Service for clinical review and initiation of required treatment. Feedback from a visiting professional included, “Staff demonstrated excellent vigilance in recognising subtle decline from the person’s baseline, undertaking timely observations, sending samples, and ensuring treatment was commenced promptly. This proactive approach has significantly reduced the risk of deterioration and prevented further hospital admissions.”

Leaders worked well with people and healthcare partners to fully understand what being safe meant to them and the best way to achieve that. Staff had a clear focus 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 always shared concerns quickly and appropriately.

We observed genuine and empathic interactions between people and staff during our visit. It was noticeably clear that staff knew the people they supported well and had developed trusting and effective relationships which helped to keep people safe.

Everyone we spoke with told us that people were safe. One person said, “Staff help me and make me feel safe.” That person’s relative told us, “I cannot tell you what this home means to us - peace of mind that Mum is safe and knowing she is happy and safe here means everything.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The management team worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were in place and contained person-centred information. Staff knew people very well and how to best and safely support individuals. Risk assessments were clear, detailed and described how to safely support individuals. One relative told us, “I know Mum is safe and staff know what they are doing. For the first time in long time, I am not getting constant calls about Mum because the staff all know what to do.”

People told us they felt safe with the care being provided, staff knew them and understood their needs. Daily records evidenced people were being supported safely. For example, one person required a special diet and their care plan documented exactly why and how their meals should be served. Further detail advised staff to liaise with the kitchen to ensure all meals with served correctly and to complete ongoing monitoring due to weight loss or gain.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The environment was welcoming and homely with a calm and relaxing atmosphere. People’s bedrooms were personalised and designed to meet their needs. There was an ongoing refurbishment and redecoration plan in place to ensure the home’s décor continued to be updated. The registered manager told us people’s rooms were decorated before they moved into the home helping to create a welcoming environment. There was a process in place that staff could follow to report any maintenance work that was required. We saw completed and in-date records of checks and all required maintenance certificates.

Environmental risk assessments were in place to protect staff and people. Risk assessments were clear and well documented. Personal emergency evacuation plans were in place, and staff knew what to do in an emergency to safely support people.

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.

The provider had a robust process in place that made sure there were enough skilled and experienced staff. The management team followed safe recruitment systems and processes. The registered manager ensured an effective and thorough induction was provided for all staff; followed by appropriate on-line and in person training. Training was up to date. Refresher training took place, when required and staff told us they received the appropriate training to be able to undertake their roles effectively. Staff told us that the induction process was effective and supportive.

There were procedures in place in the event of staff absence. Managers were available through the week and on call at weekends and out of hours, with senior staff on shift when managers were not. Staff told us the manager was on site each day and was very approachable. The registered manager told us that it was very important the staff team knew he was accessible at all times and available to speak with.

Staff told us they had regular supervision, which was supportive and helpful. They said they could speak with the manager quickly if they had any concerns. Staff were confident the manager would listen and take action to resolve concerns. Staff told us they felt listened to and valued. One staff member said, “I feel confident to go to any senior as I know they will help out with what I need.”

The management team assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Housekeeping staff followed clear cleaning schedules, and the home was immaculately clean throughout. Staff had easy access to personal protective equipment and used it correctly when needed. Handwashing facilities were available throughout the home and were clean and free from clutter.

Regular IPC checks were undertaken, and the management team undertook regular audits to maintain good IPC compliance.

Visiting professionals told us, “The home is consistently clean and well-maintained.”

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Medicinesstorage was clean, tidy and well-organised.Temperature monitoring was in place and completed appropriately for fridges and medication storage rooms. Record-keeping for controlled drugs complied with requirements.

Protocols for the administration of “as required” medicines or those with a variable dose were inconsistently detailed. Some were comprehensive whereas others lacked enough detail to enable a carer to decide what dose to give, or when to offer another dose.

Where thickeners were prescribed, these were used appropriately, however records were not completed to document each time thickener had been used. This was addressed following our visit.

Medicine administration records were complete and included accurate balances. Records showed staff training and audits relating to medicines were up to date and complete. However, all medicines audits showed 100% compliance and therefore hadn’t picked up issues identified during the inspection.