You are here


Inspection carried out on 23 March 2017

During a routine inspection

Mount Ephraim House is registered to provide care and accommodation for up to 38 older people. On the day of our inspection there were 36 people using the service.

At the last inspection in November 2014, the service was rated Good overall and we rated the service outstanding for our key question, ‘Is the service responsive?’

At this inspection, we found the service remained Good and demonstrated they continued to meet our regulations.

People told us they continued to receive safe care and were happy living at the service. Staff consistently provided care that was responsive to people’s needs. People remained safe from potential harm because staff were regularly trained to identify abuse. Staff understood their responsibility to report any concerns and were aware of safeguarding procedures to follow to keep people safe. Staff continued to assess and manage risks to people’s safety. Risk management plans remained effective and had enough guidance on the action staff had to take to keep people safe from avoidable harm.

Medicines management systems remained effective. People’s medicines were administered safely by trained staff and securely stored. The provider’s recruitment procedures ensured staff employed were suitable to provide safe care. People received appropriate care and support from a sufficient number of staff. Staff were competent in their role because they received support, training, supervision and appraisal to improve their knowledge and skills.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice. Records showed staff respected people’s choices on decisions about their care and supported them to be as independent as possible.

Staff were kind and caring and had developed positive relationships with people. People received care from staff who knew them well and understood how they wanted to be supported. People continued to receive their care as planned and in line with their needs and preferences.

People were involved in the planning and review of their care and support plans. People’s health needs were assessed, reviewed and met in a creative manner. Staff provided care that was responsive to people’s changing needs. Support plans were effective and contained guidance to staff on how they were to provide care in line with people’s wishes.

People enjoyed the food provided at the service and their dietary needs were met. Menu plans showed healthy options and included people’s preferences and choices. Staff continued to support people to access healthcare professionals when needed. Feedback for health care professionals was very positive and confirmed the service remained proactive and worked with them to better people’s lives.

People continued to receive person centred care. People, their relatives and health and care professionals said care at the service was empowering and enhanced people’s quality of life. People remained involved in a wide range of stimulating activities of their choice which they liked. People had access to various unique lounges, communal and recreational areas that allowed them to enjoy different activities, quiet times and receive visitors.

The service was decorated and the environment adorned with people’s artwork and seasonal themes such as a summer at the beach and decorations which kept people stimulated and engaged. People led meaningful lives at the service and were always kept occupied. Care plans provided details of people’s hobbies, interests, preferences and what was important to them and the support they required from staff to achieve their goals. Staff knew people`s needs and ensured they provided appropriate care and support.

The registered manager continued to demonstrate good leadership and commitment to improving the service. They were passionate and determined to continue delivering outstanding care and ensured s

Inspection carried out on 10 November 2014

During a routine inspection

The inspection took place on 10 November 2014 and was unannounced. At our last inspection on 3 July 2013 we found that the service met the essential standards of quality and safety we looked at.

Mount Ephraim House is registered to provide care and accommodation for up to 38 older people who required varying levels of support to manage conditions such as diabetes, the after effects of stroke and other illnesses that are often associated with old age or dementia. Some people required support to move around. The premises are detached with accommodation arranged over two floors. There were a variety of communal areas where people could relax, have meals or take part in activities. Bedrooms were located on the ground and first floors, and most bedrooms could be accessed via a passenger lift. Some people who were active and independently mobile occupied bedrooms without lift access. The home is situated in a residential area near to the centre of Tunbridge Wells.

There was a registered manager at the service. 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.

The provider had taken steps to make sure that people were safeguarded from abuse and protected from risk of harm. People told us they felt safe. People were protected from harm; risks to their safety were assessed and managed appropriately. People were involved as far as possible in their assessments and action to minimise risk was agreed with them.

The provider operated safe recruitment procedures which included carrying out legally required checks on every applicant to make sure they were suitable to work with the people who lived at this service. Staff told us there was a good atmosphere and staff worked as a team. They told us there were enough of them to care for people and keep them safe. People told us they did not have to wait long when they needed help or support.

Staff were provided with suitable training to enable them to carry out their roles. People told us staff were, “Marvellous, really wonderful”, “Very attentive” and “You can’t fault them”. Staff understood their roles and responsibilities. They told us they felt well supported and were provided with essential training, including induction, to make sure they had the knowledge and understanding to provide effective care and support for people. All staff received regular supervision and appraisal to make sure they were competent to deliver appropriate care and treatment.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Whilst no-one living at the home was currently subject to a DoLS, we found that the registered manager understood when an application should be made and how to submit one and was aware of the Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. These safeguards protect the rights of people by ensuring if there were any restrictions to their freedom and liberty these had been authorised by the local authority as being required to protect the person from harm.

Staff received Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) training to make sure they knew how to protect people’s rights. Staff understood the importance of obtaining consent from people before care or treatment was provided.

People told us they enjoyed the food, describing it as, “Hot and tasty” and “Lovely meals. People said there was always enough to eat and drink. People were offered choices and those who needed support to eat were helped discreetly.

People were supported to manage their health care needs. People told us they could see a doctor whenever they wanted to. One person said, “If I said I don't feel well staff would assess if I needed a doctor and they would ring for one”. Records showed that people saw other health professionals when they needed to.

