Harmony House Nursing Home

Updated 1 April 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.

This was a targeted inspection to check on specific concerns we received about the leadership and culture of the service, the management of people’s privacy and finances, people’s welfare and staff training.

Inspection team

2 inspectors carried out this inspection.

Service and service type

Harmony House Nursing Home 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 Nursing Home 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

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

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service about their experience of the care provided. We spoke with or gathered feedback via email from 14 members of staff including the registered manager, nominated individual, care and domestic staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 1 April 2023

About the service

Harmony House Nursing Home is a care home providing nursing and personal care for up to 33 people. The service provides support to adults living with mental health conditions. At the time of our inspection there were 29 people using the service.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Risks were not managed safely. Lessons were not always learnt from incidents. The premises were not always secure. Staffing levels were not always appropriate to safely manage risk. Medicines were not managed safely. Safe infection prevention and control (IPC) practices were not always followed.

Records about people’s support needs were not always complete. Most staff training was either completed or underway but staff did not always demonstrate learning from this. The environment needed refurbishment. The systems in place for checking on the quality and safety of the service were not always effective.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The registered manager handled safeguarding concerns appropriately. A safe recruitment procedure was in place. All necessary checks and tests were carried out to make sure any equipment used was safe. The provider had policies and procedures in place to minimise risk in the event of a fire. Visiting was taking place in line with current government guidance.

People were given enough to eat and drink and there were a variety of menu choices available. People had access to health professionals when required.

There was a positive culture within the home. Staff told us the registered manager was very supportive and approachable. People we spoke with were generally happy with the care they received, and we had good feedback from relatives. The registered manager understood they needed to be open and transparent when mistakes were made. The registered manager had a good working relationship with the local authority and numerous health professionals.

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 8 September 2018)

Why we inspected

The inspection was prompted in part due to concerns received about areas of concern such as medicines, infection control, consent and quality assurance monitoring at the provider’s other services. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

We have approached the provider and requested immediate assurances around their improvement plan. As a result of this an action plan has been produced detailing how they would address the shortfalls identified and work to complete this had begun.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, consent and good governance at this inspection.

We have made a recommendation about reviewing staff training.

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.