Archived: Harmony House

Updated 16 February 2023

The 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 3 inspectors, a specialist nurse advisor and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Harmony House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Harmony House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

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

The inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service, an independent advocacy service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

The provider had been asked to complete a Provider Information Return (PIR) and was in the process of completing this at the time of our 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 this information to plan our inspection.

During the inspection

During the inspection we spoke with 6 people who lived at home and 9 of their relatives. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with 15 members of staff including the registered manager, the area manager, the clinical lead, the care manager, 2 nurses, 7 care staff, the activities co-ordinator and a member of the housekeeping team. We contacted an external healthcare professional for feedback on their engagement with the service. We reviewed 6 people’s care records and multiple medicines records. We also reviewed records relating to training, recruitment and quality assurance.

Updated 16 February 2023

About the service

Harmony House is a residential care home providing personal and nursing care for up to 57 people over the age of 50. At the time of our inspection visit there were 51 people at the home.

Harmony House accommodates people in one building, split over two floors. Each floor has separate dining areas and bathroom facilities. People have en-suite facilities in their bedrooms.

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

Significant progress in improving governance procedures had been made by the management team since our last inspection to ensure people were safeguarded and received person-centred care. However, improvements were still required to ensure people consistently received safe care. Although staff understood the support people required to reduce their risk of avoidable harm, gaps in care plans and records meant there was a potential risk people may not be provided with consistent and safe care.

There were enough staff to meet people’s needs safely. Staff received regular training and support and understood their role in protecting people from the risk of abuse. The registered manager followed the provider’s safeguarding policies and procedures and reported any safeguarding concerns to the local authority. Medicines were managed in accordance with good practice guidelines.

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. People had choice and control over who visited them and there were no visiting restrictions in the home.

People were offered opportunities to engage in a variety of activities and staff understood the importance of social interaction with people. Staff received specialist training on end of life care to ensure people were supported to live as they wished to in their final days.

People and relatives gave us positive feedback about their experiences of living at Harmony House. Staff spoke very positively about the management team and felt engaged in the improvement process. The registered manager was committed to continue to embed improvements into practice.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 6 April 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of those regulations, however a breach of a different regulation was identified.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 14 and 20 January 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safeguarding, person-centred care and the good governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Responsive and Well-led which contain those requirements.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and risk management at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.