Essendene EPH

We found the following examples of good practice.

New residents were admitted following Covid19 negative test result and remained in isolation until their 14-day isolation was completed.

At the time of the inspection visits inside the home were only allowed in exceptional circumstances such as end of life. At such times special arrangements would be made, sensitive to the needs of the person and their visitors to ensure the safety and wellbeing of all concerned.

People could keep in touch with their relatives by phone, video calls and closed window visits arranged with the home. The provider had acquired an intercom to improve communication during closed window visits.

The atmosphere in the home was sociable and welcoming. People told us that they felt safe and well cared for and made positive comments about the staff including: “The home is very nice and staff are lovely” and “ Yes everything is fine the care is very good, they treat me respect and yes I am involved in decision making.”

Whole home testing was in place for residents and staff and the registered manager maintained detailed records of each test, its reference number and outcome.

A member of staff is designated COVID19 lead on every shift and was responsible for carrying out all associated checks and ensuring all appropriate safeguards were in place.

Staff had benefited from training, support and guidance on infection control including COVID19 and demonstrated skill and confidence in the way they carried out their duties and responsibilities.

Staff had access to the personal protective equipment (PPE) they needed and there were PPE ‘stations’ situated at various locations around the home.

Additional cleaning staff had been appointed since the start of the pandemic. The home was clean and free of malodour throughout. Enhanced cleaning schedules had been introduced and monitored closely by senior staff to reduce the risk of transmission of COVID-19.

Further information is in the detailed findings below.

Essendene accommodates 13 people in one building. At the time of the inspection, 8 people were living at the service.

There was a registered manager in post. 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 registered manager had been in post since the 21 December 2017.

At the last inspection, the service was rated overall Good. At this inspection we found the service remained Good.

Why the service is rated Good:

People told us they felt safe and relatives felt very confident that their family members were well looked after.

The premises were clean and safe for people as regular checks of the environment and any equipment were undertaken.

People received safe care as any risks had been identified and action taken to reduce any risk of harm. However, improvements were required to the way in which these were documented.

Care plans for people new into the service were personalised but improvements were required to ensure that the care plans for long standing residents were as up to date and detailed in their content. There was a detailed monthly review that reflected peoples' current needs.

People remained protected from the risk of abuse as staff had received training and understood their safeguarding responsibilities and the reporting process.

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 were supported to have enough to eat and drink and received timely support to access healthcare professionals when their health needs changed. If people had particular wishes for end of life care these were discussed and recorded.

There was a stable staff team many of whom had been at the service for a number of years. They were observed to be kind, caring and knew people well. People received care and support how they liked it and their independence was encouraged.

People's viewpoints were actively sought and the service responded positively to feedback and complaints. The home environment was warm and welcoming with lots of opportunities for activities, stimulation and social interaction that met people’s needs and preferences.

Staff received training and support with learning to help equip them with the skills and knowledge required to support people effectively. Staff felt well supported through the supervision and appraisal process and the regular presence of the management team.

There was robust oversight of the service and clear lines of accountability at staff, management and provider level. The registered manager and provider were at the service on a daily basis.

Lessons were learned from accidents, incidents and complaints. These were recorded with actions taken to minimise the risk of re-occurrence.

The registered manager was new to this position, having previously been a member of the care team. They were in the process of reviewing and putting into place more formal quality assurance systems place to monitor the safety and effectiveness of the service and drive improvements.

We observed the lunchtime period at the home. We saw staff assisted people to eat where they were not able to feed themselves. We saw that staff who were assisting people to eat were sat down with the person concerned and gave them undivided attention. We saw that people who used the service and staff interacted positively throughout this period. Drinks were served throughout lunch to ensure people remained hydrated.

At the beginning of our inspection we were given a tour of the home by a senior member of staff. We found the home to be very clean throughout.

It was clear that people were given the right information of who to complain to if they weren't happy or had any concerns about the service.

We looked at four staff personnel files during our inspection. We saw that Criminal Record Bureau(CRB) disclosure checks, and more recently Disclosure and Baring Service checks(DBS), were completed for all members of staff.

People experienced care, treatment and support that met their needs and protected their rights. Everyone we spoke with liked living there. One person who uses the service said, "You couldn't get a better place. They look after you and that's what matters." Another said, "They look after you pretty well. They are nice people. Very pleasant and understanding."

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

There were enough qualified, skilled and experienced staff to meet people's needs. One person who uses the service said, "This is a smaller home so you get more individual attention."

We found that the provider had an effective system to regularly assess and monitor the quality of service that people receive. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others. One family member said, "The home is fabulous. They are always doing something. The care staff here are lovely. They are very approachable."