Harwich House

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.