Esmer House

Updated 3 November 2021

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 Care Act 2014.

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

This inspection was carried out by two inspectors.

Service and service type

Esmer House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced.

We gave the service 48 hours’ notice of the inspection. This was because the service is small, and people are often out, and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

We reviewed information we held about the service and we sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection-

We spoke with four people who used the service about their experience of the care provided. We spoke with four members of staff including the registered manager, the deputy manager, a senior care worker and care worker. We reviewed a range of records. This included two people's care records and medicine records. A variety of records relating to the management of the service and staffing, including policies and procedures were reviewed.

After the inspection –

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with three relatives and two staff.

Updated 3 November 2021

About the service

Esmer House is a residential care home providing accommodation and personal care for up to six people with Prader - Willi syndrome, learning disabilities and/or autism. At the time of the inspection five people were receiving support. The property is a large detached two storey building with individual bedrooms and communal living areas with a large garden to the rear of the property. The service offers 24-hour support.

People’s experience of using this service and what we found

Feedback received from people who lived at the home and their relatives was exceptional and described a service that delivered high quality person-centred care. The provider supported and guided people in creative and innovative ways to allow them to independently take their prescribed medicines safely.

There was a genuinely open culture in which all safety concerns raised are highly valued as integral to learning and improvement.

Staff training was developed and delivered around individual needs. This promoted and achieved positive outcomes for people and allowed them to gain more independence, they were motivated and supported to live full lives. Creative ways of balancing nutritional need against the characteristics of Prader-Willi syndrome had seen a reduction in weight for all people living in the home. This led to increased mobility and reduction in prescribed medicines and had improved people’s quality of life.

The provider focus’ on building and maintaining open and honest relationships with people and their families and friends. People were consistently treated as individuals and changing needs were responded to quickly. People were fully involved in creating and reviewing their care plan. Privacy, dignity and respect were at the heart of the provider’s values and culture. People’s equality, diversity and human rights were exceptionally well supported and promoted, which resulted in positive outcomes for people and their relatives.

People told us that staff had outstanding skills and had an excellent understanding of people’s needs including care, social and cultural needs. The open culture promoted a ‘nothing is off limits’ ethos, and this covered conversations and activities people wanted to have or do. Positive risk-taking supported by robust risk assessments meant people were living active lives and fulfilling wishes and ambitions.

People, relatives and staff told us this service was distinctive, challenged and supported people to be the best version of themselves. They described an exceptional leadership team with a ‘can do attitude’ that put people first. There was exceptional organisational commitment ensuring there was equality and inclusion across the workforce, which was demonstrated through staff retention and internal progression. Performance management processes were effective, reviewed regularly, and reflected best practice. The dedication from people and staff meant this home was at the heart of the local community and lives were enriched by this connection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting how they were meeting the underpinning principles of Right support, right care, right culture. The size, setting and design of service exceeded people’s expectations and aligned with current best practice. A comprehensive holistic approach was taken to admittance to the service and people were offered choice about where and who they lived with. People were given choice and control in a supported way. For example, people had a keyworker and information was provided in a person-centred accessible format. People were fully supported and motivated to be active members within the community which reduced social isolation and promoted development of social skills.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

This service was registered with us on 23 December 2019 and this is the first inspection.

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.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.