Harnham Croft Care Home

Updated 1 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Harnham Croft is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Harnham Croft is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people about their experiences of care and support received. Following our site visit we also spoke with 7 relatives on the telephone. We spoke with 3 members of staff, the registered manager, the providers regional quality improvement lead and the area director. Following our site visit we also spoke with a further 5 members of staff and contacted 2 healthcare professionals for their feedback.

We reviewed 6 people’s care and support records, multiple medicines records, health and safety records, 5 staff files in relation to recruitment, personal emergency evacuation plans, quality assurance information, incident and accident records and analysis, safeguarding log, meeting minutes, service improvement plan and various audits.

Updated 1 June 2023

About the service

Harnham Croft Care Home is a nursing home providing accommodation for persons requiring nursing or personal care and treatment of disease, disorder or injury for up to 40 people. The service provides support to adults over and under 65 years, people with physical disabilities and people living with dementia. At the time of our inspection there were 35 people using the service.

Accommodation was provided on three floors accessed by stairs and a lift. People had their own room and access to communal rooms such as lounges and a dining room. People accessed the garden from the ground floor.

People’s experience of using this service and what we found

People’s medicines were managed safely. Staff had been trained and checked for competence to administer medicines. We have made one recommendation about safe use of topical patches.

People and relatives had mixed views about staffing numbers. We found there were enough staff on duty to support and care for people safely. The registered manager reviewed staffing numbers using a dependency tool and by listening to people’s views. Whilst some people said there were times staff were busy, they all told us they felt safe at the service. People told us the care was good and they found the staff to be kind and caring.

People and relatives told us staff treated people in a dignified and respectful way. Staff we spoke with told us they enjoyed their work and found caring rewarding. We observed people being cared for in a dignified way and all interactions between people and staff were respectful. There was regular ‘residents meetings’ and people told us they felt able to share their views and were listened to. Where possible the provider and registered manager made changes in response to feedback received from people and relatives.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Risks to people’s safety were assessed and management plans in place. Nurses regularly reviewed records to make changes and updates when needed. Where needed referrals were made to healthcare professionals and their guidance was added to people’s records.

Staff had been recruited safely and provided with training on safeguarding. Systems were in place to make sure people were kept safe from avoidable harm. Staff worked with the local authority safeguarding team when needed and notified CQC of any allegations of abuse. Staff were able to attend various meetings to discuss changes and to share any learning from reviews of incidents.

The service was clean throughout, and domestic staff were employed to maintain good standards of cleanliness. Staff were seen to be using personal protective equipment safely and there was plenty of stock available. The provider made sure staff had training on infection prevention and control procedures and had guidance on working safely. Health and safety checks were carried out and external contractors visited to complete maintenance and servicing of facilities and equipment.

There was a new registered manager in post. They had worked for the provider for many years so was familiar with their policies and procedures. Feedback about the management at the service was positive. People, relatives and staff felt able to approach the management at any time. Quality monitoring systems were in place which were effective in driving improvements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 27 January 2020) and there was 1 breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended that the service ensured they reviewed their staffing levels, on a regular basis, including seeking and listening to people's experience of care to assist them in determining the level of staffing needed. At this inspection we found the provider had acted in response to the recommendation made. The registered manager regularly reviewed staffing numbers and included feedback from people in their review.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 8 October 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Caring and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Harnham Croft Care Home on our website at www.cqc.org.uk.

Recommendations

We have made 1 recommendation in the key question safe. This is for the provider to review systems in place to keep accurate records of topical patch applications.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.