Evergreen House Residential Home

Evergreen House Residential Home is a residential care home providing personal care to up to 38 people. The service provides support to older people, some of whom have physical disabilities or are living with dementia. At the time of our inspection there were 28 people using the service.

Evergreen House accommodates people in 1 adapted building.

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

People were not supported to have maximum choice and control of their lives and staff did not 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.

Although people's mental capacity had been considered, people's capacity to make specific decisions had not been assessed or recorded. This placed people at risk of having decisions made on their behalf unlawfully. People's lunchtime experience was not always positive. Some people experienced delays in receiving their food and due to the layout of the dining room were unable to leave when they wanted to.

Audits were not always effective at identifying concerns. This included in relation to people’s mental capacity assessments and promotion of people’s rights. The registered manager and provider could not be assured all people were regularly repositioned, as assessed and planned. Staff recruitment records did not consistently evidence staff’s identities or employment histories. Where actions had been identified these were not always promptly undertaken by the provider to drive improvements in people’s care.

People felt safe receiving care at Evergreen House. Risks to people’s safety were assessed and managed safely and there were enough staff to meet people’s needs and act responsively when people needed them. People received their medicine as prescribed and systems used for the management of medicines were safe. Staff followed infection control guidance to reduce the risk of cross infection.

People's needs were assessed and reviewed and the environment was suitable for people's needs. Staff received training and support in their role and had the skills required to support people. Staff understood people's dietary needs and fluid intake was monitored to ensure people had enough to drink.

People described staff as friendly and caring and there was a relaxed atmosphere within the home. People’s independence was promoted by staff who encouraged them to do as much as they could for themselves. People’s privacy and dignity was respected by a staff team who knew them well.

People’s care was planned in accordance with their individual needs and wishes. Staff understood people’s life histories and experiences and supported them with these in mind. People were supported to take part in activities that interested them, although some people felt activities could be tailored more towards their needs. There was a system in place for the management of complaints.

People, relatives and staff spoke positively about the management of the home. People and relatives were confident to give feedback and felt the registered manager took their concerns seriously. Staff expressed confidence in the registered manager and felt supported in their roles. The staff team worked in partnership with others to ensure people’s needs were met.

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 9 January 2021).

Why we inspected

We undertook this inspection to provide the service with a rating in all five key questions.

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.

Enforcement

We have identified breaches in relation to mental capacity assessments and governance at this inspection. 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.

Evergreen House Residential Home provides accommodation and personal care for up to 38 people. At the time of our inspection the service was supporting 17 people in one adapted building, some of whom were living with dementia.

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

People were protected from harm by staff who were trained to recognise and report abuse. Risks to people’s safety were assessed and monitored regularly. People were supported by sufficient staff to meet their needs. Medicines were managed in line with policies and procedures. Effective infection and control procedures were in place. Lessons were learnt when things went wrong.

Managers did not always recognise potential notifiable incidents. Staff demonstrated a positive culture which was person centred. Staff were supported to be open and honest. The provider engaged with people living in the home and with staff to improve the service. Processes were in place to monitor and improve the service. Staff worked in partnership with other health and social care professionals.

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 under the previous provider was good, published on 5 November 2019.

Why we inspected

We received concerns in relation to the management of medicines, infection control and staffing. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained good. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe section of this full report.

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 coronavirus and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Evergreen House Residential Home on our website at www.cqc.org.uk.

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.