Archived: Harrod Court

Updated 29 November 2017

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 7th and 8th September 2017and was announced. The provider was given notice because the location provides an extra care service and we needed to be sure that people who used the service, relatives, care workers and the registered manager knew we would be coming and would available to meet us.

On the first day of our inspection the inspection team consisted of two CQC adult social care inspectors, one CQC pharmacy inspector and two experts 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 of the inspection the inspection team consisted of one CQC adult social care inspector.

On the first day of our inspection we visited all four sites of MHT Brent Extra Care Services and on the second we revisited two sites.

Before the inspection, the provider completed a Provider Information Return (PIR). 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. We reviewed notifications that we had received from the service. We reviewed all of this information to help us make a judgement about this service.

We spoke with the registered manager, the regional manager for older people, two care managers, two team leaders, two well-being co-ordinators and nine care workers. We also spoke with 41 people who used the services across all four sites and three relatives.

We looked at 15 care plans and care records. We sampled 12 medicines administration records including storage of controlled drugs, the recruitment, supervision and training records for seven staff and records in relation to quality assurance and management of the service. We also were in regular contact with placing authority and received regular updates in regards to the care provided by MHT Brent Extra Care Services.

Updated 29 November 2017

This was the first inspection of Metropolitan Housing Trust (MHT) Brent Extra Care Service since being registered in November 2016 with the Care Quality Commission (CQC).

Our inspection was announced and we visited MHT Brent Extra Care Services on 7th and 8th September 2017.

MHT Brent Extra Care provided personal care to 125 people who used the service living at four different sites in the London Borough of Brent. Extra Care Housing is housing designed with the needs of frailer older people in mind and with varying levels of care and support available on site. People who live in Extra Care Housing have their own self-contained homes, their own front doors and a legal right to occupy the property. Their registered location was Harrod Court. Harrod Court was providing personal care support for 40 older people. Beechwood Court provided personal care to 20 older people living with dementia. Rosemary House provided personal care to 40 older people and Tulsi House provided personal care to 36 older people. All people lived in either one bedroom or two bedroom self-contained flats.

MHT Brent Extra Care Services had a manager registered with the CQC. 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. The registered manager was based at the registered location Harrod Court; each site however, had their own care manager and team leader who were responsible for the day to day management.

People received short care visits at key times of the day to help them get up in the morning, go to bed at night and to give support with meal preparation and medicines.

People and relatives told us they felt the service was safe. Staff had received safeguarding training, understood how to identify abuse and explained the action they would take if they had any concerns about people's safety. People’s finances, however were not always managed appropriately and records of expenditure did not reflect monies kept by the service.

Risks to people’s health and wellbeing were not always managed effectively, risk management plans lacked detail and did not always provide sufficient guidance to staff to ensure safe care and treatment was provided.

Systems were in place to ensure the management and administration of medicines. However, medicines were not always managed safely. Incidents and accidents had been investigated and learning was shared with staff during supervisions and meetings.

Robust recruitment processes ensured that only suitable staff were employed. There were sufficient staff deployed to meet people's needs during the day.

People were supported by staff, most of whom had received appropriate training and additional professional development as well as supervision and a yearly appraisal of their skills to enable them to meet people's individual care needs.

The registered manager and staff understood and followed the principles of the Mental Capacity Act 2005 and ensured decisions were made in people’s best interests.

People were supported to maintain their health and well-being and had access to healthcare services when they needed them.

People were supported effectively around their nutrition. Some people needed support in buying their food and where they required assistance with eating their meals this was provided.

Staff treated people with dignity and respect and ensured their privacy and independence was promoted.

Staff interactions with people were kind and caring.

Friends and family were able to visit their loved ones at any time and felt welcomed by staff.

The service employed a well-being co-ordinator who organised and provided opportunities for people to engage in social and physical activities.

People had detailed care plans which were regularly reviewed and updated when people's needs changed.

There was a complaints process in place and guidance about how to use this was on display at all the four sites. Relatives and people who used the service told us that they would raise any concerns with the registered manager.

Quality assurance audits and records were not always effective. We noted that risk management processes and the safe management of medicines had not always been followed and there was a risk that people’s needs were not met.

People and relatives were encouraged to provide feedback on the service provided through satisfaction surveys and informally during visits to MHT Brent Extra Care Services

Staff meetings took place and staff felt well supported by the registered manager who was open and approachable. Staff were confident to raise any issues or concerns with them and were listened to and respected.

We have found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.