The Care Quality Commission
  • Care Home
  • Care home

Archived: Edenmore

Overall: Requires improvement read more about inspection ratings

7 Hostle Park, Ilfracombe, Devon, EX34 9HW (01271) 865544

Provided and run by:
Alexis Care Limited

Important: The provider of this service changed. See new profile

All Inspections

3 and 5 March 2015

During a routine inspection

This inspection took place on the 3 and 5 March 2015 and was unannounced.

Edenmore is registered to provide nursing and personal care for up to 48 people. At the time of the inspection there were 38 people living at the service. Most people were living with dementia and health conditions related to older age.

The service has a registered manager who has been in post for over ten years. 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.

Not all care staff had a good understanding of the Mental Capacity Act 2005 and Deprivation of Liberty safeguards. Staff were assisting people to make choices in their everyday lives but where people lacked capacity, staff did not always understand the law which underpinned those people’s rights.

Some wheelchairs and parts of the kitchen were in need of cleaning, although most other parts of the home were kept clean and fresh smelling. There were some arm chairs which were dirty and one had a hole in the arm rest which would have made it difficult to keep clean and free from cross infection. When highlighted this armchair was removed and the kitchen and wheel chairs were cleaned.

Systems were in place to ensure people were protected from the risk of cross infection. Although there were  individual risk assessments or care plans in place for people who had been ill recently with sickness and diarrhoea, we were told these had been archived.

Care and support was being well planned and staff had a good understanding of how to support people. However some records relating to some individual’s had not been updated to reflect their changing needs. The service was in the process of introducing having a named nurse for each person, who would have responsibility to ensure the care plans and risk assessments were kept up to date. They were confident this would ensure all plans were updated in a more timely way.

The staff team were well established, trained and supported to meet people’s needs. They had a good understanding of people’s wishes and preferred routines and planned their care and support in line with people’s needs and wishes. There were sufficient numbers of staff on duty across all shifts to meet people’s needs in a timely way. The nursing and care staff were supported by cooks housekeeping, administrator and maintenance personnel. People and their relatives spoke highly about the caring attitude and skills of the staff at Edenmore. One person said ‘‘This place is brilliant. Nothing is too much trouble. I feel cared about here. Everyone puts themselves out to be helpful and kind.’’

The service had a robust recruitment process to ensure only staff who were suitable to work with vulnerable people were employed. New staff received an induction to help them understand their role, but this had not always been fully documented.

Medicines were safely stored and administered by competent staff, but records were not always clear when a variable dose of medicines had been prescribed.

People were supported to eat and drink and where risks of poor nutrition had been identified, this was closely monitored. People’s health care needs were being met and monitored.

Staff reported that they felt well supported and had confidence in the registered manager. Staff felt their concerns, ideas and suggestions were listened to and acted upon. There was an ethos of caring and supporting people and the staff team. Staff described the service as a caring environment and a ‘‘good place to work.’’ There was a planned training programme covering all aspects of health and safety and some more specialised areas such as working with people with dementia care needs and care of the dying. Staff had regular opportunities to discuss their work and receive support and supervision, although this was not always recorded.

Systems were in place to ensure people and their family had opportunities to have their views heard both formally and informally. Relatives reported they were made to feel welcome and had opportunities to talk to staff and registered manager about any concerns or ideas they had in relation to any aspect of the running of the service.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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

28 June 2013

During an inspection in response to concerns

We completed a planned inspection of this service on 15 May 2013. We had brought forward this planned inspection as we had received some information of concern that suggested people may not have had all their care needs met. We did not find any evidence to support this.

We completed this responsive inspection in response to some serious information of concern about one individual who was alleged to have been given more medication than they were prescribed and that staff were not attending to people's needs, with personal care and assitance to eat meals.

We found there was a serious error in the medications of one person, but saw this was an error from the pharmacist who dispensed the medication. We saw the agreed medication change had been written by the nurse within the care records, and nursing staff should have double checked this. The manager had put in a new system of having a coloured form within the medication records, to show any agreed changes to medication that were received via phone calls. This meant nurses would have clear information to check and would assist in reducing the possibility of further similar errors occurring.

We saw the service had recording all times when care and nursing staff have attempted personal care and when personal care had been successful. There had been occasions when some people were resistive to having their personal care needs met, due to their dementia type illness.

16 May 2013

During a routine inspection

We brought forward this planned inspection as we had received some information of concern about people's care needs not being met. During this inspection we spoke with six people who currently live at the home were able to give their views. We also spoke with four visiting relatives. We spoke with three nurses, three care staff and the manager. We spent time looking at some of the key documents. These included care plans, risk assessments, staff rotas and quality assurance audits. This helped us to understand how well the home was being run.

