Harbour Care Home

Harbour Care Home provides accommodation and personal care for up to 12 people with mental health needs. At the time of the inspection there were eight people living at the service. This service also provided care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. There were seven people receiving a regulated activity. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

People’s experience of using this service:

•The service enabled people to receive care whilst enabling them to lead more independent lives. One person told us, “I like it here. Staff help me do things, they listen to me.”

•People had good relationships with staff, who were knowledgeable of their physical and emotional needs, as well as likes, dislikes and interests. Staff were responsive to changes in people's health needs. If needed, they sought advice from relevant professionals.

•People felt safe living at the service. “I really feel safe here”, one person told us.

•People were encouraged to be as independent as possible. People had goals to aim for.

•People felt comfortable raising any complaints with staff and the registered manager.

•People were fully involved in their care planning and received information in a way that they understood.

•People were protected from the spread of infection and medicines were stored and managed safely.

•People were asked feedback about the service they received.

•People found the registered manager approachable and supportive.

Rating at last inspection: This service was rated, “Good” at the last inspection. (20 January 2017)

Why we inspected: This was a planned comprehensive inspection to check the service remained Good.

Follow up: We will continue to monitor the service through the information we receive. We will carry out another scheduled inspection to make sure the service continues to maintain a Good rating.

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

Harbour Care Home provides accommodation and personal care for up to 12 people with mental health needs. The service is located in a residential area in Herne Bay and is set over three floors. Everyone had their own room. At the time of the inspection there were nine people living at the service.

An acting manager was leading the service and had been the acting manager since December 2015. They told us it was their intention to apply to the Care Quality Commission to be the registered manager. The service had been without a registered manager for 16 months. 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.

Notifications were not always sent in line with Care Quality Commission guidelines. Notifications are information we receive from the service when significant events happen, like a death or a serious injury. This was an area for improvement.

People told us they felt safe, were well looked after, happy and would inform staff if they were concerned about abuse. Staff knew what abuse was and they had completed safeguarding training. Staff knew what action to take if they suspected abuse and who to report abuse to, such as the local authority adult protection safeguarding team. Staff told us they felt confident to discuss any safeguarding concerns with the manager.

People were involved in writing their support plans and contributing towards their risk assessments. Risk to people’s safety had been assessed and staff managed risks in line with individual risk assessments. Support plans were regularly reviewed, detailed and organised.

All accidents and incidents were recorded and monitored by the manager. The manager looked for any patterns so they could take action to prevent further incidents.

Plans were in place for emergencies like a fire or a flood and staff knew what to do in the event of an emergency. Safety equipment, electrical appliances and gas safety were all checked and the checks were up to date. There were regular fire drills and people knew how to leave the building safely.

Safe recruitment procedures were in place and people were involved in recruiting new staff. New staff worked through an induction and shadowed more experienced colleagues before they worked with people alone. New staff also read people’s support plans to help familiarise themselves with people’s needs.

There was enough staff on duty to meet people’s needs and the provider was in the process of recruiting new staff. Most staff had been at Harbour Care Home for some time and knew people well. Staff had the knowledge and skills required to carry out their roles and responsibilities. Staff received relevant up to date training and were encouraged to pursue nationally recognised qualifications in health and social care if they wished to.

Staff received support through regular face to face meetings with the manager or senior staff. Staff had regular team meetings led by the manager, where updates and various work related issues were discussed.

People living at Harbour Care Home had the capacity to make decisions for themselves and staff sought people’s consent before supporting them where required. Staff were aware of the Mental Capacity Act 2005 and of the principles of holding best interest meetings if a person lacked capacity.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards protect the rights of people using services by ensuring if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. The service was meeting this requirement and there was no one under a DoLS authorisation.

People were not restricted from doing what they wanted and went out into the community freely. One person was going out when we arrived and said, “I am just popping out”. People had opportunities to explore their local community and develop their independence.

People were supported to maintain healthy lifestyles. They were given a budget for their own food shopping which helped develop people’s independence. People chose and prepared meals independently.

Medicines were managed safely. Medicines were stored in people’s rooms and staff supported people to take them safely. People were supported to maintain good health with involvement from the NHS and local authority care coordinators, psychiatrist and other healthcare professionals.

People felt valued and listened to and talked positively about staff. One person said, “Staff are very accommodating”. Another person said. “The staff look after us well here”. Staff treated people with kindness and compassion and people felt listened to with various opportunities to express their views, ideas and opinions. The atmosphere in the service was calm and people said they were happy.

