The Care Quality Commission
  • Care Home
  • Care home

Archived: Evaglades

Overall: Good read more about inspection ratings

394 Marine Road East, Morecambe, Lancashire, LA4 5AN (01524) 419684

Provided and run by:
Mrs Sheila Mavis Mecklenburgh

All Inspections

11 February 2016

During a routine inspection

This inspection took place on 11 February 2016 and was announced. The registered provider was given 48 hours’ notice because the location was a small care home for adults with learning disabilities who are often out during the day; we needed to be sure someone would be in.

-

Evaglades is a residential care home registered for up to 8 people with learning disability. The rooms are en-suite and are located on two floors with a staircase. The home is situated on the seafront in Morecambe close to local amenities. Care is predominantly provided by the family who also live on site. The registered provider employs one person who is not a family member.

At the time of inspection there were two people living at the home.

A registered provider was in post at the time of the inspection. A registered person is registered with the Care Quality Commission to manage the service. 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.

The service was last inspected 08 December 2014. The registered provider did not meet the requirements of the regulations during that inspection as breaches of the Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 were identified. Breaches were identified in requirements relating to workers, recruitment, assessing and monitoring the quality of service provision, Respecting and involving service users, records, consent and complaints.

During this inspection in February 2016, we found improvements to meet the fundamental standards had been made.

Risk assessments had been reviewed to ensure risks to people had been addressed and could be suitably managed. Staff were aware of the risks appropriate to each person and aware of processes to follow to promote peoples safety.

Systems had been implemented to ensure all environmental risks were identified and addressed to promote safety. The registered provider had carried out appropriate fire alarm testing and had carried out evacuation drills with staff and the people who lived at the home. Records had been kept to evidence they had occurred and documented any significant findings.

The registered provider had developed an audit system and was carrying out checks around the property to ensure all areas were adequately maintained. Cleaning rotas had been developed and records of all cleaning undertaken were maintained.

Records relating to staff were up to date and detailed. New employees had been subjected to suitable checks to ensure they were suitable for the employed role. All staff and family members who worked at the home had been subjected to a Disclosure and Barring check prior to commencing work.

Suitable arrangements were in place for administering of medicines. Medicines were stored securely when not in use and were only administered by staff that were trained to do so. People who lived at the home had access to homely remedies to manage any minor ailments. These had been discussed and approved with a relevant health professional. Audits of medicines were carried out by the registered provider.

Training had been implemented for staff and training progress was being documented on a training matrix. Staff told us they were offered training to meet people’s needs. New staff were supported through an induction programme and was supported by management at the start of their employment. On-going support to staff was offered through supervisions and regular team meetings.

Procedures to lawfully deprive people of their liberty had been considered and applications had been made to the Local Authority for relevant parties.

Capacity and consent of all people who lived at the home had been reviewed. The registered provider had carried out Mental Capacity assessments for each person who lived at the home to determine their capacity and to look at how people could be involved in decision making. The registered provider recognised whilst people may lack capacity it was important to still involve them in decision making where appropriate.

Person centred care was provided at all times by staff who knew the people well. Staff knew of people’s likes and dislikes and respected these whilst supporting people. Where possible people who lived at the home were encouraged to be involved in the everyday running of the home. There was an emphasis on building people’s skills and promoting independence.

People who lived at the home were asked about the care provided. When people could not verbally communicate staff took the time to observe non-verbal cues to try and understand what the person was thinking and experiencing. This enabled staff to make assumptions on how satisfied people were with the service.

We observed people being kept active and stimulated throughout the day of the inspection. There was no structured formal activity plan on a daily basis but we observed staff taking time out and carrying out 1:1 activities with people during the day. We also saw evidence the registered provider had started to increase links with the local community. We were assured these links were going to continue.

Interactions between the people who lived at the home and the staff were positive. People were treated with respect. We also observed needs being met in a timely manner.

People’s nutritional needs were met by the registered provider. Meals were prepared for people according to personal preferences and health needs. We observed people making requests for meals and these were granted. Support was provided where appropriate at meal times.

The registered provider had reviewed their complaints policy and had implemented a complaints log for all complaints to be recorded in. There had however been no complaints since the last inspection.

Quality assurance systems had been implemented since the last inspection. Feedback regarding service provision had been sought from professionals, relatives of people who lived at the home and the people who lived at the home. This was carried out to ensure people were happy with the care provided.

Staff who worked at the home told us communications with the registered provider had improved. Staff said they were now listened to and involved in making improvements to the service. Staff commended the new atmosphere in the home and the willingness of the registered provider to listen to suggestions.

The registered provider had improved standards of record keeping. Relevant documentation that was required to demonstrate compliance with the regulations was maintained and organised.

The registered provider had taken action to ensure the living premises were fit for purpose. A refurbishment plan had been drawn up by the provider to improve standards around the home.

The service will be expected to sustain the improvements and this will be considered in the future inspections.

08 December 2014

During a routine inspection

This unannounced inspection took place on 8 December 2014.

