Harbour House

Updated 4 January 2019

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.

The inspection took place on 3 and 8 November 2018 and was unannounced. The inspection was carried out by one inspector and an expert by experience on the first day and by an inspector on the second day. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. They had experience in dementia care and care home services.

Before the inspection we reviewed all the information we held about the service. This included notifications the home had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive. We contacted the local authority to obtain their views about the service.

We used the information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with 13 people who used the service and two relatives. We also spoke with eight members of staff, the registered manager and the head of care. We gathered feedback from four professionals who had knowledge about the service.

We looked at a range of records during the inspection, these included five care records. We also looked at information relating to the management of the service including quality assurance audits, health and safety records, policies, risk assessments and meeting minutes. We looked at three staff files, the recruitment process, training and supervision records.

Following the inspection, we requested that the registered manager share our email address with staff to gather feedback and received written feedback from three members of staff following this.

Updated 4 January 2019

The inspection took place on 3 and 8 November 2018 and was unannounced.

Harbour House is a residential care home for up to 35 older people. The building offers accommodation over two floors with lift access to each floor and two adjoining cottages. People have access to communal lounge and dining areas, an accessible garden and outside space. There were 29 people living at the home at the time of inspection.

Harbour House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Harbour House is a Quaker Home. The home was built in 1964 by a Quaker who had an innovative vision to build individual rooms for residents with en suite bathrooms and kitchenettes, with a focus on maintaining people’s independence. All decisions are made with consideration about the Quaker ethos: ‘Thinking with an open mind rather than following strict rules and regulations.’ The founder of the home ensured that a committee of both Quaker and non Quaker volunteers would be involved in decisions about the service and this is still in place. Although some people at Harbour House are Quaker, the home is inclusive and people have a diverse range of cultural and spiritual beliefs.

Harbour House provided outstanding person centred care. Feedback from people, relatives and professionals was that support provided was exceptional and that the home was extremely well managed.

The management of the service was cohesive and driven to ensure that people received extremely high quality support. Staff spoke with enthusiasm about their role and the staff team. Suggestions and ideas were welcomed and staff were encouraged to work autonomously.

Harbour House had strong links with the community and people were encouraged and enabled to maintain their independence. Support was respectful and staff consistently referred to Harbour House and the people they supported as their family.

Harbour House had a strong ethos and considered the spiritual and cultural needs and preferences of people when making any decisions. People were engaged and involved in changes at the service and enabled to communicate in different ways which were reflective of people’s individual needs.

Harbour House worked with people and staff to ensure that people were treated equally and that their protected characteristics under the Equality Act were respected and promoted.

People received high quality end of life care which respected and supported people’s wishes and also provided support for other people and staff when a person died.

Professionals spoke extremely highly about the service and the effective communication and engagement. Training opportunities were inclusive and we saw examples of training being given to visiting health professionals, people and other local providers as well as staff.

The registered manager had strong links with local organisations and was involved in considering innovative options for improving people’s lives by reducing acute hospital admissions. They also provided support for other local providers and registered managers.

Harbour House had been nominated for two national care home awards and had been finalists for an award in 2017 also.

Staff were aware of their responsibilities in protecting people from harm and knew how to report any concerns about people's safety or wellbeing. People had individual risk assessments giving staff the guidance and information they needed to support people safely.

People were supported by staff who were recruited safely and were familiar to them. People, relatives and professionals felt that staff had the sufficient skills and knowledge to support them and we saw that staff had access to relevant training for their role. Staff received regular supervision and appraisals and we saw that they also had competency checks to monitor their practice and drive improvements.

Staff understood what support people needed to manage their medicines safely and these were given as prescribed. Where people expressed a wish and ability to manage their own medicines, this was encouraged and supported. There were processes in place to audit the accuracy of recording medicines.

Staff understood the principles of the Mental Capacity Act and were able to explain how they considered capacity and consent when they supported people.

Where people received support from staff to eat and drink sufficiently, we saw that staff offered choices and prepared foods in the way people liked. People were supported to access a range of professionals where needed.

Care plans were person centred and provide details about what was important to people and were regularly reviewed when people’s needs changed.

People and relatives knew how to complain if they needed to

Staff respected people’s privacy and information was stored confidentially.