Archived: Emmaus House Residential Care Home

Emmaus House Residential Care Home is a residential care home providing personal care to up to 26 people. The service provides support to older people and people living with dementia or physical disabilities. At the time of our inspection there were 24 people using the service.

Emmaus House Residential Care Home accommodates people in one adapted building.

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

Although the provider had made some improvements since the last inspection, people were at risk of harm because the provider did not always understand their regulatory responsibilities. Systems were not always in place to assess, monitor and improve quality and safety across the service. The provider had not identified issues we found on inspection including with accidents and incidents and risks to people.

People were at risk of harm as risks to them were not always identified or recorded to guide staff in how to manage these. Where people used specialist mattresses to protect their skin from pressure damage, information on how these should be set was not recorded or known by care staff. Checks on equipment people used, such as bedrails were not always recorded to show their safety had been reviewed. We were not always assured accidents and incidents were reported to external organisations to share this information with them and seek appropriate advice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. We have made recommendations about Deprivation of Liberty Safeguards (DoLS) and CCTV used within the service.

Whilst shortfalls were identified in the leadership of the service, people’s experiences of their care were positive. People received person-centred care and decided their preferred routines. There was a strong culture of providing kind, compassionate care.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk.

Rating at last inspection and update

The last rating for this service was requires improvement (published 03 November 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

We have made recommendations about DoLS and the use of CCTV in the service.

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.

Emmaus House is a modern, purpose built home that can accommodate up to 26 older people in single en-suite rooms. The home is situated in a residential area of Moresby. The home is owned by the Emmaus Trust which is a Christian Brethren charitable organisation.

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

We did find some issues around care and support at night. There were problems related to fire safety because fires drills and instructions were out of date. At times there were only two staff on duty at night and this could compromise safety. The registered manager and the provider started to address this shortly after the inspection and also took advice from Cumbria Fire service.

Medicines were given at 6 a.m. and some people found this a problem as they did not wish to be woken at this time.

Quality monitoring had not been undertaken to a satisfactory level. A review of governance in the home was needed to ensure continued good standards of care were delivered.

Safeguarding was understood by the team but we made a recommendation that management clarify how to report safeguarding matters to CQC and other external bodies.

Staff and the people they supported were happy with care delivery. People were given good levels of personal, pastoral and emotional care from experienced, trained and enthusiastic staff.

We noted that some systems and routines needed to be reviewed to ensure that care plans were followed and that individualised, person centred care was delivered to meet the needs of people. Staff sometimes followed routines that did not meet individual needs. This meant that people were not always supported to have maximum choice and control of their lives

Staff had received training but their competence did need to be confirmed and staff supervision be done regularly.

The team worked with health and social care professionals and were able to contact relevant professionals.

Infection prevention and control measures were taken to keep people safe and to lessen the risk of further outbreaks of Covid-19.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

The inspection was prompted in part due to concerns received about support at night. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

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 changed from good to requires improvement. This is based on the findings at this inspection.

You can see what action we have asked the provider to take at the end of this full 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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

People were safe and protected from abuse and avoidable harm. Risk assessments helped protect the health and welfare of people in the home. People received their medicines when they needed them from staff who were trained and had their competency regularly checked. The home ensured good staffing levels to meet people’s needs. Infection control was well managed and the home was clean and free from hazards.

Staff supported people with their healthcare needs and worked well with external healthcare professionals. People were well cared for by staff who had the right skills, knowledge and training to meet their needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated with kindness and compassion by staff who respected their privacy and dignity. Staff gave people their time and understood this was important in supporting people’s well-being. We received positive feedback from people in the home and their relatives about the caring approach of staff. One relative told us, “I couldn’t believe how good this place is, it must be the best kept secret in Cumbria. The staff are really wonderful and they have never looked so well since coming in here. Nothing is ever done without consultation. It really is my relatives home."

The service put people at the centre of the care they received. People’s changing needs were identified and responded to quickly. The service provided compassionate end of life care and took into consideration the needs of their relatives and friends. Links with local community groups were well developed and enhanced people's lives. There was a wide range of organised activities and entertainments for people to choose from.

