Archived: Eleri House

The inspection took place on the 1 June 2016 and was unannounced.

There was a registered provider at this home. A registered provider is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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.

Relatives said they were happy about the care people living at the home received. They told us staff were caring and promoted people’s independence. We saw people were able to maintain important relationships with family and friends and were encouraged to develop strong links with the community. People had food and drink they enjoyed and had choices available to them, to maintain a healthy diet. Staff knew the people who lived at the home well and were able to support them to eat and drink. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage them. Relatives told us their family member had access to health professionals as soon as they were needed.

Staff we spoke with were aware of how to recognise signs of abuse, and systems were in place to guide them in reporting these. They were knowledgeable about how to manage people’s individual risks, and were able to respond to people’s needs. Staff had up to date knowledge and training to support people. We saw staff treated people with dignity and respect whilst supporting their needs. They knew people well, and were focussed on each person as an individual.

When people needed support with decisions, best interest decisions were made, involving family and health care professionals. Decisions were made in a least restrictive and lawful way, with applications to the local authority made appropriately.

Relatives said they felt included in planning for the care their family member received and were always kept up to date with any concerns. People living at the home saw their friends and relatives as they wanted. Relatives knew how to raise complaints and felt confident that they would be listened to and action taken to resolve any concerns. Staff and the registered provider knew people well and were aware if people were unhappy. The registered provider had arrangements in place to ensure people were listened to and action taken if required.

The registered provider promoted an inclusive approach to providing care for people living at the home. Staff were encouraged to be involved in regular meetings to share their views and concerns about the quality of the service.

We considered all of the evidence that we had gathered under the outcomes that we inspected. We used that information to answer the five key questions that we always ask;

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The detailed evidence supporting our summary please can be read in our full report.

Is the service safe?

We saw that care and support was carefully planned to meet service users' needs. People's preferences had been recorded. People had choices about everyday activities and the food that they ate. When people were not able to understand more complex decisions, staff had involved relevant relatives and professionals in making best interest decisions. Staff had received training and understood about mental capacity and deprivation of liberty standards (DOL) which they said were never used at the home. Staff told us how one person's behaviour had changed for the better, over time living at the home, which they felt was because they felt safe there. A balanced, varied diet was available for people. Medicines were managed safely and staff had received the appropriate training. We saw that a policy about safeguarding was available for staff but did not include contact details for the local authority safeguarding team. The manager told us that this was in the office and that they would ensure that it was added to the policy readily available for staff.

Is the service effective?

People's health and care needs had been assessed and care plans were in place. We saw that support, and methods of communication with people, matched the plans. Regular physical activity promoted health and wellbeing. Care reviews were carried out regularly and involved people significant to people using the service. Relatives had been involved in reviewing care regularly. A relative told us that a person, 'while he has been in their care has improved in many ways.'

Is the service caring?

We spoke to staff about people using the service and the way they spoke about people showed us that they cared about their welfare and happiness. Relatives told us that they thought the staff were all caring and were, "part of the family." People using the service had limited verbal communication skills. Staff showed us that they understood nuances of non-verbal communication that the different people living at the service could display to show they were anxious, unhappy or unwell. We observed that when staff interacted with service users they were kind and patient and people responded to them positively.

Is the service responsive?

Staff responded to changes in people's mood and behaviour. Staff described how they had noticed that a person seemed to be 'going a bit deaf' and had supported them to visit a GP and then an audiology specialist. Relatives told us that staff at the service were supportive of them as well as of the people using the service. They told us that staff responded to suggestions. For example, when they had suggested buying new clothes for a person using the service and staff had helped them to choose new clothes.

Is the service well led?

Staff all received annual appraisals and met with the manager in supervision meetings about every three months. Staff met together each month to discuss their performance and the care and support provided to people using the service. The service had an effective system to monitor the quality of the service they provided. This showed us that the service was well led.

People who lived at the home were unable to communicate with us at all. We conducted observations, looked at care plans and records and spoke with the registered manager, members of staff and a visitor to the home.

The three people who lived at the home had been together for many years. They had been supported by a small team of staff most of whom had supported them for many years. The staff knew what support each person needed.

Relatives had been involved in supporting people with planning their care. When relatives had not been available, support from medical professionals and the local authority had been obtained. Records had been maintained and reviews of care had been conducted regularly. Changes had been made when necessary.

People's dignity had been respected. People had also been protected from the risks of abuse. Staff could identify abuse and had a clear understanding of their roles and responsibilities in this area.

Staff had been supported to do their work and told us that they had received appropriate training. Staff also received regular training that updated their skills.

There were systems of audits in place to monitor the quality of services provided. People had been asked for their views about the home and these had been listened to. Appropriate records had been maintained.