People were treated with respect, kindness and compassion. They described the care as “Excellent”, “Staff are kind and don’t grumble” and “Couldn’t be any better”. All agreed that they felt listened to. Each person had an individual care plan. These were continually reviewed and updated to make sure all their needs were understood by staff who provided their care and treatment. People told us they had been consulted about how they wanted their care to be delivered.

Information about people was treated confidentially and records were stored securely. Staff were careful to protect people’s privacy and dignity. People received personalised care or treatment when they needed it. People told us they did not have to wait long if they needed any help. Staff knew people well. They were calm and patient with people, they communicated effectively and responded quickly and appropriately to people’s requests. Staff offered people choices such as what they wanted to eat and where and how they wanted to spend their time.

People’s needs were assessed with them before they moved to the home to make sure the home was suitable for them. Care plans were regularly reviewed with the person concerned to make sure they were up to date and reflected their individual preferences, interests and aspirations. There were a wide variety of meaningful activities on offer to suit everyone’s tastes. Everyone we spoke with told us they enjoyed the activities. There was a clear complaints procedure. There had been no complaints about the service. All the people we spoke with felt able to raise any concerns with staff or the management.

People spoke positively about the way the home was run. They told us the manager and staff were approachable. People said, “They are all wonderful. We are really blessed to be here”; “It’s very homely”; “A friendly, family environment”. The organisation had clear vision and values. These values put people at the centre of the service and had been successfully cascaded to staff. People were comfortable with the management team and staff in the home. Staff understood their roles and responsibilities and the staff and management structure ensured clear lines of accountability.

In November 2014 Mount Ephraim House won the LaingBuisson Residential Care Provider 2014 award. This is a national award, judged by an independent panel of professionals who look for organisations and individuals who have made an outstanding contribution to healthcare during the year.

There were effective systems in place to review the quality of all aspects of the service regularly. Improvement plans were developed where any shortfalls were identified. Customer satisfaction surveys and regular ‘resident’ and relatives’ meetings gave people the opportunity to comment on the quality of the service. People were listened to and their views were taken into account in the way the service was run. Any accidents and incidents were monitored to make sure that causes were identified and action was taken to minimise any risk of reoccurrence. The management team and staff had found innovative and creative ways to enable people to remain independent and to live fulfilling lives that met their aspirations and wishes.

Inspection carried out on 3 July 2013

During a routine inspection

At the time of our inspection, there were 35 people living in the home. We spoke individually with six people and with some other people when they were together at lunchtime or taking part in an activity.

People told us they were able to make choices about their lives and how their care and support was delivered. They said staff treated them respectfully and understood they liked to do as much as they could for themselves. People�s records were regularly reviewed and kept confidentially.

People said their health care needs were well met and they saw health professionals when they needed to. We found that the staff worked well with healthcare professionals and were receptive to any advice and support they provided. Care plans and risk assessments were in place and reviewed regularly to minimise identified risks to people.

Overall, people told us that the food was good and that there were always alternative choices available. People said that they could spend their time as they chose. A visitor told us they visited regularly and had never had any concerns.

People were complimentary about staff they told us �they are brilliant� and �the carers are marvellous�.

People were asked for their views about the service and were listened to. People we spoke with were satisfied with the care they received. One person told us �It is 100%, it is marvellous� and another person said �it is as much as possible like being at home�.

Inspection carried out on 29 August 2012

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service. We spoke individually with five people and with one visitor, read records including care plans and observed people during the day. This included observations of how people interacted with staff.

People told us they liked living at Mount Ephraim House and that they were involved in making decisions about their daily care and support.

People we spoke with said they were given choices about their daily routines, such as when to get up and go to bed, what to eat and what to do each day and that their choices were respected by staff.

People said they had opportunities to take part in a range of activities. People told us there was plenty of variety of activity, that activities were promoted and they were given information about them verbally an on the activities programme on display in the dining room.

People confirmed that their independence was promoted and staff supported them to do as much as they could for themselves, for instance to support them to access the community independently or with personal care.

People told us that staff were kind, caring and respectful. They said �it is the staff that make all the difference �, �staff respect that I prefer to spend time in my room as I do not like a lot of noise� and �the care is not patronising�.

People told us that overall they liked the meals, mealtimes were flexible there was always a choice on the menu and they could choose where to take meals. One person said there were �delicious meals �and another that �meals are adequate, they are not bad really�.

People liked their rooms and said their bedrooms and the rest of the building were kept clean. They said they felt safe at Mount Ephraim House.

Inspection carried out on 22 October 2011

During a routine inspection

We were told that, as far as practicable, independence and individuality are promoted within the Home. People living there are supported, enabled and encouraged to express their views and make or participate in making decisions relating to their care and treatment. We found that systems for consultation, interaction and communication are effective and individuals have their privacy and dignity upheld. During our visit people were observed being spoken with and supported in a sensitive, respectful and professional manner.

One person told us �I enjoy living here, it�s quite comfortable. I get to go on trips, sometimes we go out for the day. It�s easy to get hold of staff if I need them�.

People told us that they felt safe and were well cared for by staff. One person said �Oh yes, I do feel safe here�. Another said �I feel safe here, the staff are very good�.

We found that systems for quality assessment and improvement were in place. Information about people�s experiences had been asked for and gathered in such a way to allow for monitoring of risks and the quality of care delivery.

Reports under our old system of regulation (including those from before CQC was created)