Harper Fields

Updated 12 November 2020

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.

As part of CQC’s response to the coronavirus pandemic we are conducting a review of infection control and prevention measures in care homes.

This inspection took place on 26 October 2020 and was announced.

Updated 12 November 2020

We inspected this service on 21 March 2018. The inspection was unannounced.

Harper Fields is a purpose built home which provides accommodation with personal and nursing care for up to 80 people. There are four separate units within the home. Two are ‘memory lane’ units for people living with dementia. Another unit is for people with nursing care needs and the fourth is a residential unit. There were 75 people living in the home at the time of our visit.

At our last inspection in May 2017 we rated the service as good overall. However, we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 because risks around skin care and wound management had been not been addressed in line with people’s care plans. The key question of ‘Is the service safe?’ was therefore rated as requires improvement. The provider sent us an action plan, setting out the actions they planned to take to improve the quality of the service. At this inspection, we checked whether the actions they had taken were effective.

Since our previous inspection in May 2017 we have reviewed and refined our assessment framework, which was published in October 2017. Under the new framework certain key areas have moved, such as support for people when behaviour challenges, which has moved from effective to safe. Therefore, for this inspection, we have inspected all key questions under the new framework, and also reviewed the previous key questions to make sure all areas were inspected to validate the ratings.

There was a registered manager 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.

At this inspection staff told us learning had been taken and shared following the issues previously identified around wound management. The registered manager had implemented procedures and processes to ensure people’s skin was regularly assessed and wounds were monitored regularly. Some improvements were still required to documentation, but the registered manager took immediate action to ensure staff had all the information required to check wound treatment plans were effective.

Staff were responsive to changes in people’s health needs and sought professional advice and support so people’s health was maintained. Overall, people received their medicines safely and as prescribed. However, the provider needed to ensure safe medicines management was consistently followed throughout the home.

People were safe from the risks of harm, because staff understood their responsibilities to protect people, and were encouraged and supported to raise concerns under the provider’s safeguarding policies. The registered manager checked staff’s suitability to deliver care and support during the recruitment process.

There were enough staff on duty to support people safely. Staff had the necessary skills and experience and received appropriate training and support from the registered manager to provide effective and responsive care.

People's needs were assessed before they moved to Harper Fields so the registered manager could be confident those needs could be met. Risks to people’s personal safety had been identified and plans were in place to minimise these risks. Accidents and incidents were investigated and actions taken to minimise the risks of a re-occurrence. The premises and equipment were regularly checked to ensure risks to people’s safety were minimised.

Staff had received training in the Mental Capacity Act 2005 and understood about working in accordance with people’s best interests and in the least restrictive way. Staff offered people choices and sought their consent before they supported them.

People were supported to eat and drink enough to maintain their health and there was a strong emphasis on people eating well.

People were extremely comfortable in the presence of staff who gave people understanding, affection and physical reassurance when they needed it. Staff took time to get to know people and demonstrated this through their attitude and behaviours towards people. Staff respected people’s individuality and understood how past experiences could affect people’s responses now.

People were able to take part in a wide range of leisure activities and other pursuits which reflected their choice and interests and promoted their physical, emotional and mental health. Activities were also arranged so people could spend time together and develop friendship groups based on shared interests.

Staff enjoyed working in the home and felt well supported by managers and each other. Staff had confidence in the registered manager who listened to their views and opinions and understood the challenges they faced.

People and their relatives felt able to make suggestions to improve the home, and told us they would raise concerns if necessary.

The registered manager and provider carried out a range of quality audits to ensure people received safe, effective and responsive care that met their individual needs.