Eden House Residential Home I

At our last inspection we rated the service 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 ongoing 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.

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.

People were safe. There were sufficient staff to meet people's needs and staff had time to spend with people. People’s nutritional needs were met and staff supported people to maintain a healthy diet. Where people had specific dietary needs, these were met.

Risk assessments were carried out and promoted positive risk taking, which enabled people to live their lives as they chose. People received their medicines safely. Records relating to risks and medicines were accurate and up to date.

The service provided support in a caring way. Staff supported people with kindness and compassion and went the extra mile to provide support at a personal level. Staff knew people extremely well, respected them as individuals and treated them with dignity whilst providing emotional support. People and their relatives, were fully involved in decisions about their care needs and the support they required to meet those individual needs.

There was a positive culture at the service that valued people, relatives and staff and promoted a caring ethos that put people at the forefront of everything they did.

People received effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's GPs and the Care Home Support Service (CHSS) to ensure their health and well-being was monitored.

People had access to information about their care and staff supported people in their preferred method of communication.

The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly. People had access to a variety of activities that met their individual needs.

The registered manager monitored the quality of the service and looked for continuous improvement. There was a clear vision to deliver high-quality care and support and promote a positive culture that was person-centred, open, inclusive and empowering which achieved good outcomes for people.

Eden House One is a care home without nursing that offers a service for up to eight older people. On the day of our inspection six people were living at the home. Most people were living with dementia.

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.

We were greeted warmly by the registered manager and staff at the service who seemed genuinely pleased to see us. The atmosphere was open and friendly.

People told us they felt safe. Staff understood their responsibilities in relation to safeguarding. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.

People were supported by staff who were knowledgeable about people’s needs and provided support with compassion and kindness. People received high quality care that was personalised and met their needs.

Where risks to people had been identified risk assessments were in place and action had been taken to manage the risks. Staff were aware of people’s needs and followed guidance to keep them safe. People received their medicines as prescribed.

There were sufficient staff to meet people’s needs. Staffing levels were consistently maintained. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

Staff understood the Mental Capacity Act (MCA) and all staff applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves. The registered manager was knowledgeable about the MCA and how to ensure the rights of people who lacked capacity were protected, this included Deprivation of Liberty Safeguards (DoLs).

The service had systems to assess the quality of the service provided. Any learning needs were identified and action taken to make improvements which promoted people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care. However, the service did not always send us notifications about reportable events. A notification is information about important events which the provider is required to tell us about in law. In addition, the service failed to provide us with certain information we requested prior to the inspection.

Staff spoke positively about the support they received from the registered manager. Staff supervisions and meetings were scheduled as were annual appraisals. Staff told us the registered manager was approachable and there was a good level of communication within the service.

People and their relatives told us the service was friendly, responsive and well managed. People knew the registered manager and staff and spoke positively about them. The service sought people’s views and opinions and acted upon them.

We considered our inspection findings to answer the questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is the summary of what we found.

Is the service safe?

People were cared for safely. We asked people if they felt safe they told us they did. Care and treatment was delivered in a way that was intended to ensure people's safety and welfare. One of the care plans we looked at showed that the person was unable to manage their own money. We saw that the local authority money management team were involved with the person's finances and that the care plan documented the details of how the care and support in regard to the person's finances was managed.

People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent it from happening. We saw a copy of the safeguarding policy this detailed the various types of abuse, the means of preventing abuse and the signs to look for.

Is the service caring?

People were treated with dignity and respect. One person told us the care workers were pleasant and respectful. Care workers knocked on people's doors before entering their rooms. We saw care workers interacting with people in a manner that was respectful and upheld the person's dignity. For example; at lunch time we saw a care worker sitting with a resident who had dementia, encouraging and supporting them to drink. The care worker took time to support the person to eat and drink, they made eye contact and talked to the person and gave them reassurance.

Is the service responsive?

We saw that the provider had carried out a 'Shared Memories' questionnaire with the residents in November 2013. We saw the results of this; the manager told us that they had used the results to vary the menu offered to residents and to ensure that the favourite choice for each resident was incorporated into the menu offered. The provider made comment, complaint and suggestions cards available to people who used the service, their relatives and professionals who visited the service and we saw them displayed in the reception areas of the home. The manager told us they collected feedback during reviews and by listening to people who used the service to inform service development.

Is the service effective?

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plans. We looked at the care records of three people who used the service. One person's communication care plan showed that the person could not always understand care workers good intentions. The person could become angry and display this verbally and physically. The care plan described that care workers should allow time for the person to understand and monitor any change in mood. We spoke with a care worker about the care they provided to this person. They said they 'talk to [the person] about what they are doing, take time, take it slowly'.

Is the service well led?

We saw evidence in care plans that the provider took account of professional advice received in regard to running of the service safely; for example GP's, mental health professionals, and district nurses. The provider told us about the care home support service that regularly came in to support the home in meeting the needs of people and we saw evidence of this in care records.

We spoke with the manager about the systems in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others. They told us about the system in place for monitoring care plans and medication records. The registered manager told us they then carried out audits of these on a regular basis. Any issues that arose from these audits would be shared immediately with staff. However, we saw no evidence of how these audits were conducted, when or how often. We noted this in the inspection report to the provider

Before people received care or treatment they were asked for their consent. A person we spoke with told us "staff ask my permission before I have a chair bath".

People received care and support that met their needs. One of the people we spoke with "it's like a family here". Another person said "they (the staff) care for us ever so well". We saw care plans that detailed people's day to day care requirements and contained risk assessments appropriate to people's needs.

People told us they felt safe living at the home. We saw that staff had received appropriate training to identify and report abuse. The provider had systems in place to protect people from abuse.

Staff received training appropriate to their roles and responsibilities. Training was planned to ensure staff were kept up to date. Staff felt well supported. The member of staff we spoke with told us "I am supported with flexible hours to work and encouraged to improve my skills and knowledge".

There were systems in place to identify and manage risks to the health safety and welfare of people who used the service.

People's personal records, including their medical records were fit for purpose and were stored safely.

We found that staff members knew individuals' current needs and were observed meeting people's needs effectively.

People told us that their home was 'comfortable and homely'.

People who used the service told us that staff were 'very kind and caring.' They said 'they know all about us and keep us happy.'

We found that the home was not keeping all the management records necessary to show that people who used the service were being looked after in the safest possible way.