CQC report explained · a nursing home
What the CQC found at Harts House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Medicines were given as prescribed and at the right time. Inspectors also found suitable risk assessments, enough staff, safe recruitment checks and infection-control arrangements.
- Effective?
- Good
- People's needs were assessed, staff received training and supervision, and people had access to healthcare. Food was an area where people had mixed views and wanted improvements.
- Caring?
- Good
- Staff were kind and courteous, responded quickly and respected people's privacy, dignity, choices and independence.
- Responsive?
- Good
- Care plans were personalised and updated when people's needs changed. People could choose activities and knew how to complain.
- Well-led?
- Good
- People, relatives and staff said the management was approachable and supportive. Audits, meetings, surveys and complaint monitoring were used to check and improve the service.
What inspectors found, September 2018
Rated Good; inspectors found safe, kind and personalised care, with earlier medicines problems corrected.
This was an unannounced inspection on 8 August 2018. Inspectors reviewed care records, medicines records, staff records, rotas, training and quality checks. They spoke with people living at the home, relatives and staff.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practice, suitable care plans and staff who understood people's needs and preferences.
At the previous inspection in July 2017, medicines management was rated Requires Improvement. The home was asked to improve this. At this inspection, inspectors found the action had been completed and medicines were being given safely and at the right time.
People and relatives were generally positive about the care and management. Inspectors noted some mixed views about the standard of cooking, and one person said more staff would be helpful, although inspectors found staffing levels were enough to meet people's needs.
Medicines improved
The medicines problems identified at the previous inspection had been addressed. Inspectors found medicines were administered safely and at the correct times.
“During this visit, we looked at the administration of medicines and found they were managed safely and people received the medicines prescribed to them at the right time.” from the report
Kind and respectful care
Staff treated people kindly, protected their privacy and encouraged them to remain as independent as possible.
“Throughout our visit we saw staff interacting with the people who used the service in a kind and courteous way.” from the report
Personalised support
Care plans included people's health needs, preferences and choices. Staff could explain what people liked and the support they needed.
“Care plans were sufficiently detailed for staff to have a comprehensive picture of the person as an individual and what their needs were.” from the report
Activities and choice
People could choose how to spend their time and had access to varied activities, including entertainment, exercises, art therapy and games.
“We saw a monthly plan for ongoing weekly activities including a mix of professional visitors providing services such as exercises, art therapy and entertainment” from the report
Open management
The manager was seen as approachable. Regular meetings, audits and surveys helped the home monitor its service.
“There was an effective system in place to regularly assess and monitor the quality of the service.” from the report
Staffing feedback
minorAlthough inspectors found enough staff to meet people's needs, one person said more staff would be helpful. The home had recruited more staff who were still completing their inductions.
“The registered manager told us that they had recruited more staff and were in the process of completing their inductions before they could start work.” from the report
- 01What changes have been made to the standard of cooking since the inspection?
- 02How do you make sure medicines are given at the prescribed time, especially medicines that must be taken before food?
- 03How many staff are on duty for each shift, and have the newly recruited staff completed their inductions?
- 04How would you tailor activities and daily routines to my relative's preferences and abilities?
- 05How are my relative's future wishes and end-of-life preferences recorded and reviewed?
This was an unannounced inspection of all five CQC questions, including care, medicines, staffing, records and management systems; the previous overall rating was Good, with Safe previously Requires Improvement. This explanation was written from the published report of 7 September 2018 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, July 2017
Harts House was rated Good overall, but inspectors found medicines were not always given safely and rated Safe as Requires Improvement.
This was an unannounced, comprehensive inspection on 5 July 2017. Inspectors spoke with people living in the home, relatives and staff. They also checked care plans, medicines records, staff files, training records and management checks.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were all rated Good. Inspectors found enough staff, suitable recruitment checks, kind care, personalised support, activities and systems for handling complaints and checking quality.
Safe was rated Requires Improvement because two people were given medicines with breakfast even though they had been prescribed 30 minutes before food. Inspectors said staff were not always following the instructions on medicine records. This was a breach of Regulation 12.
At the previous inspection in September 2015, the provider was meeting the regulations inspected. The report says the provider had to send CQC an action plan and that CQC would check the action was taken.
Enough staff
Inspectors found enough staff to meet people's assessed needs. Staffing levels were reviewed as people's needs changed, and agency staff used regularly knew the people living in the home.
“There were sufficient numbers of staff to meet people's assessed needs.” from the report
Kind and respectful care
Staff knew people well and supported their choices and independence. Inspectors saw care being given patiently and respectfully.
“We observed care staff attending to people's needs in a way that was caring and patient.” from the report
Personalised support and activities
Care plans included people's preferences and were updated when needs changed. The home offered regular activities and responded to requests for more events and outings.
“Care plans were personalised and were titled My Day, My Life, My Details” from the report
Open management and quality checks
People, relatives and staff could raise issues. The management team used audits, meetings and feedback boards to identify and act on improvements.
“The provider had a system in place to check the quality and safety of the service people received.” from the report
Medicines were not always given as prescribed
seriousTwo people were given medicines with breakfast even though they had been prescribed 30 minutes before food. Inspectors said staff were not always reading or following the instructions on medicine records.
“This could have a negative impact on people's health.” from the report
Fire doors were propped open
needs fixingInspectors found two fire doors held open with wedges. This was raised with the interim manager, who was reminded that staff must follow fire regulations.
“During our visit, we noted two fire doors were propped open by wedges.” from the report
Some clinical training needed improvement
needs fixingThe deputy manager said training in some clinical areas needed improvement. The provider said further courses were being put in place for nurses.
“However, the deputy manager felt that the training in some clinical areas such as venepuncture and male catheterisation could be improved upon.” from the report
- 01What action was taken after the finding that two people's medicines were given with breakfast instead of 30 minutes before food?
- 02How do you now check that staff read and follow medicine administration instructions?
- 03What was done about the two fire doors that were found propped open?
- 04What extra clinical training was arranged for nurses in areas such as venepuncture and male catheterisation?
- 05How have the recent management changes affected day-to-day care and who would be the main manager to contact?
This was an unannounced comprehensive inspection covering all five questions and the overall service rating. This explanation was written from the published report of 26 July 2017 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 Harts House
4 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- September 2018Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- April 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 21 March 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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