Archived: Harmony House

Harmony House is a residential care home providing personal and nursing care for up to 57 people over the age of 50. At the time of our inspection visit there were 51 people at the home.

Harmony House accommodates people in one building, split over two floors. Each floor has separate dining areas and bathroom facilities. People have en-suite facilities in their bedrooms.

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

Significant progress in improving governance procedures had been made by the management team since our last inspection to ensure people were safeguarded and received person-centred care. However, improvements were still required to ensure people consistently received safe care. Although staff understood the support people required to reduce their risk of avoidable harm, gaps in care plans and records meant there was a potential risk people may not be provided with consistent and safe care.

There were enough staff to meet people’s needs safely. Staff received regular training and support and understood their role in protecting people from the risk of abuse. The registered manager followed the provider’s safeguarding policies and procedures and reported any safeguarding concerns to the local authority. Medicines were managed in accordance with good practice guidelines.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People had choice and control over who visited them and there were no visiting restrictions in the home.

People were offered opportunities to engage in a variety of activities and staff understood the importance of social interaction with people. Staff received specialist training on end of life care to ensure people were supported to live as they wished to in their final days.

People and relatives gave us positive feedback about their experiences of living at Harmony House. Staff spoke very positively about the management team and felt engaged in the improvement process. The registered manager was committed to continue to embed improvements into practice.

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 for this service was requires improvement (published 6 April 2022) and there were breaches of regulation. 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 those regulations, however a breach of a different regulation was identified.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 14 and 20 January 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safeguarding, person-centred care and the good governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Responsive and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Harmony House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and risk management at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Harmony House is a residential care home providing personal and nursing care for up to 57 people over the age of 50. At the time of our inspection visit there were 43 people at the home.

Harmony House accommodates people in one building, split over two floors. Each floor had separate dining areas and bathroom facilities. People had en-suite facilities in their bedrooms. At the time of our inspection visit there was an outbreak of COVID-19. Those people who had tested positive for COVID-19 were co-horted (grouped together) on the ground floor of the home.

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

Procedures to ensure risks to people’s health were managed effectively required improvement. On the first day of our inspection the provider did not have a system in place to check the COVID-19 vaccination status of health professionals and contractors visiting the home, as required by law since 11 November 2021. However, by the second day of our inspection they had put a system in place in response to our feedback.

Staff understood their responsibility to protect people from abuse and avoidable harm. However, we found the provider had not always notified us of relevant information regarding a recent safeguarding concern. This is currently being re-investigated.

People, staff and relatives told us there were enough staff to meet the needs of people using the service. Medicines were managed safely. The home was clean and was adapted to meet people’s needs.

People received food and nutrition that met their needs, and were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Overall, people were referred to external health professionals when concerns were identified about their health or wellbeing

Staff were caring. People’s privacy and dignity was respected.

People told us their care could be more personalised, as they were not always supported to bathe as often as they wished. Improvements were required to ensure people continued to have visitors in accordance with government guidance.

The provider's systems and processes were not used effectively to review and maintain oversight of the quality of care being provided. There was no registered manager at the service. Leadership and support to the management team was required to ensure the home was managed effectively.

Staff and the management team were committed to the people living at the home and feedback from our inspection was welcomed. The provider told us action would be taken to address all the areas which required improvement.

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

Why we inspected

This was a responsive inspection. The provider had reported an outbreak of COVID-19 at the home which involved more than twenty per cent of the people who lived there. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We reviewed the information we held about the service. During the first day of our inspection visit we identified concerns in the other key questions. We therefore opened our inspection to look at all five key areas.

Rating at last inspection

This service was registered with us in April 2021 and this is the first inspection of the service under this provider. The overall rating for the service is requires improvement.

We have found evidence that the provider needs to make improvements.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to regulation 9, person-centred care, regulation 13, safeguarding and regulation 17, good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will work with the local authority to monitor progress. We will also request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.