Archived: Real Life Options - Earlswood House

Earlswood House accommodates up to eight people in one building. At the time of our inspection seven people lived at the home. At our last inspection on 09 November 2016, we rated the service as ‘Requires improvement’ in the key questions of safe and well-led and ‘Good’ in the key questions of effective, caring and responsive. We rated the service as ‘Requires improvement overall’.

During our most recent inspection we found improvements had been made and we rated the service as ‘Good’.

A registered manager was 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 protected from the risk of harm or abuse because staff were aware of the actions they should take to escalate any concerns for people’s safety. Effective systems were in place to assess, monitor and manage people’s known risks. There were sufficient numbers of staff available to meet people’s needs. People received their medicines safely. The home environment was clean and systems were in place to audit infection control practices.

People were supported by staff who had the skills and knowledge to care for people effectively. People were asked for consent before care was provided. Where people’s rights were restricted this had been done lawfully. People received sufficient food and drink. People were supported to access healthcare professionals when required.

People were supported by staff who were kind and caring. People were supported to maintain their independence as much as possible. People were supported to make their own decisions and staff respected their dignity and privacy. Staff understood people’s needs, preferences and communication styles.

People were involved as much as possible in the planning of their care. Staff supported people to follow their interests and hobbies. The provider had a system in place to monitor and manage complaints.

Staff felt supported by the registered manager and were aware of their roles and responsibilities. There was a system in place to monitor the quality of the service provided to people and people had been asked to feedback about the service. The registered manager had submitted notifications to CQC of specific events as required by law

Since our last inspection the manager had registered with us and they were available throughout our inspection visit. 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 who were able to speak with us confirmed that they did feel safe living in the home. Some people we met found verbal communication difficult. We observed people looking relaxed and showing happiness with their facial expressions and body language. Safeguarding procedures were available in the home and staff we spoke with knew to report any allegation or suspicion of abuse.

Additional staff had been recruited so that the use of agency staff had been reduced and people were usually supported by staff who knew them well. Some improvement was needed to the deployment of staff to make sure people had the required level of supervision to keep them and others safe. New staff that had commenced had been provided with an in-house induction and had also attended the providers own induction on how to care for people and work safely. Staff told us that they were given the opportunity to develop their knowledge and skills in order to carry out their roles effectively.

People told us, or indicated by gestures, that they were happy at this home. We observed some caring staff practice, and staff we spoke with demonstrated a positive regard for the people they were supporting.

People's changing health and wellbeing needs were responded to and people had regular access to health care professionals to maintain their health. People were usually given a choice of foods and staff knew what people liked to eat. Meals were prepared according to people's specific dietary needs.

Systems to monitor and develop the quality of the service people received had been improved but not all incidents had been investigated and used to learn lessons to prevent similar occurrences in future.

The service had a registered manager. Staff said the manager was approachable and available to speak with if they had any concerns. The provider and registered manager had used feedback from the last inspection to make some improvements to the service.

We saw that people's needs had been assessed. Care and support was provided according to people's plans. Work was taking place to involve people in re-writing their plans so that they better reflected their current needs and preferences.

People were involved in a range of activities in the home and the community. Staff encouraged people to make choices about how they spent their time. People told us they were happy and provided examples of how staff supported them to do the things they wanted to do. We saw staff communicating well with people and providing reassurance.

There were enough staff with sufficient skills to meet the needs of people living in the home. However, although the home was not providing nursing care, it was registered to provide nursing and for the treatment of disease, disorder or injury. These activities need suitably qualified staff and the rotas showed that they were not always available. The manager assured us that an application would be made to remove these activities from the home's registration.

We found that staff were well supported in their roles. Staff told us that they had very good access to training in addition to staff meetings and supervision.

There were good arrangements for the storage, administration and recording of people's medication.

There were good systems for monitoring the performance of the home. These had been used to identify some shortfalls in relation to the environment and the records. Action was being taken to improve these areas.

Evidence of verbal encouragement was noted to good effect and staff demonstrated their detailed knowledge of people by responding appropriately to gestures, tones or other expressions. During the course of the inspection, staff were heard to be offering people choices, ensuring person centred care, and to be responding appropriately to the more physical and tactile affections of some people living at the home.