We carried out a review of the data available to us about Harleston House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Harleston House, you can give feedback on this service.
We found the following areas of good practice:
As relatives are currently not able to visit, staff had set up different ways in which people could stay in touch with those who are important to them. This included by phone, tablet and a large TV screen. People experiencing dementia were supported by staff to engage with these virtual opportunities. Staff recognised that people missed contact with their loved ones and had continued to deliver a full programme of activities to cheer people's mood. This included a 'Butlins' day where staff dressed up as red coats, the dining room was transformed into a big white tent, residents chose their own menu and a knobbly knees competition was enjoyed by all.
All people living at Harleston House Care Home are currently shielding and so staff wear PPE at all times and remain socially distant whenever this is possible. Where people are discharged from hospital, the care home requests that a COVID test result is provided by the hospital. People are supported to isolate for 14 days upon the entry to the home. To date no people have tested positive for Covid-19.
All staff are happy to undertake PCR tests in order to protect the people they care for. Where staff test positive, they are supported to isolate at home and the appropriate authorities informed. Staff we spoke with were clear that the management team were supportive of their needs. Risk assessments for all staff had been undertaken and staff who needed to shield were supported to do so in an appropriate way. Handovers and staff breaks had been modified to ensure that only small groups gathered at any one time. If staff did meet in one room, they remained socially distant and wore PPE. Harleston House is currently using only staff from their permanent team in addition to one bank staff member (who works only at Harleston House).
The premises looked clean throughout and communal areas were ventilated. Cleaning schedules had been updated by the housekeeper in light of COVID-19 risks and frequent cleaning of high touch areas was undertaken by all staff, both day and night. The home had a large stock of cleaning detergents which had been checked for their efficacy in preventing the spread of COVID-19. Oversight of laundry was comprehensive and housekeeping staff demonstrated a good knowledge of the guidelines in place for washing people’s clothing should someone test positive for COVID-19.
At our last inspection on 20 April 2016, we rated caring as outstanding and the service overall as good. At this inspection we found that the service had continued to develop and improve, with caring, responsive and well led now rated outstanding. The overall rating for the service is outstanding.
A registered manager was in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People were at the heart of the service; receiving outstanding care that was personalised to them, taking account of their individual needs and wishes. Without exception people, relatives and professionals were full of praise about Harleston House. They were extremely complimentary about the approach of the staff and the management team, describing them as incredibly kind, compassionate and respectful towards them. People and relatives shared numerous examples of how compassionate and dedicated staff repeatedly went the extra mile to ensure they were extremely satisfied with all aspects of their care. This included taking the time to ensure every small detail of the care provided met the person's individual needs and wishes to provide a positive outcome for the person. Everybody we spoke with said that they would highly recommend the service.
Harleston House was exceptionally well led. There was dynamic and effective leadership within the service. The service was organised and extremely well run, with an open, transparent and empowering culture. Morale in the service was extremely high, at all levels within the service.
Staff were proud to work at Harleston House and were remarkably motivated and enthusiastic about delivering high quality care. The registered manager led by example and was passionate and committed to ensuring people received tailored care to meet their diverse needs. They were visible and hands on in the home, supported by a management team that demonstrated a holistic approach to achieving positive outcomes for people through person centred care. The registered manager had clear oversight of how the home was meeting people’s physical, emotional and social needs. They effectively demonstrated how their robust quality assurance systems had sustained continual development and improvement at the home.
All the staff continued to be extremely compassionate, attentive and caring in their interactions with people. They consistently promoted and encouraged people’s independence and treated them with the utmost dignity and respect. Staff understood the importance of obtaining consent when providing care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Ensuring people received care and support tailored to meet their individual needs to enhance their quality of life was integral to the ethos of the home. Staff demonstrated an enhanced understanding about people’s choices, views and preferences and acted on what they said. An enabling and supportive culture focused on meeting the diverse needs of people had been established and was clearly documented in people’s care records.
The staff and management team were exceptionally responsive to meeting people’s needs. People were actively involved in contributing to the planning of their care and support. This was regularly reviewed and adapted to meet changing needs. People were encouraged and supported to pursue their hobbies, participate in a wide range of meaningful activities that they chose, enabling them to live as full a life as possible.
People enjoyed a positive meal time experience and were supported to eat and drink enough to maintain a balanced diet. They were also supported to maintain good health and access healthcare services.
People knew how to complain and share their experiences. Their views and opinions were actively sought, valued and listened to. Concerns and complaints were thoroughly investigated, responded to and used to improve the quality of the service.
The service continued to provide a safe service to people. Effective systems were in place intended to minimise the risks to people, including from abuse, falls and with their medicines.
Staff fully understood their roles and responsibilities in keeping people safe. They were trained and supported to meet people’s needs. Staff were available when people needed assistance and had been recruited safely. Where people required assistance to take their medicines there were appropriate arrangements in place to provide this support safely.
The design and layout of the building was hazard free, clean and in a good state of repair with equipment maintained. People’s individual needs including those living with dementia were met by the design and decoration of the home. Consideration had been given to providing points of interest and stimulation along with quieter tranquil areas in the building to create a safe, homely and easily understood environment.
The service had a quality assurance system and shortfalls were identified and addressed. There was a culture of listening to people and positively learning from events so similar incidents were not repeated. As a result, the quality of the service continued to develop.
The registered manager demonstrated an open, reflective leadership style working in partnership with other stakeholders to drive continual improvement within the service and local community. Feedback from healthcare professionals cited collaborative and highly effective working relationships.
There were 35 people living in the service when we inspected on 20 and 21 April 2016.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The service provided care and support to people which took account of their individual needs, preferences and wishes. Staff and management were dedicated to providing care which exceeded people’s expectations. Meaningful relationships had been built up between people and staff, and we observed caring and compassionate interactions. Feedback from people, relatives, and professionals during the inspection was very positive.
Staff were motivated to provide care which impacted positively on people’s well-being. Staff worked in partnership with people to ensure that the care delivered was individualised. We observed people and staff singing, dancing and laughing throughout the day. The atmosphere was relaxed and vibrant.
Effective systems were in place which protected people from the risk of abuse. Staff were trained to identify potential signs and knew how to report any concerns.
Risks to people were identified, monitored and reviewed regularly. Assessments guided staff on how to ensure the safety of the people who used the service.
The registered manager and staff supported people who may not be able to make decisions about their own care in line with relevant legislation.
People were supported to maintain good health and had access to a range of health and social care professionals when required.
Appropriate systems ensured people received their medicines safely.
A complaints procedure was in place. People’s comments, concerns and complaints were listened to and addressed in a timely manner. The service encouraged feedback from various sources, and used this as an opportunity to make changes.
The service had effective management and leadership. There was an open and inclusive culture within the service. There were systems and processes in place to monitor and evaluate the quality of the service provided. Any issues identified by these systems were acted upon quickly and the appropriate actions taken.
We saw that staff asked the people who used the service if they wished to participate in activities and receive support to meet their personal needs. We observed that staff gave people choices.
The service had good infection control procedures in place and there had been no complaints since our last inspection.
The service had appropriate recruitment processes in place to ensure that staff were recruited and vetted before starting work with the service.