Background to this inspection
Updated
9 August 2023
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was completed by 2 inspectors.
Service and service type
Enablement Care is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Enablement Care is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection and we sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 3 relatives, 1 person who used the service and 1 healthcare professional. We spoke with 7 staff members, including the registered manager, nominated individual, domestic, nurse and care workers. We reviewed a range of records, including 5 people's care records. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service were reviewed including policies and procedures.
Updated
9 August 2023
About the service
Enablement Care is a residential care home providing accommodation and personal care to up to 23 people. The service provides support to younger and older adults. At the time of our inspection there were 22 people using the service. The home provides care over 2 floors with communal areas for dining and relaxation.
People’s experience of using this service and what we found
Staff did not receive sufficient training to be able to carry out their roles. Staff were mostly recruited safely and appropriate pre-employment checks were completed prior to employment. Recruitment records were not always complete in relation to employment history.
People’s care plans and risk assessment were inconsistent, some people’s risks were assessed whilst others were not identified. People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
People received their prescribed medicines safely and correct infection and prevention control measures were followed, however medicines were not always managed safely. Accidents and incidents for the whole service were recorded, however individual incidents were not always analysed to identify people’s individual trends to minimise the risk of re-occurrence.
The culture of the service did not always promote positive person-centred care. Quality assurance systems and checks were in place to monitor areas of the service, however, did not always identify shortfalls in relation to care planning, consent and monitoring charts.
There was enough staff to meet people’s needs. People were protected from the risk of abuse. Most staff received safeguarding training and understood the procedures of how to raise a concern. People were supported to maintain a healthy diet and there was a choice available.
The provider engaged with external professionals to help achieve people’s outcomes.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 11 January 2020).
Why we inspected
We received concerns in relation to staffing, training and governance. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the all sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to staffing and consent. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.