Edge Hall Care Home

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained good.

There was a registered manager in post working at the service. 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 the inspection we identified that some health and safety records were difficult to locate and we saw one person’s records relating to care had not been updated to reflect current support. The registered manager took swift action to address these areas, so that records were more organised and those relating to care updated. We found no evidence of health and safety checks not being undertaken and people received the care and support they needed.

People’s medicines were administered as prescribed by staff who were trained and deemed competent. PRN (‘as and when’) medicines were administered when people needed them.

In June 2017 CQC published Registering the Right Support. This along with associated good practice guidance sets out the values and standards of support expected for services supporting people with a learning disability. At this inspection we assessed the service in line with this guidance.

Edge Hall Care Home met most of the values and principles of Registering the Right Support and associated guidance. Current good practice guidance encompasses the values of choice, independence, inclusion and living as ordinary a life as any citizen. We found that the staffing arrangements supported these values. The size and layout did not support the values of Registering the Right Support, as the guidance recommends that people live in small settings. However, Edge Hall Care home presented with a homely atmosphere and people and relatives told us Edge Hall Care Home felt like “Someone’s own home”, rather than a care home. Staff provided people with the required support to learn or retain everyday living skills. People and relatives told us the staff were committed to this support.

Quality assurance systems and processes were in place to monitor standards in the care home and to drive forward improvements. This included audits of key areas such as, care and medicines. These systems were effective and we observed that appropriate action had been taken to address issues where they had been identified.

People had support plans which provided important information to staff regarding the level of support people needed. Information about people’s personal histories, likes and dislikes were recorded, along with detailed information as to how people communicated to help staff get to know people.

People’s comments about staff were very positive. We observed examples where people were treated with kindness, dignity and respect. Throughout the inspection it was apparent that positive relationships had been developed between people and staff. People's consent was sought and people's choices and preferences round day-to-day decisions were respected.

People took part in a range of social activities and volunteering programmes of their choice. This promoted good social interaction and helped to prevent people from becoming isolated. People told us how much they enjoyed their social arrangements.

Edge Hall Care Home was clean and promoted a homely environment. The care home was going through a period of building works and decoration. People’s rooms were being decorated and people were involved with choosing their own colour schemes. Equipment and aids were available to support people to ensure their comfort, independence and safety.

The service was working in line with the principles of the Mental Capacity Act 2005. This meant that people’s rights and liberties were being upheld.

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

People were protected from the risk of abuse. Staff had received appropriate training in safeguarding and told us they would not hesitate in speaking up if they felt someone was at risk.

Accidents and incidents were being monitored as required and action had been taken to protect people from these re-occurring.

Risk assessments were in place which clearly outlined the support staff needed to provide to people to protect them from the risk of harm. These helped formulate people’s plan of care. Environmental risks were also assessed and health and safety checks undertaken to ensure the premises was well maintained and safe.

Recruitment processes were robust and ensured that those staff employed were of suitable character.

Staffing levels were appropriate to meet the needs of people living at the home.

People were involved in choosing the menus and staff provided dietetic support at the appropriate time.

Staff received training and support to ensure they had the skills and knowledge to provide safe effective care.

Further information is in the detailed findings below.

Edge Hall Care home is located in a residential area of Southport, Edge Hall Care Home provides accommodation and care for a maximum of 12 people with a learning disability. There were 12 people living at the home at the time of our inspection.

The accommodation includes single rooms with ensuite facilities, a shared lounge and dining area. A passenger lift is available for access to the upper floors. Parking is available to the front of the property and a garden to the rear. The home is located near to local places of interest and the main shopping area of Southport.

A registered manager was in post. 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.

People we spoke with told us they felt safe and staff knew what actions to take if they thought that anyone had been harmed in any way.

People received their medicines as prescribed and safe practices had been followed in the administration and recording of medicines.

People confirmed there were enough staff available to meet their needs.

Staff we observed delivering support were kind and compassionate when working with people. They knew people well and were aware of their history, preferences and dislikes. People’s privacy and dignity were upheld. Staff monitored people’s health and welfare needs and acted on issues identified. People had been referred to healthcare professionals when needed.

People told us there were enough suitably trained staff to meet their individual care needs. Staff were only appointed after a thorough recruitment process. Staff were available to support people to go on trips or visits within the local and wider community.

Staff understood the need to respect people’s choices and decisions if they had the capacity to do so. Assessments had been carried out and reviewed regarding people’s individual capacity to make care decisions. Were people did not have capacity, this was documented appropriately and decisions were made in their best interest with the involvement of family members where appropriate and relevant health care professionals. This showed the provider understood and was adhering to the Mental Capacity Act 2005.This is legislation to protect and empower people who may not be able to make their own decisions.

The provider was meeting their requirements set out in the Deprivation of Liberty Safeguards (DoLS). DoLS is part of the Mental Capacity Act (2005).

People’s bedrooms were individually decorated to their own tastes. People who could not communicate were encouraged to express their views in a variety of ways – verbally, through physical gestures, body language, Makaton and British Sign Language.

People were supported to purchase and prepare the food and drink that they chose. People who lived at the home, their relatives and other professionals had been involved in the assessment and planning of their care. Care records were detailed and gave staff the information they required so that they were aware of how to meet people’s needs.

There was a complaints procedure in place and people felt confident to raise any concerns either with the staff, the deputy manager or the registered manager.

Staff were trained and skilled in all mandatory subjects, and additional training which was taking place within the organisation. Staff we spoke with were able to explain their development plans to us in detail and told us they enjoyed the training they received. Staff told us they could approach the management team anytime and ask for additional support and advice.

Staff spoke highly of the organisation’s values and all of the staff we spoke with told us they were proud to work for the organisation. Staff said they benefited from regular one to one supervision and appraisal from their manager.

There was a safeguarding and a whistleblowing policy in place, which staff were familiar with.

Quality assurance audits and feedback were collected regularly from staff, relatives and people living at the home, and were analysed and responded too appropriately. We could see the registered manager was using this feedback to continually improve the service. Other quality assurance audits we saw were highly detailed and the registered manager responded appropriately to shortfalls identified within the service provision. Working action plans and target dates for completion were seen.

During the inspection we looked at care planning, how the service was staffed and how they monitored the quality of service provision for residents. We also talked with residents about the home. Comments were positive and included, 'I have been here for years it is the best place.' Also, 'The staff and manager are really nice and we have lots of things to do.'

We spoke individually with residents living at Edge Hall about their daily routines and outside interests they followed. One resident said, 'I have a paper round and really enjoy it. I go on my own the staff support me when I need their help.' Another resident said, 'I have been attending college and now doing another course.'

Staff we spoke with were satisfied with the amount of people on duty during the day and night. One staff member said, 'We work well together and because we have enough people on duty we can spend one to one time with residents.'

There were a range of audits and systems in place to monitor the quality of the service being provided.

Prior to our visit we contacted the Sefton contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.