The home was well-led by the registered manager, with support and oversight from Emmaus Trust Board. Together they carried out safety and quality checks of the home. Staff felt valued and enjoyed working at the home. People's views about the quality of care were being used to make improvements. Everyone we spoke with told us they would recommend the home.

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 10 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Emmaus House Residential Care Home, (Emmaus House), provides accommodation and personal care for up to 26 older people, people living with dementia and people who have a physical disability. The home is in a residential area of Moresby, Whitehaven. Accommodation is provided in single bedrooms over two floors. There are a range of sitting rooms and a large dining room that people who live in the home share. The home is owned by Cumbria Emmaus Trust. Cumbria Emmaus Trust is a registered charity formed to provide residential care for older people of the Christian faith.

At our last inspection of the home in October 2014, the service was rated Good. The service was meeting the fundamental standards of quality and safety. However we found some aspects of the safety of the service required improving. One issue had not been reported to the local safeguarding authority when required and the management of medicines needed to be improved.

At this inspection in July 2017 we found the service remained Good. Medicines management had improved and people were safe and protected against abuse.

There were enough staff to provide people’s care. Robust systems were used when new staff were employed to check they were suitable to work in a care service.

People enjoyed a choice of meals and drinks. The staff were trained and competent to provide people’s care. People were supported by appropriate health care services to maintain their mental and physical health.

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 agreed to the support they received and their rights were protected.

The staff were kind and caring to people. People liked the staff and enjoyed laughing and joking with them. The staff gave people the time they needed to carry out tasks themselves and to maintain their independence.

Care was planned and delivered to meet people’s needs. People were included in planning their own care and expressing what was important to them. People enjoyed a range of activities that they enjoyed and that supported their spiritual needs.

There were systems in place to ensure the effective management of the home. People were asked for their views about the service they received. The registered provider and registered manager maintained good oversight of the quality of the service to ensure people received high quality care. The registered provider was open to advice to further improve the service provided.

Further information is in the detailed findings below.

We discovered that people were treated respectfully and that their consent was obtained before any care intervention.

People told us that they were happy with the way the staff team provided them with care:

"The staff are wonderful...I have no complaints."

"This is the best home in the area and I have no regrets about coming here."

"We get excellent care here..."

People received good levels of personal and health care. People who lived in the home were full of enthusiasm about the varied activities and entertainments on offer. One person said:

"I go to the services and I go out to church but I also go shopping and last week I went ten pin bowling...plenty to do here!"

The building was clean, well maintained and suitable for the needs of the people who lived there. People said:

"The house is always warm and clean and I like my room."

"It is very nice here and I like to sit in the main lounge and look out over the garden and the view..."

We found that the home had suitable equipment to help people with their mobility and to help them to get the care and support they needed.

Staff recruitment and staff disciplinary matters were dealt with appropriately.

There were up to date and detailed records kept about all aspects of the operation of the home.

"Living here is like being on a long piece of elastic. It gives you lots of freedom but stops when you over stretch yourself".

We heard about the respectful and dignified care given by the staff team. People in the home were relaxed and happy and had only positive things to say about their lives.

"We have plenty of activities ...including worship...I am well cared for and I feel I am important to the staff."

People were very complimentary about the food provided. We saw plenty of evidence to show that staff paid a lot of attention to nutrition and hydration.

Medication and health care were well managed and people got the right levels of support to keep well and comfortable.

Staffing levels were good and met the needs of the people living in the home. The staff team were skilled, knowledgeable and well supported.

The Emmaus Trust who operated the service had a detailed and effective way of monitoring quality and in ensuring good care and services were maintained.

The service had received no formal complaints but people in the service were empowered to speak up and ask for what they wanted and needed.

"I have never had to complain. All my wishes are respected. I wouldn't be afraid to speak up if I had to. In fact I am encouraged to say what I think and to make suggestions."