Background to this inspection
Updated
13 September 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 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.
This inspection took place on 06 and 07 August 2018 and was unannounced. The inspection team consisted of one inspector, a Specialist Advisor 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. The Specialist Advisor was a qualified mental health nurse with experience working with people living with dementia, mental health conditions and behaviour that can challenge others.
As part of the inspection we reviewed the information we held about the service. We looked to see if statutory notifications had been sent by the provider. A statutory notification contains information about important events which the provider is required to send to us by law. They can advise us of areas of good practice and outline improvements needed within their service. We sought information and views from the local authority. We also reviewed information that had been sent to us by the public. We used this information to help us plan our inspection.
During the inspection we spoke with nine people who used the service and nine relatives. We spoke with the registered manager, district manager, head of care, a regional support manager, a dementia and care advisor, a deputy manager, the maintenance person, the cook, domestic staff and eight care staff. We also spoke with a healthcare professional who gave positive feedback about the care provided to people.
To help us understand the experiences of people we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people living at the service. We also carried out observations across the service regarding the quality of care people received. We reviewed records relating to people’s medicines, nine people’s care records and records relating to the management of the service; including recruitment records, complaints and quality assurance records.
Updated
13 September 2018
This inspection took place on 07 and 08 August 2018 and was unannounced. At our last comprehensive inspection completed in March 2017, we rated the service as ‘requires improvement’ and identified three breaches of regulation regarding safe care and treatment, staffing levels and the overall management and quality control within the service. We returned in August 2017 and found improvements had been made and the legal requirements were being met. The service remained rated as ‘requires improvement’.
Harden Hall is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 54 older people in one purpose built building. At the time of our inspection there were 52 people living at the service. Many of the people living at Harden Hall are living with dementia.
A registered manager was in post. 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 provider and registered manager were making improvements to the layout and utilisation of the building in order to meet people’s needs effectively. Positive changes were being made including the introduction of a pub area and redecoration within the service. At the time of the inspection some people had insufficient access to outdoor space which impacted on their wellbeing.
Staff knowledge around the Mental Capacity Act 2005 had improved, however, there were inconsistencies in the effective use of this Act. Appropriate consent and best interest decisions were not always consistently made.
People were supported by a staff team who understood how to minimise the risk of abuse and injury from accidents. Lessons were learned from any accidents or incidents that arose. This was used to drive improvements and minimise future risk. People received their medicines safely and as prescribed and were protected appropriately from the risk of infection. People were supported by sufficient numbers of staff who had been recruited safely.
People enjoyed the food and drink they received. People were supported to maintain their day to day health. A healthcare professional gave positive feedback about the support provided by staff. Improvements had been made to the quality of care people received.
People were supported by a staff team who were kind and caring towards them. People felt valued and important. People were supported to make choices about the care they received. People’s independence was promoted. People were supported to received visits from their friends and family.
People were involved in the development of their care plans and were consulted about the care they received. Where appropriate, people’s relatives or representatives were involved.
People enjoyed access to a range of leisure opportunities and further improvements were underway. People were consulted about how they wished to spend their time and staff respected the differences between individual people.
People felt able to raise complaints and concerns. Where complaints had been raised an appropriate investigation had taken place and response sent.
People were cared for by staff who were supported, motivated and worked well as a team. People were involved in the development of the service and had a voice which was heard and acted upon.
The provider and registered manager had made improvements to quality assurance systems in the service. Where further improvement was required this had been identified and work on remedial action was underway. The provider was committed to providing a quality service to people and appropriate support systems were in place to drive improvements within the service. The registered manager was engaging with external partners and organisations in order to improve the service and quality of life of people living at the service.