Archived: Emyvale House

Updated 30 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Emyvale House is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager who was registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Prior to the inspection visit we gathered information from a number of sources. We also looked at the information received about the service from notifications sent to the Care Quality Commission by the manager. We asked the provider to complete a provider information return [PIR]. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used the PIR as part of our planning. We also spoke with other professionals supporting people at the service, to gain further information about the service.

During the inspection

We spoke with nine people who used the service. We spent time observing staff interacting with people. We spoke with six staff including care workers, senior care workers, the cook, the operations manager and the registered manager. We also spoke with seven relatives. We looked at documentation relating to three people who used the service, staff files and information relating to the management of the service

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data sent to us by the manager. We have also received an email from the registered manager and operations manager, which detailed how they will address some of the shortfalls.

Updated 30 October 2019

About the service

Emyvale House is a residential care home providing care and support for older people. The service also provides support for people living with dementia. The service can support up to 16 people.

On the day of our inspection 11 people were using the service.

The service was previously inspected in August 2018 and was rated requires improvement. We found there were two breaches of the regulations. These referred to shortfalls medicine management and governance. At this inspection, we identified improvements in medicines management. However, risks were not managed, and governance was still not addressed.

People’s experience of using this service and what we found

On the day of our inspection there were not enough staff to meet people’s needs in a timely way. People we spoke with told us they had to wait for assistance as staff were always busy. Relatives also told us it was usual to not see staff in communal areas as staff were busy in people’s rooms. Staff were knowledgeable about people needs, however, at times staff could not provide the support required due to lack of staff available.

Staff received appropriate training and staff were supervised and supported. However, staff felt they were not always listened to as they had raised the staffing issues. The operations manager told us this was being addressed and staff were aware they were looking at staffing levels.

When staff engaged with people we observed they were kind and caring. However, we observed staff did not have time to spend with people. Staff we spoke with understood people’s needs however, were not always able to respect their choices, due to staffing levels. For example, people told us they did not get a bath as often as they would like.

The service did not have a dedicated activities coordinator. People told us there was limited in-house activities taking place. Care staff told us they did not very often provide any social stimulation as there was not enough staff on duty.

Predominantly people received personalised care that met their needs. Risks associated with people’s care and support had been identified, they contained good detail. People had access to health care professionals. However, we found risks were not always updated and documentation did not evidence professional’s advice was followed.

People received a balanced diet. However, from our observations, people could be offered more support to ensure their needs were met.

There was a registered manager in post. There was a quality monitoring system in place, but this was not always effective. We saw the audits had not always identified issues we raised on inspection. The registered manager had made some improvements to the environment. However, there were still areas that were not well maintained and not able to be kept clean. The provider was also trying to improve the bathing facilities by installing a walk-in shower on the ground floor which would be easily accessible to people. They had considered the needs of people living with dementia, however, many areas were still not dementia friendly and could be improved further. The outside space was easily accessible and safe this area had greatly improved.

Staff understood safeguarding and whistleblowing procedures and would use them when required. Accidents and incidents were monitored, and lessons were learnt.

Medication systems were in place and we observed these were followed. However, some protocols were not in place, but these were addressed immediately by the registered manager.

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

People and relatives were involved in the service, quality questionnaires were sent out and meetings were held.

Rating at last inspection

The last rating for this service was requires improvement (published 26 July 2018). The service remains rated requires improvement. This will be the third consecutive inspection to be rated as requires improvement.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner. Since our inspection we have been provided with a detailed action taking place to improve the staffing. We have also had reassurances that bathing facilities will be improved so people have access to a shower.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk