Background to this inspection
Updated
14 April 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 15 March 2016 and was unannounced.
The inspection team consisted of two inspectors, a nurse specialist 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. The expert-by-experience on this inspection had personal and professional experience of caring for someone and using care services.
Before the inspection we looked at all the information we had about the service, including notifications of significant events and the provider’s action plan following the last inspection.
During the inspection visit we spoke with seven people who lived at the service, six visitors and the staff on duty, who included the registered manager, deputy manager, nurses, care assistants, kitchen staff, domestic staff and the activities coordinator. We observed how people were being cared for and supported. We looked at the environment and records relating to this. We also looked at the care records for 10 people, the recruitment, training and support files for five members of staff, the records of complaints, accidents and incidents and the records that the provider used to monitor the quality of the service.
Updated
14 April 2016
The inspection took place on 15 March 2016 and was unannounced.
The last inspection of the service was on 1 September 2015 when we found breaches in five Regulations relating to person centred care, privacy and dignity, staffing, consent and good governance.
The Harefield Nursing Centre is a care home with nursing for up to 40 older people. At the time of our inspection 33 people were living at the home. Some people living at the home were living with dementia. The home was run and managed by Bupa Care Homes (ANS) Limited. 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 and associated Regulations about how the service is run.
Although the provider had reassessed and improved the staffing levels and deployment at the service, there were times when people’s needs were not being met and they were placed at risk because there were not enough staff deployed to support them.
You can see what action we told the provider to take at the back of the full version of the report.
The environment was well maintained and clean.
There were appropriate procedures for safeguarding people.
People received their medicines in a safe way and as prescribed.
The provider’s recruitment checks were designed to ensure the staff were suitable to work at the service.
People’s capacity to consent had been assessed and the staff made sure people consented to their care as it was offered. Where people lacked the capacity to make specific decisions the provider had acted in the person’s best interest and had consulted with those who were important to the person.
The staff received the training, supervision and support they needed to care for people safely and meet their needs.
People’s nutritional needs were met.
The staff worked with other healthcare professionals to make sure people’s healthcare needs were met.
People told us they had positive relationships with the staff. The staff were kind, caring and respected people’s privacy. However, some people felt that there were long periods of time when they did not have sustained or meaningful interactions.
People’s care needs were met in a way people wanted. Although some of their preferences and personal wishes were not recorded in care plans.
People had access to a range of organised activities, but some people wanted more opportunities for things to do.
There was an appropriate complaints procedure and the provider responded to complaints.
People living at the service, staff and visitors found the manager approachable and felt the service was well managed.
There had been improvements to the service and the manager had a plan for on going and continuous improvements.
Records were well maintained, accurate and up to date.
There were a number of different audits and checks which enabled the manager and staff to monitor the quality of the service.