Archived: Mary Fisher House

Updated 11 September 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

Prior to our inspection we reviewed the information we held about the service. This included any safeguarding alerts and outcomes, complaints, previous inspection reports and notifications that the provider had sent to CQC. Notifications are information about important events which the service is required to tell us about by law. The registered manager had also completed a Provider Information Return (PIR).The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

This inspection took place on 21 July 2015 and was unannounced.

The inspection was carried out by one inspector, a pharmacist inspector 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.

We spoke with eight people who used the service, 2 relatives, a visiting professional, the registered manager, operations manager and five members of staff during the course of our visit.

We looked at four people’s care records to see how their care was assessed and planned. We reviewed how medicines were managed and the records relating to this. We checked three staff recruitment files and the records kept for staff allocation, training and supervision. We looked around the premises and at records for the management of the service including quality assurance audits, action plans and health and safety records.

We contacted the local authority commissioners and Healthwatch to ask for their views and to ask if they had any concerns about the home. From the feedback we received no one had any concerns.

Updated 11 September 2015

This inspection took place on 21 July 2015 and was unannounced.

At our last inspection on 10 September 2014 the provider was meeting the regulations that were assessed.

Mary Fisher House provides personal care and accommodation for up to 24 older people. The service is a converted house with a purpose built extension. Accommodation is provided over three floors by a passenger lift and chair lifts four further steps on the first floor. All bedrooms are single occupancy and have ensuite facilities. There is limited parking in the grounds but plenty of roadside parking nearby. The home is within walking distances of Harrogate town centre and local amenities. On the day of the inspection there were 21 people living at the service.

There was a registered manager in place. 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.

Staff knew the correct procedures to follow if they considered someone was at risk of harm or abuse. They received appropriate safeguarding training and there were policies and procedures to support them in their role.

Risk assessments were completed so that risks to people could be minimised whilst still supporting people to remain independent. The service had systems in place for recording and analysing incidents and accidents so that action could be taken to reduce risk to people’s safety.

Staff recruitment practices helped ensure that people were protected from unsafe care. There were enough qualified and skilled staff at the service and staff received ongoing training and management support. Staff had a range of training specific to the needs of people they supported.

The home had safe systems in place to ensure people received their medication as prescribed; this included regular auditing by the home and the dispensing pharmacist. Staff were assessed for competency prior to administering medication and this was reassessed regularly.

The home was clean, however, we felt infection control could be compromised as some areas of the home required refurbishment in order they could be cleaned effectively. For example some of the ensuite toilet floors were badly stained.

People were offered choices and staff knew how to communicate effectively with people according to their needs. People were relaxed and comfortable in the company of staff.

Staff were patient, attentive and caring; they took time to listen and to respond in a way that the person they engaged with understood. They respected people’s privacy and upheld their dignity when providing care and support.

There had been a recent decline in the number of activities on offer because of a staff vacancy and people commented negatively about this. However, prior to the vacancy people commented positively on activities and we were assured the newly appointed activities organiser was starting at the home the following week.

People’s rights were protected because the provider acted in accordance with the Mental Capacity Act 2005. This is legislation that protects people who are not able to consent to care and support, and ensures people are not unlawfully restricted of their freedom or liberty. The manager and staff understood the requirements and took appropriate action where a person may be deprived of their liberty.

People’s needs were regularly assessed, monitored and reviewed to make sure the care met people’s individual needs. Care plans we looked at were person centred, descriptive, and contained specific information about how staff should support people.

People knew how to make a complaint if they were unhappy and all the people we spoke with told us that they felt that they could talk with any of the staff if they had a concern or were worried about anything.

Staff spoke positively about the registered manager. They told us she was supportive and encouraged an open and inclusive atmosphere. The staff we spoke with were aware of their roles and responsibilities and they told us that the registered manager was a positive role model in providing a high standard of care.

The provider completed a range of audits in order to monitor and improve service delivery. Where improvements were needed or lessons learnt, action was taken.