Archived: Essex House

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Is the service safe? Records showed staff had received training in safeguarding, health and safety, food hygiene, infection control and medication administration. Staff we spoke with confirmed this was the case. We checked the storage of medicines and the medication administration records and found these were up to date and accurate. This showed the provider had appropriate systems in place to ensure people received their medicines safely.

Is the service effective? Staff explained the induction process they completed and we reviewed staff training records which confirmed this. This demonstrated staff had the necessary skills to meet people's needs. During our visit we noted the menus offered a nutritional and varied diet and people were offered drinks regularly. The cupboards and fridge freezer contained a variety of low fat food and drinks to offer people. This meant that people were protected from the risks of inadequate nutrition or dehydration.

Is the service caring? We observed staff speaking to people using a kind and respectful tone. For example, we saw one staff member using pictures to help a person to communicate and giving praise when they used the correct word. A staff member told us 'I am here for them, [the people using the service], and to give them what they need, I am not here for myself or the staff.' This showed that staff developed positive caring relationships with people.

Is the service responsive? People had an assessment of their needs done prior to moving into the service and this contained contributions from their relatives or representatives. Each person had a care plan and this contained their likes, dislikes, medical needs and communication needs. Staff were able to describe what was contained in the individual care plans and the care plans had been reviewed in the previous three months. This meant that people could be confident that their care plan contained accurate and up to date information.

Is the service well-led? The provider had a system in place to obtain the views of people using the service, their representatives and staff. There was also a system of carrying out daily health and safety checks. Staff we spoke with told us they felt able to approach the manager if they had any concerns and confirmed they had regular supervisions. We checked staff records and found this to be the case. This showed that the provider promoted an open and fair culture.

Relatives told us they had observed staff asking for and obtaining people's consent before providing care. We found that people had signed care plans and consent forms.

People had assessments of their needs and risks. Files contained health action plans and care plans showing how management of risks was balanced with people's rights and independence. People were able to take part in a range of activities. There were arrangements to deal with foreseeable emergencies.

People said the food was "nice." However, we found that menus were not planned to provide a variety of suitably nutritious food. Relatives said "they need to watch her diet" and that they felt menus could be improved.

We found adequate standards of cleanliness were maintained and people were encouraged to keep up good hygiene practices. Relatives told us the home was "generally very clean."

There were not effective recruitment and selection processes in place. The provider had not ensured that any gaps in employment were explained and had not always obtained evidence of suitable qualifications. Relatives told us staff "seem quite experienced" and that they were "always respectful."

People's personal records including medical records were not accurate and fit for purpose. Some information was missing, duplicated or out of date.

People were supported in promoting their independence and community involvement. Staff stated that people who used the service attended regular weekly activities such as attending day centres and going swimming. One user stated 'I like it here, staff take me swimming a lot.'

Care plans clearly documented the care and welfare needs of each person and also contained health action plans. People who used services were involved in all reviews and assessments.

The provider had clear policies and procedures in place that address safeguarding. The staff and the manager were able to describe the types of and signs of abuse and discuss the actions they would take and who they would involve and inform if they suspected abuse had taken place.

We saw audits that were carried out by the provider annually. These audits mainly covered the CQC's outcome areas. The audits detailed how outcomes where being met and where they were not an action plan was produced which was monitored and reviewed quarterly by the manager.