During an assessment under our new approach
Date of Assessment: 04 March to 01 April 2025. Edward House is a residential care home set over 2 floors providing personal care and support to older people and people living with dementia. The provider did not consistently demonstrate a positive learning culture. People could raise concerns but responses were not always robust and the management team were not clear on the provider’s policy guidance for this. Learning was not documented or always shared with the wider team. People were not always protected and kept safe and there were concerns around the environment. Staff did not clearly understand and manage risks and people’s care plans lacked effective guidance, for example, where a person was at increased risk further to experiencing a stroke. Staff did not consistently manage medicines well and follow the provider’s policy guidance specifically around topical medicines (prescribed creams) and controlled drugs and this had not been identified through management checks. Staff and external resources were effectively deployed to ensure people could engage with meaningful activities. Assurance processes were poor and failed to identify quality concerns. Managers had not provided staff with regular supervision to support to maintain the quality of care people received.
There were enough trained and experienced staff to meet people’s support needs. Leaders were visible in the home and operated an open-door policy so people could speak to them. However, people did not always feel the management team were approachable or able to speak up and give feedback.
People and those important to them were not always involved in assessments of their needs or reviews of their care needs. Assessments did take account of people’s communication, personal and health needs. People had enough to eat and drink to stay healthy but we noted some people requiring additional assistance were not always effectively supported with this. Staff worked with all agencies involved in people’s care for the best outcomes but had not consistently monitored people’s health to support healthy living. Staff worked in line with the Mental Capacity Act, used least restrictive practices, sought consent and took decisions in people’s best interests where they did not have capacity.
People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. The provider had failed to support staff wellbeing effectively and consistently.
Staff did not always feel supported to give feedback, that they were treated equally or were free from bullying or harassment. Leaders and staff did not have a shared vision and culture and the inspection team explored through discussion closed culture with the registered manager. Any service that delivers care can have a closed culture. We define this as ‘a poor culture that can lead to harm.’ Staff understood their roles and responsibilities. Managers were receptive to new ideas and wanted to improve standards of care, the environment and support of staff at the home.