CQC report explained · a nursing home
What the CQC found at Harborne Lane Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, October 2021
Harborne Lane Nursing Home is rated Good overall, but inspectors found management and communication still required improvement.
Inspectors carried out an unannounced, focused inspection on 1 September 2021. They looked at whether the home was safe and well-led. They spoke with people, relatives, staff and a visiting professional, and reviewed care, medicine, recruitment and management records.
The home was rated Good for safety. Inspectors found people were protected from abuse, risks were reviewed monthly, medicines were managed safely and there were enough staff on duty during the inspection. The home was clean, although some staff were not always wearing face masks correctly.
The home was rated Requires Improvement for being well-led. Management systems had improved, but inspectors found gaps in some recruitment records, inconsistent involvement of relatives in monthly reviews and communication issues about the new management team.
The overall rating improved from Requires Improvement at the previous inspection to Good. However, the other three key question ratings were not inspected at this visit and were carried forward from earlier inspections.
Safe medicines
Medicine protocols were in place, regularly reviewed and tailored to people. Audits of medicine records found no errors.
“All protocols were in place, regularly reviewed, person centred with clear instructions for staff to follow.” from the report
Clean environment
Inspectors found the home clean, tidy and without clutter or unpleasant smells. Infection prevention arrangements were generally satisfactory.
“The home environment was very clean, no clutter and free from unpleasant odours.” from the report
Kind care
Inspectors saw staff offering support patiently and kindly. People's preferences and needs were recorded in detailed care plans.
“We observed staff offering support in a kind and patient manner.” from the report
Improved oversight
Quality checks and staff supervision had improved since the previous inspection. Managers carried out regular audits and recorded actions where issues were found.
“The service had improved their auditing and quality monitoring processes.” from the report
Management communication
needs fixingRelatives said communication from the new management team was not consistent. One relative said they had not been introduced to the new manager and had not received newsletters since the change.
“The one issue I have is communication. We had no information about the new manager, no introduction and no newsletters since the new manager started.” from the report
Involvement in reviews
needs fixingPeople and relatives said they had not always been included in monthly reviews. The manager said relatives would be notified and invited to future reviews, with the person's consent.
“People and relatives we spoke with told us they had not been consistently included in their monthly reviews.” from the report
Recruitment records
needs fixingTwo recruitment records did not show that gaps in employment had been discussed during interviews. Inspectors could not confirm that this information had been checked.
“We found on two recruitment records gaps in employment had not been recorded in their interview notes and therefore could not confirm if the gaps had been discussed.” from the report
Face mask use
needs fixingSome staff were not always wearing face masks over both their mouth and nose. The manager said staff supervision, training and spot checks would be increased.
“On occasion we found some staff were not always wearing their face masks covering their mouth and nose.” from the report
- 01How do you now introduce new managers and keep relatives updated?
- 02How will you make sure relatives are invited to monthly reviews when the person agrees?
- 03What checks now confirm that staff wear face masks correctly?
- 04How do you check and record gaps in employment during recruitment?
- 05What evidence will you use to show that the well-led rating has improved?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 21 October 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2020
Harborne Lane Specialist Centre was rated Requires Improvement; care was kind and responsive, but medicines records and management checks still needed strengthening.
Inspectors visited on 14 and 15 January 2020. They spoke with people, relatives, visitors and staff, observed care, and checked care plans, medicines, recruitment, training and management records.
The home had improved since the previous inspection. People were treated kindly and with respect. Their care plans were more personalised, staff training had improved, and people generally received appropriate food, drinks and healthcare.
However, the home was not always safe or well-led. Some medicines instructions and records were incomplete or inconsistent. Checks on staff competence were not always recorded, and communication with staff could be better.
The overall rating remains Requires Improvement. This was the fourth consecutive inspection with that overall rating. The provider was no longer in breach of regulations at this inspection.
Kind and respectful care
People were treated with dignity and staff made more effort to engage with them than at the previous inspection.
“The staff seem to know what they are doing, they speak to people, make an effort and are interacting now, before they would just walk past the person, we have seen real improvements.” from the report
Personalised care
Care plans included people's preferences and involved people and relatives in planning and reviews.
“Care plans we looked at were person centred and we could see people and their relatives had been involved with the planning of care and support.” from the report
Improved staff training
Staff spoke positively about the new training arrangements and said the training was more detailed and useful.
“It's (training) a lot more detailed and interesting; you actually go away knowing something you didn't know before.” from the report
Access to healthcare
People were supported to use healthcare services and staff shared changes in their health with relatives and professionals.
“People had access to healthcare services when required to promote their health and well-being and records we looked at confirmed this.” from the report
Medicines records
seriousSome instructions for medicines given when needed or through a stomach tube were not detailed enough. Skin patch records also showed inconsistent rotation on two of four records.
“However, we found on two of the four records, patches were not being consistently rotated around the body in accordance with the manufacturer guidance.” from the report
Inconsistent weight records
needs fixingPeople's weights were not always recorded consistently. New scales and further staff training were being introduced to address this.
“Although there had been some improvements to the inconsistent recording of people's weights, this had continued to occur but not to the extreme levels seen before.” from the report
Competence checks
needs fixingThe home carried out checks on staff competence, but these were not always recorded consistently and some staff did not know whether checks were formal appraisals.
“There were checks on staff competency but not consistently recorded or staff were aware they were being appraised.” from the report
Staff communication
minorStaff said communication from management could be better. Team meetings were not always well attended and were not mandatory.
“Staff spoken with told us the communication from the management team could be improved.” from the report
- 01How are you now recording and checking medicines given when needed or through a stomach tube?
- 02How do you make sure medicinal skin patches are rotated correctly every time?
- 03How are people's weights recorded consistently, and how are unusual changes followed up?
- 04How do you record staff competence checks and make sure all staff know when they have been assessed?
- 05How will staff receive important updates if team meetings are not always well attended?
This inspection covered all five CQC questions and looked at both the premises and the care provided. This explanation was written from the published report of 6 February 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Harborne Lane Nursing Home
5 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- October 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- August 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- August 2018Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- July 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2017
Registered with the Care Quality Commission on 25 September 2017.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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