The Harefield Care Home

Updated 12 April 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

The inspection was carried out by 2 inspectors, a member of CQC’s medicines team 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

The Harefield Care Home 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. The Harefield Care Home 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 sought feedback from the local authority and professionals who work with the service. 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 who used the service and 4 relatives about their experience of the care provided. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with 12 members of staff including the area director, registered manager, nurses, care workers, the housekeeper, the chef and the laundry person. We also spoke with a visiting healthcare professional.

We reviewed a range of records. This included 10 people’s care records and 11 medicines records. We looked at staff records in relation to recruitment, training, and supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. Following the inspection, we reviewed a range of records we requested from the provider.

Updated 12 April 2023

About the service

The Harefield Care Home offers accommodation and personal or nursing care for up to 40 people, some of whom are living with the experience of dementia. The accommodation is provided in 2 ground floor units in a purpose-built building. There were 39 people using the service at the time of our inspection. The service is part of HC-One No.1 Limited, a large organisation which operates over 300 care homes across the United Kingdom.

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

People received their medicines safely and as prescribed, but we found several minor shortfalls in relation to the management of medicines. The provider took immediate action to make the necessary improvements.

Where people required closed monitoring or repositioning to avoid skin damage, there were monitoring charts in place for staff to complete. We saw the recording of these was mostly accurate and regular. However, for one person, there were gaps in recording. The provider took appropriate action with the relevant staff to make improvements.

Although the provider’s monitoring checks had not identified the minor issues we found on the day of our inspection, we saw evidence of a continued and marked improvement since our last inspection. The registered manager was in the process of auditing all records to help identify and address any further shortfalls.

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 and wellbeing had been appropriately identified, managed, and mitigated. The provider had processes for recording and investigating incidents and accidents. We saw that these included actions taken and lessons learned.

There were enough staff on duty to meet the needs of people who used the service. There were procedures to help make sure staff were suitable and had the skills and knowledge required. These included recruitment checks, regular training, and supervision.

There were systems in place for the prevention of infection and cross contamination.

Care and support plans were comprehensive and contained the necessary information about the person and how they wanted their care provided. People’s end of life wishes were recorded in their care plan. This included their religious and cultural needs and how they wanted their care when they reached the end of their life.

People and relatives were happy with the care they received and spoke highly of the registered manager and staff whom they said were kind and caring. People were supported to take part in activities they liked.

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 24 September 2022) and there were 2 breaches of regulation. The provider completed an action plan after the 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. However, further improvements were needed. We made a recommendation in relation to the management of medicines.

Why we inspected

We carried out this inspection to check if the provider had made the necessary improvements since the last inspection.

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.

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

Follow up

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