Background to this inspection
Updated
21 June 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 checked 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.
The inspection took place on 11 and 13 April and was unannounced. The inspection team consisted of an inspector and an inspection manager.
Before the inspection we reviewed the information we held about the home. This included previous inspection reports and any statutory notifications. A notification is information about important events which providers are required to notify to us by law. A Provider Information Review (PIR) had been submitted for the inspection in March 2016. 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. This information enabled us to understand more about the service and how the provider viewed themselves in terms of the quality of care they provided. It helped us to plan for the inspection and understand which areas we might want to focus on during our visit.
We spoke with one person who lived at the home, three relatives, the registered manager, three members of care staff, a health professional and a member of staff from one of the day centres attended by some of the people. We reviewed care records for all four people living at the home and the medicine administration records (MAR) for three people. We also reviewed recruitment and personnel files for four staff, staff rotas and other records relevant to the management of the service such as health and safety checks and quality assurance audits and systems. During the inspection we spent time observing staff interacting with people, including during a lunchtime sitting. This helped us see how caring staff were when they were engaging with and supporting people.
The last inspection of this home was completed on 20 May 2014 where no concerns were identified.
Updated
21 June 2016
We carried out an unannounced inspection of 7 Eggars Close on 11 and 13 April 2016.
7 Eggars Close is a residential care home providing accommodation and support for four people with learning disabilities in a residential area of Alton in Hampshire. At the time of our inspection four people were using the service.
The home had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The service is required by a condition of its registration to have a registered manager.
People’s relatives told us that they felt their loved ones were safe at the home. People were supported by staff who had been trained in safeguarding and were able to recognise signs of abuse. The provider ensured that safeguarding policies and procedures were in place and kept up to date.
Risks affecting individuals had been identified, and measures put into place to protect them from harm. People’s risks were assessed and regularly evaluated by people’s key workers to ensure they remained current. A key worker is a named member of staff that is responsible for ensuring people’s care needs are met. Environmental risks were regularly reviewed and documented and personal evacuation plans were in place to ensure that people were kept safe in the event of an adverse incident such as a fire. Equipment and utilities were serviced regularly, and internal health and safety checks protected people and others from potential risks in the home.
There were enough staff to meet the needs of the people living at the home. Recruitment procedures were in place to ensure that people were protected from the risk of employment of unsuitable staff. New staff undertook a period of induction which included mandatory training. This was followed by a period of working alongside more experienced staff and observation from the registered manager, to ensure that they had the necessary skills and confidence to fulfil their role.
People were protected from the unsafe administration of medicines because staff had received training to ensure that medicines were administered, stored and disposed of correctly. Staff had their competency to administer and manage medicines assessed by the registered manager annually.
The provider had a programme of mandatory training to support staff to fulfil their roles and responsibilities safely and effectively. The registered manager kept an overview of when this was due to be refreshed for each member of staff, to ensure it was kept up to date. The registered manager carried out observations to ensure that she was satisfied with people’s skills in certain areas and ensured they had further training if necessary. Permanent staff were supported in their roles through regular supervision and appraisal, while they and the registered manager provided guidance and support to bank relief and agency staff.
People can be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA) 2005. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).
People, where possible, were supported to make decisions about their care and treatment. Where people lacked the capacity to agree to the restrictions placed on them to keep them safe, the provider had made the appropriate DoLS applications to the local authority. Staff had a good understanding of the Mental Capacity Act 2005 and were able to talk about it in the context of the people living at the home. Records confirmed that procedures had been followed to ensure that decisions about people’s care had been made in their best interests.
People were supported to have enough to eat and drink and staff encouraged people to have healthy diets. People were offered choices and made their own decisions about what they wanted to eat and drink and looked forward to and enjoyed mealtimes.
People were well supported to maintain good health and have access to healthcare services. Staff were observant and quick to identify potential concerns, promptly engaging with other healthcare agencies and professionals to ensure people received the support they needed.
Staff demonstrated that they knew and understood people's wishes and preferences. People and their relatives were happy with the care provided and we observed interactions between staff and people which were warm and encouraging. Time and effort was invested by staff to build close relationships with people and to understand their needs. In turn, people were relaxed and comfortable in the company of staff.
People’s independence was promoted and they had their own individual goals and steps to achieve them, which were regularly reviewed. This helped ensure that people had continuous opportunities to develop new or existing skills. Staff were proactive in seeking out opportunities for social activities which people would enjoy. When people didn’t want to take part in things, their wishes were respected. People were encouraged to lead full, active and rewarding lives and to make choices for themselves, such as what they wanted to eat, what they wanted to wear and how they wanted to spend their day. Staff were able to identify and discuss the importance of maintaining people's respect and privacy and described how they ensured these.
People had thorough care and support plans which were individualised to them. In addition to outlining people’s support needs, they gave a detailed account of their personal history, their likes and dislikes, their interests and goals and their behaviours and routines. They enabled support workers to have the information they would need in order to support a person effectively. They were regularly reviewed by the person and their key worker to ensure that they remained current and relevant.
People were encouraged and supported to lead active social lives and to follow their interests and enjoyed being part of the local community.
Staff, people and their relatives knew how to raise concerns and were confident in doing so. Staff and residents' meetings were held regularly and provided opportunities for feedback on the quality of the service. Procedures were in place to record, investigate and respond to complaints effectively. Annual stakeholder surveys enabled the provider to keep an overview of people’s views of the service and to respond accordingly.
Both relatives and staff told us that the registered manager provided positive management and leadership. They felt able to talk to the registered manager if they had concerns and had confidence that she would do her best to resolve issues. The culture of the service was one of personalised individual care. It had a focus on promoting independence where possible and providing people with opportunities to live happy and fulfilled lives.
The service was led by a capable registered manager who was competent and understood her responsibilities. Staff were confident, worked hard and were inspired to do their best for the people living at the home. Staff told us that they felt well supported by the registered manager, and that the team worked well together and were supportive of each other.
The provider carried out effective monitoring to assess the quality of the service being delivered and to identify and drive improvements required.