Staff encouraged people to be independent only supporting them where required. People felt involved in the care they received contributing during meetings with professionals and staff. People’s privacy, and dignity was respected and any information was treated confidentially. One person said, “Sometimes I enjoy the privacy of my room”. Staff listened to people, explained things before completing tasks and knocked on people’s doors before entering. One member of staff said, “This is their home”.

People received personalised care that was responsive to their needs. People said staff knew them well and arrangements were in place for individual needs to be assessed and reviewed regularly. People were encouraged to follow their interests and had opportunities to discuss social activities they wanted to do.

Staff supported people to raise concerns and managed potentially difficult situations well. People and staff were aware of the complaints procedure and people had confidence in the staff team if they wished to raise a concern. People said they would not hesitate to talk to staff if they wished to make a complaint. Complaints were documented but learning was not always documented from them. This was an area for improvement.

There was a positive culture in the service, people were relaxed and staff had confidence in the manager who they said was very approachable. People said staff were very supportive and staff knew people well. People developed their independent living skills through consistent staff support and this had helped empower people to move on from the service and into their own properties.

There were systems in place to monitor the quality of the service. Regular checks and audits were completed by staff and people were asked for their feedback on a regular basis. The views of staff relatives and stake holders were not always sought formally and this was an area for improvement.

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and looking at records.

Is the service safe?

A thorough assessment process ensured that the home could meet the needs of the people who used the service.

The environment was well maintained with regular safety checks carried out so that the home was safe for people to live in.

Recruitment processes were safe. This was because there were robust procedures in place which meant all prospective members of staff were subject to thorough checks before they started working at the home.

Is the service effective?

The aim of the home was to provide accommodation and support for people who were moving on to live independently in the community. By the means of goal and support planning people were helped to achieve this.

Our observations showed that people received the support outlined in their plan in the way that suited their needs. It was clear from what we saw and from speaking with staff that they understood people's needs and they knew people well. People told us that they were supported in the way they wanted to be.

Is the service caring?

People who lived in the home felt they could trust the manager and staff and felt that they were listened to.

People who lived in the home had regular meetings where they could put forward any ideas or suggestions. We saw that these were listened to and people's opinions were respected.

People who lived in the home were able to contribute to the recruitment of new staff. A 'resident' representative sat on the interview panel and was able to ask prospective members of staff questions that had been devised by the people who lived in the home. This enabled people to have the opportunity to have their say about the staff who would be caring for them.

Is the service responsive?

We found that the manager and staff were approachable and encouraged people to voice any concerns or ideas for change.

People regularly contributed to their support planning so that any changes could be identified and new goals agreed.

People completed a range of activities in and outside the service regularly and new suggestions were listened to.

People who lived in the home were able to contribute and have their say about how the service was run. There was a resident representative who represented other people who lived in the home at staff meetings. People could choose who they wanted their representative to be, and people who lived in the home all had the opportunity to take over this role.

Is the service well led?

Staff we spoke with had a good understanding of the different policies and procedures. They knew where to access them and where they get further advice from. Staff told us that they felt well supported and were given the information they needed to support the people who lived in the home.

The manager took an active role in the running of the home and met with staff and people who lived in the home to listen to what they had to say.

There were suitable quality assurance processes in place that checked that people received safe care and lived in an environment that was well maintained.

People told us they received care from a small team of staff and were happy with the care received and had no concerns relating to the home.

All spoken with expressed a great deal of satisfaction from living within the service and did not raise any concerns about the quality of care. All said if they were not happy they would speak to staff or the manager.

Many comments received were complimentary of the service. One person said 'I like living here there are no problems' another said 'I'm quite happy here. Staff treat me well'. Other people were complimentary of the food and had no concerns about the quality of care. Another said 'Staff are very good. They respect us and treat us well'.

Staff spoken with showed knowledge of safeguarding people from abuse and how and where to report any suspicions or concerns. Staff had received training on how to keep people safe. Staff were able to obtain further relevant qualifications. Staff spoken with demonstrated, through discussion that they had the skills to carry out their role. Records viewed showed the majority of staff had received training in core courses.

People said that they were happy with the care and support they were receiving and that their needs were being met in all areas. They said that the staff treated them with respect, listened to them and supported them to raise any concerns they had about their care. People told us that the service responded to their mental health needs quickly and that the manager talked to them regularly about their plan of care and any changes that may be needed.