Archived: Eldonian House

Updated 21 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 9 February 2016 and was unannounced.

The inspection team consisted of two adult social care inspectors and an expert by experience. An expert by experience is a person who has personal experience of either using or caring for someone who uses this type of service.

Before our inspection we reviewed the information we held about the home. This included the Provider Information Return (PIR). A PIR 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 also looked at the notifications and other intelligence the Care Quality Commission had received about the home.

During the inspection we spent time with four people who were living at the home and spoke to five family members. We also spoke with the deputy manager and three care staff.

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 looked at the care records for three people living at the home, three staff personnel files and records relevant to the quality monitoring of the service. We looked round the home, including people’s bedrooms, the kitchen, bathrooms and the lounge areas.

Updated 21 April 2016

This inspection took place on 9 February 2016 and was unannounced.

This inspection was also to follow up on the concerns which were identified in a previous inspection on 18 and 19 August 2015. The home was rated as ‘requires improvement’ overall and was rated ‘inadequate’ for the well-led domain Following the inspection we issued a notice to stop any further admissions to the home. The statutory notice we issued remains in place at this inspection.

Eldonian House is a purpose built care home for 30 older people 22 people were living at the home at the time of our inspection. . It is part of the Eldonian Village community in the Vauxhall area of North Liverpool, close to the city centre. Accommodation includes all single bedrooms with en-suite facilities, two main lounges and a dining room. The home was built by the Eldonian Community but is now operated by Raydonborne Ltd who operates the home on a leasehold basis.

There was not a registered manager they had left two weeks prior to our inspection. However the deputy manager had applied to the Commission to become registered.

A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During our last inspection in August 2015, the home was in breach of one regulation regarding the safe management of people’s risks. Some people did not have risks appropriately assessed. We also found that people had not been referred to dieticians when there were concerns around their food/fluid intake, and we did not find a nutrition risk assessment/care plan to manage these concerns or improve people’s health. During this inspection, we could see that improvement had been made and risk assessments were in place and had been reviewed in relation to nutrition and pressure care. People had care plans in place which contained personalised information. The home was no longer in breach of this regulation.

We saw that staff were not always supervised or appraised. Staff told us they had not had a regular supervision and records confirmed this.

We saw the home did not have a thorough complaints procedure in place, the procedure was not displayed in a place readily accessible for people and complaints were not managed well. The complaints policy had not been reviewed since 2012.

We saw that the home was not always operating in accordance with the Mental Capacity Act 2005 (MCA). Applications to deprive people of their liberty were not always submitted and one application had expired without the home realising.

During our last inspection in August 2015 we found the home in breach of regulations relating to the quality assurance of the home. This was because medication audits and audits on peoples care plans and risk assessments were not always effective and did not pick up any errors or omissions. We found during this inspection that most of this had been addressed and quality assurance procedures were regularly being checked and audited. However, even though these systems were much improved they had not highlighted that people’s liberties were being unlawfully restricted or their DoLS had expired. We could see that the deputy manager, having only been in post two weeks, had not audited the DoLS applications yet. They had highlighted that staff supervisions were overdue, and the deputy manager had devised an action to address these. The home was no longer in breach of this regulation.

People told us they felt safe living at the home. Relatives of people living at the home told us they felt their loved ones were safe.

Staff were recruited safely and the relevant checks had been carried out on staff before they started work.

Staff we spoke with understood what constituted as abuse and knew what actions to take if they felt someone at the home was being abused. There was a safeguarding adults policy in place for the staff to refer to.

People living at the home were protected with the risks associated with the safe administration of medications.

The home was clean and tidy, there was an issue with regards to the central heating at the time of inspection, however we received information that this has now been addressed.

We observed warm and caring interactions between staff and people who lived at the home. Staff we spoke with clearly demonstrated knowledge of the people they supported, and could explain how they maintained peoples dignity and respect.

We saw that people were supported to access other medical professionals, such as the GP, if they felt unwell.

The food was plentiful and flavoursome, and we saw if someone did not want what was offered they were given something else to eat.

Staff told us the deputy manager of the home was approachable and was working hard to ensure staff felt supported.

The concerns we identified are being followed up and we will report on any action when it is complete.