Background to this inspection
Updated
6 March 2018
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 7 and 8 February 2018 and was unannounced on the first day. On the first day, the inspection was carried out by an adult social care 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. On the second day, the inspection was carried out by two adult social care inspectors.
Before the inspection we looked at any information CQC had received about Safe Harbour since our last inspection. The manager had completed a ‘Provider Information Return’. This 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.
During the inspection we spoke with six people who lived at the home, seven relatives, nine members of staff, and one of the providers. We also had a meeting with 13 staff. We observed care and support people received in communal areas including one to one care provided to two people. We looked at the care records of five people who used the service. We looked at staff records, health and safety records and management records, and the management of people’s medication.
Updated
6 March 2018
This inspection took place on 7 and 8 February 2018 and was unannounced on the first day. At our last inspection we found a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because the provider had not always effectively assessed and monitored the safety, risks and quality of the service provided. During this inspection we found that improvements had been made to meet this requirement.
Safe Harbour is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home accommodates up to 47 people who are living with dementia.
The home is required to have a registered manager and a registered manager was in post at the time of the 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 living at the home were protected from abuse because staff knew how to report any concerns they had and had access to the relevant contact details. Potential safeguarding incidents had been reported to the local authority and the Care Quality Commission as required. Training records showed that staff had received training about safeguarding.
During our inspection we found that there were enough staff and the use of Agency staff had reduced. Staff had time to chat with people and reassure them. New staff were recruited in a safe way that ensured they were suitable to work with people at risk of neglect or abuse.
Enough domestic staff were employed and on duty each day. The home was clean and fresh smelling. We found good records of repairs, regular tests, calibration and servicing of equipment and services at the home to ensure they were safe. People’s medication was managed safely.
Where people were identified as being at risk of harm, risk assessments were in place and action had been taken to mitigate the risks.
The home was compliant with the Mental Capacity Act 2005. Where people required the protection of a Deprivation of Liberty Safeguard, this had been applied for and records in the home showed who had a DoLS in place and who had had a DoLS applied for.
People told us they enjoyed their meals and arrangements were in place to support people who were at risk of malnutrition or dehydration.
Staff told us that they had access to a variety of training and were currently undertaking First Aid training. The training records we looked at during the inspection were incomplete, but following the inspection the manager sent us further information to show that the staff team were up to date with important training to ensure they knew how to work safely.
The care staff were based in the lounge areas to support people as and when required. We saw that throughout the day staff sat with people and talked to them. People's friends and relatives were free to visit at any time and some visitors told us they came every day.
People’s care files contained a series of assessments of the person’s care and support needs. Where an assessment indicated the person required care then a care plan was in place to guide staff. These had been reviewed on a monthly basis and were generally up to date.
The home employed an activities co-ordinator and there was a schedule of social activities on noticeboards throughout the home. During our inspection we saw people engaging in and enjoying group activities.
The home’s complaints procedure displayed in the home needed to be made clearer and more concise.
The manager held monthly relatives meetings and regular staff meetings.
The manager undertook various audits and checks to monitor and improve the standard of care provided at the home. These included monitoring of medication, care files, accidents, hygiene, and health and safety. There were reports of periodic night time visits to the home by the manager and the deputy manager and reports of mealtime observations.
Since our last inspection, CQC has received a number of complaints about the home made by former members of staff. The issues they raised have been fully investigated by an external company and none have been upheld. During our inspection we found no evidence to support the complaints.