Archived: Harbour House

Updated 25 July 2017

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.

We undertook an announced inspection of this service on 8 June 2017. The provider was given 48 hours notice of the inspection. This was to ensure people would be there for the inspection process if they wanted to be and to ensure staff would be present. The inspection was undertaken by one inspector, this was because the service was small and it was considered that additional inspection staff would be intrusive to people’s daily routine.

We spent some time talking with people in the service and staff; we looked at records as well as operational processes. We reviewed a range of records. This included two care plans and associated risk information and environmental risk information. We looked at recruitment information for three staff; their training and supervision records in addition to the training records for the whole staff team. We viewed records of accidents/incidents, complaints information and records of some equipment, servicing information and maintenance records. We also viewed policies and procedures, medicine records and quality monitoring audits undertaken by the provider. We spoke with each person, two staff and the provider who manages the day to day running of the service.

Before the inspection we reviewed the information we held about the service. We considered information which had been shared with us by the local authority and healthcare professionals. We reviewed notifications of incidents and safeguarding documentation that the provider had sent us since our last inspection. A notification is information about important events which the home is required to tell us about by law. The provider had completed a Provider Information Return (PIR) before the inspection which we used to help us inform our Key Lines of Enquiry (KLOE) for inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make.

Updated 25 July 2017

This inspection took place on 8 June 2017 and was announced. Harbour House provides accommodation and personal care for up to four people who have learning disabilities, some health conditions and some complex and challenging behavioural needs. The service is not accessible to people in wheelchairs.

At the previous inspection on 5 and 6 May 2016 we found four breaches of our regulations, an overall rating of requires improvement was given at that inspection. The breaches of regulation related to some practices for the storage and administration of medicines; some aspects of recruitment were incomplete because decisions about the employment of some staff were not recorded; some quality assurance checks were not fully effective and where the service had a legal obligation to notify the Commission of certain decisions and events, notification was not always made. We issued requirement actions for these breaches and the provider wrote to us telling us how and when the required improvements would be made. At this inspection we found the provider had met the previous requirement actions and addressed all of the breaches of regulation.

The service did not require a registered manager as the provider manages this service and another owned by her locally. A registered manager is a person who has registered with the Care Quality Commission (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 Care Act 2008 and associated Regulations about how the service is run. The provider was present throughout the inspection.

Three people lived at the service; we met and spoke with each of them. People told us that they liked living at the service, they were happy, they thought the staff were good at their jobs, were kind and cared about the people they supported.

There were safe processes for the storage and management of medicines. Recruitment processes were in place to protect people and ensure staff employed were suitable for their roles. Staff felt supported and listened to and received appropriate supervision. Staff had appropriate training and experience to support people well.

Quality assurance and management oversight of the service was effective, all statutory notifications required by the Commission were made when needed.

Staffing was sufficient and flexible to meet people’s needs. Staff knew how to keep people safe from harm, they were trained to recognise and report abuse, risks were appropriately assessed.

Staff were aware of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and applied these principles correctly.

People had personalised records detailing their care and support, including well developed support plans for their emotional and behavioural needs.

People were supported to access routine and specialist health care appointments. People told us staff showed concern when they were unwell and took appropriate action.

People enjoyed their meals, they were involved in deciding what they wanted to eat and went shopping to buy groceries. Some people helped to prepare meals.

Staff were caring and responsive to people’s needs and interactions between staff and people were warm, friendly, respectful and often made with shared humour.

Staff spent time engaging people in communication and activities suitable to their needs.

People felt comfortable about complaining, but did not have any concerns. People, relatives and visiting professionals had opportunities to provide feedback about the service provided both informally and formally. Feedback received had been reviewed and acted upon.

The provider had a set of values forming their philosophy of care. This included treating everyone as an individual, working together as an inclusive team and respecting each other. Staff were aware of these and they were followed through into practice.