Harwich House

Updated 25 February 2021

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 Care Act 2014.

Inspection team

This inspection was carried out by two inspectors.

Service and service type

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

The service did not have a manager registered with the Care Quality Commission. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. A manager had been appointed to the service, however at the time of our inspection, they had not started the process to register with the CQC.

Notice of inspection

We gave a short notice period of the inspection. This was because of the COVID-19 pandemic. We wanted to be sure that no-one at the service was displaying any symptoms of the virus and needed to know about the provider’s infection control procedures to make sure we worked in line with their guidance. Due to the COVID-19 pandemic we needed to limit the time we spent at the service.

What we did before the inspection

Before the inspection we reviewed the information we held about the service and the service provider. We sought feedback from the local authority and healthcare professionals that are involved with the service. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law. We used all of this information to plan our inspection.

During the inspection

People living at the service were unable or unwilling to speak with us. We spoke with six members of staff including the interim manager, the newly appointed manager, a deputy manager and support staff. We spent a short time in the home whilst people were eating their lunch. This allowed us to safely look at areas of the home that had previously been identified as a concern. It also gave us an opportunity to observe staff interactions with people.

We reviewed a range of records. This included five people’s care records, medicine records, staff files in relation to recruitment and further records relating to the quality assurance of the service, including accident and incident records.

After the inspection

We spoke with five relatives and a healthcare professional by telephone in order to gain further feedback around the care delivered.

Updated 25 February 2021

About the service

Harwich House is a residential care home that provides care and accommodation for people with learning disabilities. It is registered to support up to nine people. Eight people were living at the service on the day of our inspection.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was not fully able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. Systems and processes to ensure people received safe care and treatment needed further time to be fully effective. Many people were not able to fully verbalise their views and used other methods of communication, for example pictures. Due to people's needs we spent time observing people with the staff supporting them.

Right support:

• People were beginning to receive personalised care and support specific to their needs and preferences. However, the service had been through a period of management change, which had affected the quality of care delivery. Further work was needed to effectively support people to achieve goals and encourage them to learn and grow as individuals. People had not always been fully protected from the risks of harm, abuse or discrimination, because staff had not always known what actions to take if they identified concerns. There were enough staff working to provide the support people needed. Staff understood the risks associated with the people they supported. Risk assessments were being improved to ensure they provided guidance for staff about individual and environmental risks. People received their medicines safely, when they needed them.

Right care:

• Care was person-centred and promoted people’s dignity, privacy and human rights. People’s individual needs and choices were recognised, and respected. People were supported to have 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.

Right culture:

• Despite the need to keep people safe during the COVID-19 pandemic taking priority, the provider and staff had worked hard to improve quality and leadership at the service. Quality monitoring systems were still to be embedded fully, however morale had improved amongst the staff team. We received negative feedback in relation to the care people received and how the service was run. One relative told us, “[My relative] has had a tough time at Harwich House recently, there have been a lot of changes, I just hope things improve now”. The provider and staff were aware of the areas for development and improvement. Management staff told us of their commitment to improve care delivery, to fully engage with relatives and reassure them they could meet people’s needs. We saw improvements had been made to the provider’s oversight of the care provided, engagement with families and health and social care professionals and record keeping.

Due to the COVID-19 pandemic, the provider had ensured that appropriate infection control procedures for the pandemic were in place to keep people safe. This included increased cleaning and ensuring adequate supplies of personal protective equipment (PPE) were available. Staff completed training in relation to COVID-19. We were assured the provider managed infection prevention and control through the COVID-19 pandemic.

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

This is the first inspection of this service under their new legal entity. The last rating for the service under the previous provider was Requires Improvement, published on 22 April 2020.

Why we inspected

We undertook this comprehensive inspection on 12 January 2021 in light of concerns we had received in respect to the care people were receiving. Concerns included, the management of medicines, risk assessments, staff training, staffing levels, quality monitoring, governance and leadership, and a negative and closed culture at the service. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from these concerns, however we identified several areas of practice that need improvement. Please see the full report of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.