Archived: Harmill House

Updated 21 April 2015

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.

This inspection took place on 11 December 2014. The provider was given 24 hours’ notice of the inspection because the location provides a domiciliary care service, to ensure she would be present to undertake the inspection. The inspection was carried out by one adult social care inspector.

Prior to the inspection we reviewed the records we held about the service, including the details of any safeguarding events and statutory notifications sent by the agency. Statutory notifications are reports of events that the provider is required by law to inform us about. We had received no information of concern.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the information provided in the PIR and used this to help us plan the inspection.

We contacted four external care and health professionals with recent experience of the service, to obtain their views. We also reviewed the feedback about the service obtained from the surveys sent out to 14 people who use the service, 13 relatives/friends, 27 staff and one external health professional.

During the inspection we spoke with the registered provider who was also the registered manager of the service. We examined three people’s care records and read other records relating to the operation of the agency. These included risk assessments, staff supervision and appraisal records and management monitoring systems.

After the inspection we spoke on the telephone to four relatives of people with dementia who were supported by the service, to seek their opinions about the agency.

Updated 21 April 2015

We inspected Harmill House domiciliary care agency on 11 December 2014. The agency provides personal care and support for almost 50 people living in the community. People had a range of needs arising from old age or physical disabilities. The agency owner is also the registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff were well trained and knew how to keep people safe. No safeguarding issues had arisen since the previous inspection. No missed calls had been reported. Where issues had arisen around medicines, staff had openly reported the issue and had prioritised the person’s safety through seeking medical advice. The manager had made changes to medication recording systems to reduce the risk of recurrence. A senior staff member completed a detailed risk assessment of the home environment in each case and staff were trained to use any relevant moving and handling equipment.

The staff had access to the information they needed to meet people’s needs in a person-centred way. Staff were very good at identifying changes in people’s wellbeing and were proactive in approaching healthcare services and family to pass on their concerns. People and their relatives were very happy with the care and support provided and felt people were safe in the care of Harmill House.

The agency had advocated effectively for people to get their needs met via healthcare services and in protecting their rights. The agency had acted beyond the usual expectations in taking steps to try to maintain the safety of one person prone to wandering off from their home. They had also taken the lead in getting medicines prescribed in an alternative form where this was beneficial to keep people safe.

Prospective staff were subject to a thorough recruitment process and the required checks were carried out to ensure they were suitable to work with vulnerable people. New staff were introduced to people before providing their support and regularly monitored to ensure they provided care to the high standards expected by the manager.

People told us staff were very good at managing the balance between people’s dignity and rights and the need for support with aspects of their care. People and relatives told us the agency was very good at communicating with them about any issues of concern. People were very happy with the consistency and continuity of care provided by the staff.

Staff had the skills and training they needed to recognise and meet people’s needs and were provided with additional or specialist training when necessary. Staff practice and competency were regularly monitored and staff were well supported in their role. The manager had a good understanding of the Mental Capacity Act 2015 and had advocated in this regard on people’s behalf where necessary. Staff provided appropriate support around nutrition and people’s health and had promptly reported concerns to health agencies when they observed changes in people’s wellbeing.

People and relatives praised the agency’s caring approach and compared it very favourably with others they had experienced. People often commented about how this agency had gone beyond what was usually expected in meeting people’s needs. Where any issues had been raised they had been promptly addressed. Relatives told us they were very confident in the ability of the agency to care for their family member. People and relatives felt the staff were very kind, caring and compassionate and looked after people’s dignity.

People were involved in planning and reviewing their care. Where they were unable to manage this or with people’s consent, the views of their family were sought. Relatives told us that the agency had been very effective in ensuring that, where necessary, other agencies were engaged to meet people’s needs. Staff felt they were given the information they needed and had sufficient time allocated to provide support to people without rushing them.

People and relatives felt the agency was approachable and the manager responded positively to any issues raised. Relatives said the agency exceeded their expectations and gave them peace of mind. They were appropriately involved and informed and felt the agency was flexible as people’s needs changed.

The manager regularly sought the views of people and their relatives through surveys and post-visit calls and any issues identified were addressed. People and relatives knew how to complain but this was rarely necessary as any concerns were responded to promptly. The agency was well managed by an experienced manager who had effective systems in place to monitor and maintain standards.