Archived: Ephraim House

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff and from looking at records. We requested information from the provider and spoke with three community based health care professionals who visited the service on a regular basis.

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

Is the service safe?

People who used the service told us they felt safe. When people were at risk staff followed risk management procedures to protect them. Systems were in place to make sure managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people were safeguarded as required.

A member of the management team was available on call in case of emergencies. Staff had received training to meet the needs of the people living at the service.

Is the service effective?

People's health and care needs were assessed with their involvement. Areas of the support required for each person had been identified in care plans. Records, our observations and discussions with staff confirmed that this support was provided.

Is the service caring?

People were supported by kind and attentive staff. Our discussions with staff on duty and our observations of the care and support provided confirmed this. We saw that care workers showed patience and gave encouragement when supporting people. People using the service told us "everything's perfect here", "the staff are brilliant- they help me with forms", "my keyworker is a top woman. She really helps me" and "it's fine here- the staff help me with my cleaning."

Is the service responsive?

The service responded quickly when people needed extra support from their health professionals. People had requested a different range of leisure activities and the service responded by arranging them. People knew how to make a complaint if they were unhappy and had frequently been asked for their views of the service. We saw that the provider used this feedback to improve the service. This meant people could be assured that their views were taken into consideration in regards to the running of the service.

Is the service well-led?

The service was well- led. The provider visited the service often and followed up on any quality issues identified. The service worked well with other agencies and services to make sure people received their care in a joined up way. Recruitment was underway for a new home manager and the service was being managed by an experienced senior support worker when we visited.

We observed staff communicating with people at the service. They engaged positively with them and showed a good understanding of their support needs. Staff ensured people gave their consent to the support offered and people we spoke with confirmed that staff included them in decisions about their daily lives.

There were appropriate arrangements for the supporting people in the self administration of their medicines.

There were enough staff to meet people's support needs and staff were approriately supported in relation to their responsibilities.

We spoke with one of the placement authority's care co-ordinators for people at the service. They told us that there had been some discussion with the service about how to ensure some people's needs set out in their support plans were best provided face to face by staff on a day to day basis. Staff now had a clear understanding of this and there were currently no concerns about the service provided.

People told us that if they had any problems or concerns they would speak to the manager or other staff, who were always available and approachable. They met with staff monthly to review their health and social care needs. There were also social evenings during the week where they could socialise and discuss issues relating to the running of the service.

People said they liked living in the house, felt safe there and received good support from the staff, who treated them with dignity and respect. One person said, 'I'm very happy with the service, it is excellent.'

Although people told us they were satisfied with the support they received, we found other evidence that people were not always protected against the risks of receiving inappropriate or unsafe care and support.