CQC report explained · a nursing home
What the CQC found at Harley House Care Home Ltd
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and reviewed, medicines were managed safely, staffing levels were suitable, and infection control measures were in place.
- Effective?
- Good
- Staff training and supervision had improved. People's dietary, healthcare, communication and decision-making needs were supported.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found stronger audits, better oversight and more person-centred care planning. The provider was no longer in breach of Regulation 17.
What inspectors found, March 2021
Harley House Care Home was rated Good; inspectors found safer care and stronger management after earlier improvements.
This was an unannounced, focused inspection on 2 March 2021. Inspectors spoke with eight people, staff and management. They reviewed care records, medicines records, staff files, training information and management records.
The home was rated Good for Safe, Effective and Well-led. Inspectors found people were protected from avoidable harm, received medicines safely, and had enough trained staff. Food, healthcare, infection control and the environment were also found to support people's needs.
The previous rating was Requires Improvement, with a breach of Regulation 17 about good governance. Inspectors found that improvements had been made and the provider was no longer in breach. Caring and Responsive were not inspected during this visit, so their previous ratings were carried forward.
Risk management
Care plans and risk assessments gave staff clearer instructions about falls, choking and pressure ulcers. These were regularly reviewed.
“Risks assessments had been completed to identify and manage risks to people's health and safety, such as the risk of falling and developing pressure ulcers.” from the report
Medicines
People received their medicines as prescribed. Storage, ordering, disposal and staff competence were checked.
“Safe systems were in place for the ordering, storage and disposal of medicines.” from the report
Staff training
Training, supervision and competency checks had improved. Staff were observed using safe techniques when helping people move.
“Training and support provided to staff had significantly improved. Records showed training for staff was up to date” from the report
Infection control
Inspectors found enhanced cleaning, suitable PPE, testing and arrangements for visitors and people returning from hospital.
“Regular cleaning of surfaces and frequent touch points such as door handles and handrails helped to reduce the risk of infection.” from the report
Management oversight
The provider had strengthened its audits and acted promptly when problems were found. Care plans were more person-centred.
“Significant improvements had been made to the provider's quality assurance systems which was used effectively.” from the report
Minor environmental repair
minorInspectors identified a wobbly bannister. It was secured promptly during the inspection.
“A maintenance staff member was on site and promptly secured the wobbly bannister we identified.” from the report
Safeguarding information display
minorInformation about safeguarding and whistleblowing was not displayed at first because COVID-19 information had replaced it. The information was put back immediately.
“Information about safeguarding and whistle-blowing procedure was no longer displayed for people to refer to.” from the report
- 01How do you continue to review and update each person's risk assessments and care plans?
- 02How often are medicines audits and staff medicine-competency checks completed, and what happens if an error is found?
- 03How do you check that staffing levels remain suitable when people's needs or staff absences change?
- 04How are staff supervision, training and competency checks kept up to date?
- 05What was the previous Regulation 17 governance breach, and how do you show that the improvements have been maintained?
This was a focused inspection of Safe, Effective and Well-led, including infection prevention and control; Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 26 March 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, November 2019
Rated Requires Improvement; inspectors found kind, personalised care, but weaknesses in training, medicines checks and management oversight.
This was an unannounced inspection on 17 September 2019. Inspectors spoke with people living in the home, relatives, staff and health professionals. They reviewed care records, medicines records, staff files and management records.
People were generally treated kindly and with dignity. Their care was personalised, and their social, cultural and religious needs were supported. However, some staff did not always use safe moving and handling techniques, and some people and relatives raised concerns about staffing levels.
Inspectors found gaps in staff training and competency checks. Medicines were prescribed correctly, but some storage temperatures and patch checks were not properly monitored. Information was not always easy to read or access, especially for people with dementia, visual impairment or wheelchair use.
The overall rating was Requires Improvement. Safe, effective and well-led were rated Requires Improvement, while caring and responsive were rated Good. The rating had fallen from Outstanding at the previous inspection, published on 6 January 2017.
Kind and respectful care
People had good relationships with staff, who generally treated them with kindness, privacy and dignity.
“People received care from kind and caring staff and had developed good relationships with them.” from the report
Personalised care
Care plans recorded people's likes, dislikes, routines and preferences. People and relatives were involved in planning and reviewing care.
“People received personalised care.” from the report
Activities and relationships
People took part in activities, outings and coffee mornings. Relatives and friends were welcome, and the home supported religious and cultural needs.
“People were observed to be engaged in a range of activities.” from the report
Access to healthcare
People saw health professionals when needed, and staff responded to changes in their health.
“People continued to access health care services and were seen by the GP and the nurse practitioner as needed.” from the report
Weak management checks
seriousThe home's audits and checks did not identify several problems with care, medicines, staff competence and the environment. This was a breach of Regulation 17.
“The quality assurance systems were not robust or effective.” from the report
Training and competency gaps
seriousSome staff had not completed essential training, and competency checks for moving and handling and medicines were delayed. Inspectors observed unsafe moving and handling practices.
“Records showed staff training was not kept up to date.” from the report
Medicines monitoring
seriousMedicines in a trolley were not kept within a monitored temperature range. Records also lacked daily checks that some medicine patches were still in place.
“This increased the risk of the medicines to be ineffective because the temperature was not monitored.” from the report
Accessibility of information
needs fixingMenus, activities and allergy information were sometimes in small print or displayed too high for some people to read. Signage around the home also needed improvement.
“People could not always access information easily.” from the report
Staffing concerns
needs fixingSome people and relatives felt there were fewer staff at weekends or that staff were too busy to spend enough time with people.
“There appears to be reduced staff at weekends” from the report
- 01What action has been completed to bring staff training and moving and handling competency checks up to date?
- 02How are medicines in the trolley now kept at a safe, monitored temperature?
- 03How do you check that staff use the correct moving and handling techniques for each person?
- 04How do you review staffing levels at weekends and make sure staff have enough time with residents?
- 05What changes have been made to signage, menus and other information so people with visual or communication needs can use it?
This was an unannounced comprehensive inspection covering all five CQC questions and both the premises and care provided; the previous ratings had been Outstanding. This explanation was written from the published report of 7 November 2019 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 Harley House Care Home Ltd
3 rated inspections over 4 years: the service has slipped, from Outstanding to Good.
- March 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2019Requires improvementdown from OutstandingSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- January 2017OutstandingSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- September 2013
Report published without a new overall rating.
- September 2012
Registered with the Care Quality Commission on 10 September 2012.
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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