- Care home
Archived: Harmony House
Assessment report published 8 October 2025
Contents
Ratings
Our view of the service
Date of assessment: 30 July to 13 August 2025. Harmony House is a nursing home providing care to younger and older people, people with a physical disability and people living with a cognitive impairment. At the time of our inspection there were 55 people living at the service. Care and support is provided across 2 floors in one purpose-built building.
During the assessment process, the legal entity of the provider changed. The directors and registered person remained the same, therefore any actions have been imposed against the new provider, so the new legal entity has inherited the locations regulatory history. This will enable us to monitor any ongoing risk and ensure the regulations are being met within the service.
This assessment was completed to follow up on action we told the previous provider to take at the last inspection (not rated) in February 2024. The service was in breach of 2 legal regulations in relation to safe care and treatment and good governance. Some improvements were found at this assessment however the service remained in breach of these 2 regulations because a lack of oversight and effective risk management which remained. The service did not demonstrate an effective system for overseeing incidents to identify trends to reduce the risk of reoccurrence through shared learning. This placed people at risk of harm. We found a further 2 breaches of regulations at this inspection, in relation to person centred care and safe and effective staffing of the service.
During this assessment we spoke with people who lived at the service, their relatives, care staff, housekeeping staff, a maintenance person, the manager, a deputy manager and an area manager. We reviewed care plans, recruitment files, health and safety records, medicines administration records and quality assurance records. There had been changes in the management team since the last inspection. The service did not have a registered manager however the manager told us they had recently been interviewed by CQC registration colleagues and were awaiting their registered manager certificate.
We could see the service had rectified some of the issues we found last time within their quality assurance systems, however these were not yet fully embedded to be effective in day-to-day practice. Where checks were delegated to others, there was limited or no oversight to ensure those checks were completed or accurate. A lack of effective checks of the environment through an effective daily walkaround continued to expose people to unnecessary risks. Various items and unsafe liquids were stored in communal areas that could cause people harm, especially if ingested. We found an unlocked room directly off a communal lounge contained in excess of 6 large plastic boxes that contained people’s liquid and tablet medicines. Because these medicines were not stored securely, this put people at risk of harm. Although regular environment checks were completed, evidence we saw showed there remained a lack of consideration to balance and manage risks.
Nursing staff reviewed assessments taking account of people’s communication, personal and health needs but in some cases, senior staff said they did not always have enough information to complete a detailed care plan for staff to follow in a timely way. Staff worked with agencies involved in people’s care to support the best outcomes.
We observed some positive interactions between people and staff and saw that people were treated with kindness. However, we were not confident there were sufficient levels of staff to support people’s day to day needs, for example in spending quality time with people or supporting people with activities and interests. This had a negative impact on some people. During our visit we heard a person repeatedly asking for help and a drink but they were not attended to by staff. We immediately raised this with staff and the management. Almost 95% of people living at the home were cared for in their bedroom. The manager completed a dependency tool to assess safe levels. However, they used 2 separate systems which scored people’s risk scores differently so we could not be confident staffing levels were meeting people’s assessed needs. The manager did not give us a clear rationale why they chose the lower assessed care needs to staff to.
People and staff had opportunities to provide feedback to management, but we received mixed feedback about how they thought their concerns had been listened to. We saw staff protected people’s privacy and dignity and offered people choice in their day-to-day decisions, for example with food and drink. However some people told us they wanted to be involved in activity sessions but on occasions, their wishes were not always supported. The home was clean and staff followed safe infection control guidance, however the decanting and mixing of chemical cleaning agents into an incorrect bottle with no labelling was not safe. Equipment was cleaned and checked to ensure it was fit for use though people and staff told us there was a shortage of wheelchairs. Staff discussions showed they knew what and how to use specific equipment but staff gave us mixed responses regarding quantities of equipment and whether some equipment was available.
Staff received training relevant to their roles to keep their skills and practice updated. People were protected and kept safe from abuse, however some staff conversations showed us they did not know how to escalate concerns of poor practice other than to the manager. Where accidents and incidents took place, managers reviewed those to identify trends but staff told us, they were not always informed. Managers worked well with external teams to ensure people received the right care at the right time. It was evident there were improvements from the previous inspection, but more work was needed. The management team were committed to improve to make sure people received care in a safe and effective way.
People's experience of this service
People felt safe living at the home. Relatives said staff knew how to care for their family member and relatives were complimentary of the staff’s caring nature and how staff wanted to do the right thing. Some people and relatives told us at times, staffing levels did impact on them, whether being delayed in receiving personal care or not always being able to be involved in activities in the home. One relative said the activities had recently become less of a priority and this made them worry about their family member becoming isolated. Not everyone thought there were enough staff but we saw staff were responsive to requests for help. Where people could not always communicate, regular checks were undertaken to check on people. People and relatives said at times, staff were extremely busy and although they were helpful they did not always receive the help at the time they needed it. People and relatives told us staff were extremely helpful, caring and wanted to do the best they could.
People and relatives told us the food was good but we saw people, especially those with a cognitive impairment were asked to give their choice 24 hours in advance. We recommended the staff and manager gave this some thought as not everyone remembered their choice. People said they had choice of meals, and most people ate in their room with staff assisting them. No one we spoke with had made a formal complaint but if they did, they knew how and who to report to. Some people said they had raised some issues but for them, actions were not always taken. While people and relatives expressed general satisfaction with their care and treatment from a kind and caring staff team, our assessment found elements of care did not meet the expected standards and this placed people at unnecessary risk of potential harm.