Background to this inspection
Updated
21 June 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection team consisted of two inspectors.
The service is required to have a registered manager:
The service had a manager who was registered with the Care Quality Commission. However, they had recently left the service and were in the process of de-registering. A new manger was in day to day charge of the service and had started the process of registering with CQC. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided at this time.
The service type:
Ersham House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Ersham House can accommodate up to 40 people in one building.
Notice of inspection:
We did not give the provider any notice of this inspection.
What we did:
Before the inspection we reviewed the information, we held about the service and the service provider, including the previous inspection report. We looked at the action plan provided to CQC following our last inspection. The registered provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at notifications and any safeguarding alerts we had received for this service. Notifications are information about important events the service is required to send us by law.
During the inspection we spoke with:
10 people and observed care and support given to people in the dining room and lounges
four people’s relatives/visitors.
Seven members of staff
Four external healthcare professionals.
We also reviewed the following documents:
Six people’s care records
Records of accidents, incidents and complaints
Four staff recruitment files and training records
Audits, quality assurance reports and maintenance records
Updated
21 June 2019
About the service:
Ersham House provides accommodation and nursing care for up to 40 older people, who lived with a range of general health problems, such as strokes, dementia, diabetes, heart problems, Parkinson’s disease and general mobility problems. At the time of the inspection there were 16 people living at the home. It is a purpose-built home with level access throughout for those with mobility problems.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
People’s experience of using this service:
People said, and we observed that they were safe and well cared for and their independence was encouraged and maintained. Comments included, “Good place to live, I feel safe,” and “The staff are nice and kind.”
The service had made improvements since our last inspection. This meant people’s outcomes had improved in respect of risk and medicine management. However, whilst the provider had progressed quality assurance systems to review the support and care provided, there was a need to further embed and develop some areas of practice that the existing quality assurance systems had missed. For example, updating the care plan when peoples’ needs had changed and ensuring medical equipment was ready for use.
There were sufficient staff to meet people’s individual needs who had passed robust recruitment procedures that ensured they were suitable for their role. There were systems in place to monitor people's safety and promote their health and wellbeing, these included health and social risk assessments and care plans. The provider ensured that when things went wrong, these incidents and accidents were recorded, and lessons were learned.
Staff received appropriate training and support to enable them to perform their roles effectively. Visitors told us, “Staff are really helpful, they know what they are doing,” and “The staff are great.” People’s nutritional needs were monitored and reviewed. People had a choice of meals provided and staff knew people’s likes and dislikes. People gave very positive feedback about the food. Comments included, “Nice home cooking.”
Staff treated people with respect and kindness at all times and were committed to providing a quality service that was person centred.
People were encouraged to live a fulfilled life with activities of their choosing and were supported to keep in contact with their families. People's care was now more person-centred. The care was designed to ensure people's independence was encouraged and maintained. Staff supported people with their mobility and encouraged them to remain active. People were involved in their care planning. End of life care planning and documentation guided staff in providing care at this important stage of people’s lives.
Improved audits and checks had been put in place to ensure the service was continuously striving to improve. Areas identified as needing improvement during the inspection process were immediately taken forward and action plans developed.
The service met the characteristics for a rating of ‘Good’ in four of the five key questions we inspected, with the well-led question remaining ‘Requires Improvement.’ Therefore, our overall rating for the service after this inspection has improved to "Good".
Rating at last inspection:
At the last inspection the service was rated Requires Improvement (report published 01 May 2018).
Why we inspected:
This was a planned inspection based on the rating at the last inspection. At our last inspection of the service in April 2018, improvements were needed to ensure that medicines were managed safely, that there were sufficient trained staff to deliver person centred care and that quality assurance systems were fully embedded.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner. We will follow up on our recommendations at the next scheduled inspection.