Evaglades is a residential home situated on the promenade at Morecambe and provides accommodation and support to people with learning disabilities. It is registered to provide personal care for up to eight people. Each room has an en-suite. Rooms are located on two floors with a staircase. At the time of the inspection there were two people using the service.

A registered provider was in post at the time of the inspection. A registered person is registered with the Care Quality Commission to manage the service. 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.

At our previous inspection on 25 September 2013 the provider was assessed as meeting all the requirements set out in the Health & Social Care Act 2008.

Feedback from relatives in relation to care provision was positive. Family members stated that their relatives were happy living at the home. One person who had lived at the home for many years confirmed that they were happy with the care being provided.

We observed staff being caring and interacting with people who lived there in a positive manner. We observed staff using touch and appropriate eye contact to enhance communication and aid interactions. People were treated in a dignified manner at all times, by all the staff.

People’s health needs were monitored and any changes in health needs were acted upon in a timely manner. The home worked with other health professionals to ensure continuity of health care.

Medication was administered safely by appropriately trained staff using an individualised approach. We observed staff seeking consent from each person before administering medication. Staff informed us of people’s preferences surrounding medication administration. We have made a recommendation about the management of medicines.

However, we noted that the safety of the people using the service was being compromised in a number of areas. We found that care plan records and risk assessment records were not always up to date. This meant that people were at risk of receiving inappropriate and inconsistent care because records were not completed appropriately.

We looked at staffing records and found that staff files were missing or incomplete. Staff files were missing references and not every staff member named as working at the home had all the required relevant documentation in place. For example not all staff had a Disclosure and Barring Certificate (DBS) or Criminal Records Bureau (CRB) checks in place. This meant that the registered provider had failed to safeguard people against unsuitable staff because thorough recruitment processes and checks had not been completed prior to commencement of employment. You can see what actions we told the provider to take at the back of the full version of the report.

Staff told us that they were appropriately trained to carry out their role. However we found a lack of systems in place to ensure that there were adequate numbers of trained staff on duty at all times.

The provider did not have an effective training matrix in place and could not verify all training attended by all staff as certificates were missing. Training had not been completed by all staff members in the area of safeguarding. One staff member stated that they knew what defined abuse but they were unaware of who to report it to, should the registered provider not intervene and act appropriately. This meant that people may be at risk of not being correctly safeguarded as staff may not be able to report it appropriately. You can see what actions we told the provider to take at the back of the full version of the report.

We also found that the provider did not facilitate communications between the staff members by holding regular formal supervision and team meetings. This shows that significant information held by individuals within the team may not be passed on or relayed to other staff members. This may lead to inconsistencies in delivery of care. You can see what actions we told the provider to take at the back of the full version of the report.

The home had a poor culture for supporting openness and change. Staff working at the home said that it was sometimes difficult to make suggestions to the registered provider which may be of benefit to the people using the service. You can see what actions we told the provider to take at the back of the full version of the report.

The provider did not seek feedback on a regular basis. The registered provider had not sought feedback on quality assurance as a means to highlight any areas of deficiencies in which improvements could be made. You can see what actions we told the provider to take at the back of the full version of the report.

We were informed that both people living at the home lacked capacity to make significant decisions. However there was no evidence of any capacity assessments being completed in relation to decision making. The provider was not following the Mental Capacity Act 2005 code of practice for people who lacked capacity to make a decision. There was also no evidence available to show that the provider had consulted with other significant people or any evidence of best interest meetings taking place. The provider had not considered making applications for the people who lived at the home to deprive them of their liberty. You can see what actions we told the provider to take at the back of the full version of the report.

We were concerned about the lack of activity and structure at the home. Whilst carrying out the inspection people were not encouraged to be active. The two people sat in the lounge all day watching TV whilst staff went about their jobs. We have made a recommendation about using good practice guidelines to improve the service.

You can see what actions we told the provider to take at the back of the full version of the report.

25 September 2013

During a routine inspection

We spoke individually with the provider and staff at the Evaglades. Because people living at the home had communication difficulties, we were unable to speak to anyone receiving care. Therefore, we observed staff interactions with people in their care. We reviewed staff records, policies and procedures and various audit processes.

We observed staff interacting with people in a supportive and respectful manner. People at the Evaglades had lived there for many years and we observed that staff had an understanding of their needs. This matched their related care plans. Care records were person-centred and reviewed regularly.

An area of non-compliance found at the last inspection had been addressed. The provider had introduced appropriate measures to safely manage medication. We found during our inspection that medication had been given as prescribed.

Staff felt supported in their work and had received training to enable them to deliver care. The Evaglades had additionally undertaken a range of audits to monitor the quality of its service. The service had not received any complaints over the last twelve months and had a complaints procedure in place.

16 April 2012

During a routine inspection

There were two service users at Evaglades, of whom one had no verbal communication. She made her wishes clear by gestures and these were respected by the owner. The other person told us she was very happy and liked living there,and had plenty of opportunity to get out with members of the family, and to college. She enjoyed crafts such as card making, which she was encouraged to take part in.