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Harmony Projects received an overall rating of Requires Improvement at its first inspection, with a regulatory breach of Regulation 17 identified due to unsafe medicines management including incomplete MAR records, unrecorded allergies, and an ineffective medicines audit system. Effective, caring, and responsive key questions were rated Good, reflecting person-centred care and competent staff, but governance and leadership weaknesses — including poor support for overseas staff and inadequate quality assurance — also contributed to a Requires Improvement rating for well-led.