Archived: Harrod Court

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.