Archived: Harrison Park

Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This means tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection, 37 people were receiving personal care calls.

People’s experience of using this service and what we found

Since the last inspection, there had been improvements in medicines management, record keeping and quality monitoring. People had risk assessments and care plans which gave staff the information they needed to support people and keep them safe. Supplementary monitoring records such as food and fluid charts were well-maintained. People and their relatives were fully involved in developing and updating their planned care. People were safely supported with handling medicines; the number of medicine errors had significantly reduced.

The provider’s quality monitoring system had improved. Audits, surveys and meetings were completed, feedback was listened to and shortfalls addressed. People told us they were confident complaints would be listened to and resolved.

Staff knew how to safeguard people from the risk of abuse and poor practice and knew how to raise concerns. People told us they felt safe with staff and trusted them.

Staff were recruited safely. There were enough staff to complete the care calls. Staff had received appropriate training and support to enable them to carry out their role. People considered they received consistent care from a skilled staff group.

Care and support was tailored to each person's needs and preferences. People and their relatives were fully involved in developing and updating their planned care. We received positive feedback from people about the support provided to them. People had good relationships with staff and told us staff were kind and respectful.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People who used the service were supported to maintain a healthy diet when this was part of their care plan. The registered manager had developed positive links with health care professionals which promoted people’s wellbeing.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating and update for this service was requires improvement (published 25 October 2018). At the time, there were concerns with safe administration of medicines, records and ensuring a good quality assurance system.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Harrison Park provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. The CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

There are 65 individual flats in Harrison Park. Not everyone living there receives a regulated activity. The CQC only inspects the service being received by people provided with ‘personal care’, for example, help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of the inspection, 37 people were receiving the regulated activity of personal care from Hales Group Limited. Most were older people who had a range of needs, which included physical difficulties and those people who were living with dementia. Some people had communication needs and some had a learning disability.

The service had a registered manager in post. A registered manager is a person who has registered with the CQC 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 Act 2008 and associated regulations about how the service is run.

During this inspection, we identified shortfalls in relation to medicines management, gaps in recording and quality monitoring of the service. These issues were breaches of Regulation 12 (Safe handling of medicines) and Regulation 17 (Good governance) 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.

We found people had not always received their medicines as prescribed. There had been a number of errors with medicines management and staff received additional training and competency checks, however, the errors had persisted. This meant people remained at risk of harm as the provider could not be assured people were receiving their medicines in line with the prescribing instructions. The provider was monitoring medicines management closely and there had been a reduction in errors.

The quality monitoring system and audits had identified the medicines errors but how this was managed could be improved to ensure improvements were sustained. There were some gaps in records such as medication administration records and food and fluid monitoring charts.

Staff received training in how to safeguard people from the risk of harm and abuse; they knew what action to take if they had concerns. People had risk assessments in place to guide staff in how to minimise risk without restricting people’s choices. Some of the risk assessments were very detailed, whilst others could include more information and guidance for care staff. The registered manager told us they would address this.

Staff supported people to maintain their health and nutritional needs. They contacted health professionals and emergency services when required and let relatives know to keep them informed. Health professionals said contact with them could, on some occasions, be timelier. This was mentioned to the registered manager to discuss with staff. Some people had support from staff to prepare meals and complete food shopping.

People told us staff supported them well, respected their privacy and dignity and had a kind, caring approach. The provider had a policy and procedure for end of life care and the registered manager told us people who wished to remain in their own homes could do so with support from community health care services.

People were supported to make their own decisions as much as possible. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. However, there was one instance when a person had fluctuating capacity and documentation had not been completed or had not been obtained from the local authority to reflect a decision about the use of a restricting door. The registered manager addressed this.

There was a good staff recruitment process with full employment checks before staff started working with people who used the service. There were sufficient staff employed. The registered manager monitored call times to ensure staff stayed for the time required and attended at the right time, if this was critical to the needs of people.

There was a system in place to help develop staff skills. This included training, supervision and appraisal. Staff told us they received sufficient training.

Staff were provided with personal protective equipment such as gloves and aprons, which helped them prevent the spread of infection.

The provider had a complaints policy and procedure, which was given to people when they moved into Harrison Park and received a service from Hales staff. People told us they felt able to raise concerns.