Eversley Rest Home

Eversley Rest Home is a residential care home providing personal care to up to 28 people. The service provides support to adults with a range of needs including people who have dementia. At the time of our inspection there were 21 people using the service.

People’s experience of the service and what we found:

People were not always protected from environmental and building risks. People’s medicines were not always safely managed. It was not clear if there was on-going learning from incidents that had taken place. There were some infection control risks identified. People were supported by enough staff who understood how to keep people safe from harm. People were able to see visitors in the home.

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; the policies and systems in the service did not always support this practice.

The provider had not always identified risks to people and systems in place were not always robust enough in supporting the provider with this. People’s care plans and risk assessments were not always detailed enough. The provider notified CQC about any safety events in line with their responsibilities. The manager understood their responsibilities under the duty of candour. People and their relatives felt involved in care planning. Staff worked well with other health and social care organisations. There was an open culture and the provider was responsive in addressing concerns identified to improve care.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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

Rating at last inspection

The last rating for this service was good (published 6 May 2021).

Why we inspected

The inspection was prompted in part due to concerns received about the management of people’s care and support needs as well as the management of the service. A decision was made for us to inspect and examine those risks.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Eversley Rest Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to people’s safety and the management oversight.

Please see the action we have told the provider to take at the end of this report.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.

Eversley Rest Home is a residential care home providing personal care to 23 people aged 65 and over at the time of the inspection. The service can support up to 28 people.

The home provides accommodation across two floors. People have access to various communal areas and a secure garden area. The home supports people with a range of needs including support for people living with dementia.

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

The governance systems in the home had improved and people’s care was reviewed in a more effective and robust way.

People were protected by the risk of harm by staff who had received training and were confident in speaking up, if concerned. People were supported by sufficient numbers of staff who understood people’s risks and how to support then appropriately.

People received their medicine on time and the correct infection prevention and control measures were in place. We were assured the provider was following national guidance in response to the COVID-19 pandemic.

A culture of learning lessons when things went wrong was observed and people, staff and relatives were able to contribute to discussions about what was needed. The provider understood their regulatory responsibilities and acted upon their duty of candour.

The culture in the home was positive and we saw evidence of continuous improvement and working with other professionals.

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

Rating at last inspection

The last rating for this service was good (published 10 October 2018)

Why we inspected

We received concerns in relation to staffing levels and the potential impact that had. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained the same. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At this inspection we found improvements had been made and the service was now rated as Good overall.

Eversley Rest Home 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.

Eversley Rest Home accommodates up to 28 people in one adapted building. At the time of the inspection there were 25 people using the service.

There was a registered manager in post at the time of our inspection. 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.

Governance systems were not always effective in identifying concerns and driving improvements whilst some improvements had been made, following our last inspection, more were needed.

People received their medicines as prescribed. Risks to people were managed safely and documentation about people’s care was consistently completed, including when people had an accident. People were protected from the risk of cross infection and safeguarded from abuse. The provider learned when things went wrong. There were sufficient staff available to meet people’s needs and staff were safely recruited.

Staff had received training; and felt supported in their role. The environment was suitable for people’s needs and they received consistent care from staff. People were supported to meet their dietary needs. People were supported to maintain their health and well-being.

People had choice and control of their lives and staff were aware of how to support them in the least restrictive way possible; the policies and systems in the service were supportive of this practice.

People received support from staff that were caring. People’s communication needs were planned for. People were respected and their privacy was protected. People received dignified care and support.

People’s preferences were clearly documented and staff understood these. People’s end of life wishes were documented. People were clear about how to make a complaint and these were responded to.

Notifications were submitted as required and the registered manager understood their responsibilities. We people and their relatives were engaged in the service.

This inspection took place on the 13 July 2017. This was an unannounced inspection. Our last comprehensive unannounced inspection took place on 29 October 2015 and the provider was meeting all the regulations that we checked relating to the Health and Social Care Act 2008.

Eversley Rest Home provides accommodation and personal care for up to 28 people who may be living with dementia. There were 23 people living at the home on the day of our inspection.

The service had 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.

At this inspection, we identified that some improvements were needed; audits were undertaken and areas for improvement identified but timely action was not always taken to address these areas. For example, people’s safety was not fully maintained as substances that were classed as hazardous to health were not always kept securely. Records regarding the management of medicines did not always demonstrate that people received their medicine as prescribed. Since the inspection the provider has taken action to address these areas.

We identified that the staffing levels in place did not always ensure people’s needs were met in a timely way. Since the inspection the provider has confirmed they have increased the staffing levels.

Although people’s care needs were met, improvements were needed to ensure care plans accurately reflected people’s current needs. This had been identified by the provider and registered manager and actions were in progress to address this.

People felt safe with the staff and staff understood their role in reporting any concerns. Checks on staff were undertaken to ensure they were safe to support people. People’s verbal consent was sought by staff before supporting them and people were supported to make their own decisions when possible. Where people were unable to make decisions independently they were supported in their best interests and in accordance with the Mental Capacity Act. People received food and drink that met their nutritional needs and preferences, and were referred to healthcare professionals when needed to maintain their health and wellbeing.

People’s needs and preferences were understood by the staff that supported them and staff were caring towards them. People were supported to maintain their dignity and privacy and relationships that were important to them. People knew who the provider was and how to complain. When complaints were made these were responded to in line with the provider’s policy. The provider and registered manager sought people’s opinions to enable improvements to be made in accordance with their wishes.