CQC report explained · a nursing home
What the CQC found at Harewood Court Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Inspectors found people were protected from abuse and medicines were generally handled safely. They also found unmanaged behaviour risks, incomplete food and fluid records, concerns about staff presence and a lack of some medicine stock counts.
- Effective?
- Good
- People's needs and choices were assessed and reflected in care plans. Staff were trained, people could access healthcare and the home worked within the principles of the Mental Capacity Act.
- Caring?
- Good
- No separate rating was given in this report. Inspectors said people and relatives were generally happy with the care and that preferences and choices were reflected in care plans.
- Responsive?
- Good
- No separate rating was given in this report. Inspectors found that people could request alternative food and staff knew how to respond to concerns.
- Well-led?
- Good
- Inspectors found a positive culture, regular audits and satisfaction surveys. The manager acted on improvements identified and kept relatives informed.
What inspectors found, May 2023
Overall rated Good; inspectors found good care and leadership, but Safe Requires Improvement because of risks, staffing visibility and incomplete records.
This was an unannounced inspection on 5 April 2023. The inspection team spoke with eight people, five relatives and four staff. They reviewed care records, medicines records, staff files and management records.
The home protected people from abuse, supported access to healthcare and had a clear system for learning from incidents. Staff training, consent arrangements and care planning were also viewed positively. People and relatives generally said they were happy with the care.
However, the inspection found safety shortfalls. Risks linked to people's behaviour had not been assessed, some people at risk of weight loss did not have food and fluid records, and there were times when no staff were visible in communal areas. The overall rating was Good, but Safe was Requires Improvement.
Staff training
Staff completed a broad range of training, including dementia care, person-centred care and mental capacity.
“Staff completed a wide range of training including but not limited to dementia care, person centred care and mental capacity.” from the report
Healthcare support
People were supported to access healthcare services, and staff knew how to seek help when people's health changed.
“People were supported to access healthcare services as needed.” from the report
Leadership and improvement
The home had a positive culture, carried out regular audits and used surveys to identify actions for improvement.
“There was a positive culture within the service which showed the provider's values had been embedded” from the report
Staff visibility and staffing levels
seriousThere were times when no staff were present in communal areas, and relatives and staff said more staff were needed. The inspector had to intervene when a person became distressed.
“It would be better to have more staff as it can get hard when there's only a few of us on, especially when people become challenging.” from the report
Behaviour-related risks
seriousRisks linked to people's behaviour had not been assessed or managed. The provider put risk assessments in place immediately after this was identified.
“Risks around behaviours had not been assessed and managed.” from the report
Food and fluid monitoring
needs fixingPeople assessed as being at risk of weight loss did not have records showing their food and fluid intake while they waited for outside professional input.
“There was a lack of records in place to record fluid and food intake of people assessed at risk of weight loss.” from the report
Medicine stock records
needs fixingMedicines were handled, stored and given safely, but stock counts were missing for some medicines outside bio-dose trays.
“There was a lack of stock counts for medicines not included in bio-dose trays.” from the report
- 01What has changed to make sure staff are present in communal areas, especially when people are distressed or need extra support?
- 02How are behaviour-related risks assessed, recorded and reviewed now?
- 03How do you record food and fluid intake for people at risk of weight loss?
- 04How are stock counts completed for medicines that are not in bio-dose trays?
- 05What is the current plan to ensure a nurse is on site at all times?
This inspection focused on Safe, including infection prevention and control; the report says ratings for key questions not inspected were carried over from the previous inspection. This explanation was written from the published report of 26 May 2023 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, August 2021
Harewood Court Nursing Home was inspected but not rated; infection controls were largely assured, but mask use and cleaning records needed immediate action.
Inspectors visited on 29 June 2021. This was an announced, targeted inspection during the coronavirus pandemic. They looked at infection prevention and control measures.
The home was clean and tidy, and inspectors were assured about testing, visitors, admissions, social distancing, infection outbreak arrangements and the infection control policy. Staff had infection control training and PPE was available.
Inspectors found that some staff were not wearing masks correctly and that cleaning records were not always completed. The registered manager said the masks did not fit properly, removed the defective batch and provided evidence of further checks. Amended cleaning schedules were also provided after the inspection.
The service was inspected but not rated. This report does not give an overall quality rating or ratings for the other four CQC questions.
Infection control arrangements
Inspectors were assured that the home had good infection prevention and control arrangements, including policies and plans for emergencies.
“We were assured that this service met good infection prevention and control guidelines.” from the report
Testing and admissions
The home had arrangements for COVID-19 testing and was following guidance for people admitted during the pandemic.
“The provider had appropriate arrangements to test people and staff for COVID- 19 and was following government guidance on testing.” from the report
Action after inspection
The manager removed masks that did not fit properly and introduced amended cleaning schedules so staff could record cleaning during the day.
“The registered manager removed all defective masks and provided evidence of observing staff wearing masks correctly.” from the report
Masks were not worn correctly
needs fixingSome staff were not wearing masks in line with government guidance during the visit. The report says this was linked to masks fitting loosely and that action was taken afterwards.
“We observed some staff not wearing their masks correctly in line with current government guidance.” from the report
Incomplete cleaning records
needs fixingThe home was clean, but records did not always show that cleaning had been completed. New daily schedules were provided after the inspection.
“The home was clean and tidy; however, cleaning records had not always been completed.” from the report
- 01How do you now check that every staff member has a correctly fitting mask?
- 02How do you check and review the new daily cleaning schedules?
- 03What protocols are currently in place for visitors to reduce infection risks?
- 04How are people and staff tested for COVID-19?
- 05What arrangements are in place if an infection outbreak or another emergency occurs?
This was a targeted inspection of infection prevention and control measures only, so the service was inspected but not rated and the other four questions were not assessed. This explanation was written from the published report of 7 August 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.
Every inspection of Harewood Court Nursing Home
8 rated inspections over 8 years: the service has improved, from Inadequate to Good.
- May 2023Goodcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2021Inspected but not ratedSafe: Inspected but not rated
- January 2020Goodup from Requires improvementSafe: Requires improvementEffective: GoodWell-led: Good
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2017Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2017Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2015Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2014InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 24 February 2011.
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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