Emmaus House

The inspection took place on 4 and 19 January 2018. The first day of the inspection was unannounced and the second day was arranged in advance.

At the last inspection, in December 2015, the service was rated ‘Good’. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

A manager started at the service in November 2017 and they had applied to the CQC to become the registered manager. The manager was away from work on the first day of our inspection, but was available for the second day. The deputy manager, operations manager and other members of the staff team assisted us throughout the inspection.

Informal quality assurance checks, alongside monthly provider visits, were completed. The manager was in the process of implementing the audit system, which had not been used due to the absence of a registered manager.

People within the service reported feeling safe and staff training and practice supported this. Staff understood potential signs of abuse, their responsibilities to report any concerns and how they would do this.

Detailed risk assessments described the actions required to keep people safe and reduce potential risks. This is a small service with a consistent staff team and staff knew the needs of the people they cared for.

We found medication was stored, recorded and administered safely.

Staff continued to be recruited in a safe manner to ensure their suitability to work within the service. Staff received training in relation to their role and reported feeling well supported by the management team. Support was provided by way of team meetings and supervisions. Appraisals were in the process of being completed.

People reported the food at the service was excellent. We observed a lunchtime meal and noted a relaxed atmosphere with food that looked appetising. People were supported to eat and drink and risks in relation to nutrition were responded to.

We found the environment was immaculately clean and tidy. The dining room had recently been updated and further improvement plans were in progress. The environment was not specifically designed to be ‘dementia friendly’ and would benefit from further consideration to this.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

We received positive feedback about the staff team. Staff were caring in their interactions with the people who used their service and we observed patient and discreet care being provided. People’s dignity was promoted.

Assessments and care plans were completed which contained person centred information. Activities were arranged for people within the service and the manager was in the process of further developing these.

People understood how to make a complaint. There had been no formal complaints within the last 12 months.

A further detailed summary is provided below.

During the inspection five key questions were answered; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service, their relatives and the staff told us.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

All the people we spoke with told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported. One person told us, 'There is definitely no abuse here, I really do feel safe.' Another person also told us, 'Yes, I am well looked after, I do feel very safe here.'

All the people we spoke with told us the care delivered by the staff was of a good standard. One person told us, 'The staff are so patient and attentive.' Another person told us, 'Oh, the staff are very helpful. They are so patient and know how to help me'. A relative we spoke with told us, 'The staff are very good. They do a good job'. We saw the staff had been well trained and supported in their work and they told us it helped them deliver good care.

We spoke with staff about Deprivation of Liberty Safeguards (DoLS). The registered manager told us there had been no applications submitted in the last year. We saw the policy and procedures they followed. They told us all staff had received relevant training and had access to the policy and procedures. Those staff also told us they had received this training.

Is the service effective?

People told us they were involved in their care. They had regular residents' meetings. One person told us, 'There are residents' meetings and you can raise things. I find it just as easy to talk to the staff if I have any issues and they sort it.' The staff told us they always asked people if they were happy and required assistance before providing help. All the people we spoke with confirmed this and told us they were always asked by staff if they needed help or assistance.

People explained how their care and welfare needs were met. All the people we spoke with told us they had support with health appointments and felt the service was flexible. One person told us, 'I needed help with my walking and staff arranged for me to have a zimmer to help with this. I just need to ask them if I think I need an appointment with a doctor or a physiotherapist'. Another person told us, 'I see a district nurse for small things, the staff help with this.'

All the staff told us they felt supported in their work. They told us they received a full training programme. One person told us, 'When I started I had the opportunity to shadow other staff. I had a few weeks of induction.' Another staff member told us, 'I feel I can approach a senior or the manager at any time. I have supervision regularly and the training is very good.'

Is the service caring?

All the people we spoke with told us they felt well supported and cared for by the staff. One person told us, 'The staff are marvellous. They are very good, such a good sense of humour. They are so caring and patient.'

We saw the staff communicated well with people and were able to explain things in a way which could be easily understood. We saw they did not rush people in the home and we saw the interactions were caring. The relative we spoke with said they felt the care was very good.

We saw people were treated with respect and dignity by the staff. We saw people were given choices in their care provided and all the relatives we spoke with told us they were very happy with the care.

Is the service responsive?

The relative we spoke with told us the service had been very responsive and told us, 'When I have any issues I go and speak with the manager and things will always be responded to. They keep me well informed about things.'

All the people we spoke to told us staff would respond to any of their requests for support. One person told us, 'The staff do encourage us to do things for ourselves.'

We saw staff responded to people's requests for help in a timely way.

Some of the people we spoke with told us they were involved in decisions about their care. They told us the staff were flexible and responded to their requests promptly. One person told us, 'I like to stay in my room for some of my meals. I like to go to the lounge when there are activities on'.

People's care needs had been reviewed at least every month. We saw how when people's requirements had changed the provider had responded. Care needs had been reviewed so changed support and care needs could be met.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service well-led?

We spoke with the registered manager. They showed us there was an effective system to regularly assess the quality of service people received. We found the views and opinions of people, relatives and staff had been regularly recorded and responded to. The manager showed us how they had responded to requests for different activities or suggestions about improvements to the home.

We saw the home had systems in place which made sure managers and staff learnt from any accidents, complaints, whistleblowing reports or investigations. This helped reduce the risks to people and helped the service to continually improve.

Staff told us they understood their roles and responsibilities. Staff had a good understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure people received a good quality care service at all times.