Archived: Earlmont House

We undertook this focused inspection on 20 March 2017 to check whether the provider now met the legal requirements. We found the service had taken action to address our concerns. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the 'all reports' link for Earlmont House on our website at www.cqc.org.uk

Earlmont House is a service providing personal care for up to seven people with mental health needs who reside in supported living accommodation. At the time of our inspection there were five people using the service.

There were two registered managers 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.

Records showed staff received the training they needed to keep people safe. The manager had taken action to ensure that training was kept up-to-date and future training was planned.

Staff told us they felt supported by the management and received supervision and appraisals, which helped to identify their training and development needs.

There were policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005. Staff were trained in the principles of the MCA and could describe how people were supported to make decisions. Where people did not have the capacity, decisions were made in their best interests.

People were supported to have a healthy diet dependent on their assessed individual needs. People were offered a choice of foods and were involved in preparing their own meals where possible.

People's health needs were monitored and people were referred to external healthcare professionals if such a need was identified.

There was a registered manager 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.

Staff who supported people were not always appropriately trained. Records showed that the provider had not ensured that staff had received up-to-date training in areas such as moving and handling equipment, fire awareness, safeguarding or infection control.

Staff had not completed relevant training and therefore did not understand the principles of the Mental Capacity Act 2005 (MCA). The MCA provides the legal framework for acting and making decisions on behalf of individuals who lack the mental capacity to make particular decisions for themselves. The MCA also requires that any decisions made on behalf of a person who lacks capacity, are made in the person's best interests. Staff had limited awareness of the MCA.

People’s needs were assessed and plans were in place to meet those needs. People’s wishes and preferences were taken into account, recorded in the care plans and followed during care delivery. Risks to people’s health and well-being were identified and plans were in place to manage those risks.

Thorough recruitment practices and appropriate pre-employment checks ensured that staff were of a suitable character to care for people. Staff were supported through regular supervisions and appraisals.

When people required assistance to take their medicines, there were arrangements in place to provide this support safely.

There were sufficient numbers of staff available to ensure people’s needs were being met at an appropriate time.

People had access to activities that were meaningful to them. People were also supported to obtain advice and support from relevant health professionals in order to maintain their health and well-being.

Care files included information regarding people’s social history, preferences and choices, which enabled staff to provide support based on the person’s wishes. Staff we spoke with knew the people they supported well. People were involved in making decisions about their care.

Staff promoted people’s independence, privacy and dignity and they treated people with respect.

People who lived at the home were fully involved in the planning and review of their care.

There was an open and transparent culture within the service. The management team demonstrated effective leadership skills and care workers said they felt valued and supported. Staff understood their roles and responsibilities in providing safe and good quality care to people who use the service.

Staff were complimentary about the registered manager and had no concerns about raising issues.

Quality assurance systems such as surveys were in place to monitor the quality of the service. However, the service had not taken appropriate action to address the issues relating to staff training.

People told us they were able to raise any issues with the manager and knew how to make a complaint should they need to.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. You can see what action we recommended the provider to take at the end of the full version of the report.