We saw that care and support was well planned by a staff team that understood people's needs and used specialist support when needed. People we spoke with who were able to give their views were very complimentary about the staff. Comments included '' I haven't been here long, but the staff have made me really welcome. I feel safe here and I want to stay. I don't want to go back to how ill I was before I came here.''

We saw that although staff were busy, care and support was being given in a timely way and people's personal and health care needs were being met.

There were systems in place to check and monitor the quality of the service provided. This included seeking the views of people living there, their families and staff.

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2 August 2012

During a routine inspection

This inspection was unannounced and took place on 2 August 2012. The visit lasted eight hours and 20 minutes. We last visited Edenmore on 21 October 2011. No compliance actions were made on this inspection as the home was compliant under the Health and Social Care Act 2008.

The manager told us that there were 44 people living at the home. During this visit, we spoke with twelve people who lived at Edenmore and eight people were able to comment directly on their care. Most people were not able to comment directly on their care so we spent time with them to help us understand what life was like at the home. This meant we spent time observing care and people's interactions with staff to see whether they had positive experiences. To do this we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us about their experiences of care. We spent time in the dining room and two lounges, which helped provide insight into the quality of people's care. We also completed a tour of the building with the registered manager and we met with people who were spending time in their rooms.

We also spoke with four staff members and the manager. We looked at the care plans for three people, which included completed health and social care assessments.

People looked well cared for and appeared to be dressed appropriately. Some people told us about their choice of clothes and we could see that people's care plans recognised the importance of supporting people to choose what they wanted to wear.

Three people told us how their dignity was respected by staff who supported them with personal care. They told us they did not feel embarrassed and felt at ease with staff. During our visit, we looked to see how people living at the home reacted to staff. We saw that people looked at ease and many had a joke with staff, who responded with affection and in a caring manner.

Seven people told us about the choices that were promoted within the home, such as when they got up and went to bed. Three people commented positively on the choices available at mealtimes, and told us that they could ask for alternatives. We could see in people's care plans that their food preferences, and general likes and dislikes were recorded.

Our conversations with people living at the home confirmed that they were happy with the quality of care. People told us about their lives and their experience of care and everyone we spoke with were positive about the support offered by staff. We spoke to three relatives and they confirmed this view.

People told us that they were happy with the quality of the food; some felt it had improved with the arrival of a new cook. We heard people talking to staff about their meal. Staff observed people's body language, for example they responded by checking with people if they were thirsty or uncomfortable.

People told us about their opportunities to be involved in activities in the home, although one person said they would like to do more but were unclear what they would like to do.

People that we met during our visit indicated from our conversations with them and from our observations of their body language that they felt relaxed in their surroundings. People appeared comfortable with staff and people told us they felt listened to by staff. We met three relatives who were positive about the quality of the care and told us that they had no concerns regarding the way the service was run.

Five people living at the home told us that their rooms and the home were kept clean. They told us they were happy with their surroundings.

People that we spoke with said there was enough staff to meet their care needs, although one person said that they had to wait longer in the evening for assistance, although they confirmed they were still able to go to bed at their preferred time.

During our inspection, we saw that staff were busy but the atmosphere was organised and staff were not rushing people as they assisted them, for example, supporting people to have a drink. We saw staff stopping to have a chat with people and a few people were engaged in activities, such as craft work and having their nails painted. We also observed that staff who were not involved in caring, interacted well with people living at the home creating a friendly culture in the home.

24 October 2011

During an inspection in response to concerns

We carried out this responsive review in response to concerns that we received.

The information focused on key themes, which highlighted that the home may not:

' Respect people as individuals

' Understand how to manage challenging behaviour in a way that does not breach people's human rights.

We carried out a responsive review with a visit to Edenmore Nursing Home on 21 October 2011 and because of the concerns we looked at the key outcomes 1 and 4. The purpose of this review was to check compliance in these key outcome groups for people currently living in the home.

We looked at the experiences of one person in detail, by observing how they were being supported, looked at their records and, where possible, spoke to the person and care workers supporting them. We observed eight other people being attended to whilst we were visiting.

We saw that there were no restrictions placed on people who may, for some reason, present with challenging behaviours. For example we saw that care workers were very skilled in diffusing situations quickly, ensuring that people felt valued as individuals and enabled to improve their quality of life.

People we spoke to and who were able to comment said that Edenmore was a 'very good place to be'. We saw that people are treated with dignity and respect.