Harbour House

Updated 28 March 2023

Inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Harbour House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection, we sought feedback from external healthcare professionals. We reviewed information we held about the service and the provider which included any statutory notifications sent to the CQC. A notification is information about important events which the service is required to send us by law. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all of this information to plan our inspection.

During the inspection

We reviewed 3 people's care plans and risk assessments. We reviewed staff training and supervision. We also reviewed other records relating to the management of the service. We spoke with the 3 people, 1 visitor, 3 staff, the operations manager, the registered manager and the provider. We spoke with 2 visiting healthcare professionals.

Updated 28 March 2023

About the service

Harbour House is a care home providing accommodation and personal care to up to 20 people. At the time of our inspection there were 19 people using the service.

People’s experience of using this service and what we found

CQC had received concerns regarding poor communication, management and staff not responding to guidance and advice and the management of some medicines.

People were supported to access healthcare services. Staff reported changes in people's health and sought professional advice. However, communication between the staff, the manager and external healthcare professionals was not always effective.

Guidance and direction provided to staff and the registered manager was not always carried out as requested. Audits were not always effective and management oversight was not robust.

Harbour House was using an electronic system to manage people’s medicine requirements. The system helped ensure people received their medicines as prescribed. However, the administration and recording of some medicines was not always carried out appropriately.

Medicines that required stricter controls were not always accurately recorded. Oversight and auditing of medicines management was not effective.

Staff had not always been recruited safely. Gaps in employment history were not always explored. The dates provided on some returned references did not always match with the dates provided on the person’s application form.

References were not always received before staff began working unsupervised. The provider was aware of this, and immediate action was being taken to obtain these.

Several people living at Harbour House had lost weight recently. There was no clear process in place for responding to these concerns.

Risks were not always effectively reviewed when care plan reviews took place. Weights were not checked along with Malnutrition Universal Screening Tool (MUST) assessments and care plans were signed off as ‘no change’ when checks had not always taken place to confirm this.

Care plans did not always contain clear accurate guidance. One person’s care plan stated information that was contradictory. We asked for some care plans to be reviewed by the registered manager to ensure they provided up to date, accurate and clear guidance to staff.

There were enough staff to respond to people's needs. Staff had been provided with training and support to enable them to carry out their role.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. There were no Deprivation of Liberty Safeguards (DoLS) authorisations in place at the time of this inspection.

People told us that they felt safe in the service. Visitors told us they felt their family member was safe and protected living at Harbour House. Comments included, “Yes, it seems very nice. Lovely room and the staff are kind.”

The premises were clean and well decorated. People had filled their rooms with familiar items and photographs. People enjoyed the food provided at Harbour House.

People had been asked for their views and experiences at residents meetings and via a questionnaire. Responses were mostly positive.

The provider had systems in place to monitor equipment and utilities. Systems were in place to support people in the event of an emergency.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good published (4 November 2021).

Why we inspected

This inspection was prompted by concerns received by CQC regarding a lack of staff skill and knowledge in some areas, poor communication, guidance and advice not always being followed, poor management response to changes in people’s needs and the storage of some medicines.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We inspected Safe, Effective and Well-led only at this inspection. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Harbour House on our website at www.cqc.org.uk.

Notice of inspection

This inspection was unannounced.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.