All inspections: Ernvale House Care Centre

This inspection took place on 2 February 2016 and was unannounced.

The service was registered to provide accommodation and nursing care for up to 85 people. People who used the service tended to be over 65 years old and had physical and/or mental health diagnoses. There were five units at the service. These included a residential unit for people without nursing care needs, a nursing unit, a unit for older people with mental health needs and two single gender units for people with behaviours that challenge. At the time of our inspection 68 people were using the service.

We carried out an unannounced comprehensive inspection of this service on 2 and 3 September 2015. Breaches of legal requirements were found. After the comprehensive inspection, we asked the provider to take action to make improvements to meet legal requirements in relation to protecting people from harm and abuse, providing safe care and treatment, staffing levels, meeting nutritional and hydration needs and assessing and monitoring the quality of the service provided. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements.

The service had a registered manager. 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 at risk of receiving inconsistent care because risk management plans were not always in place or not clear.

People were encouraged to make their own decisions and support was provided in line with current legislation and guidance. However, not all staff understood the legal requirements of the Mental Capacity Act (2005) which meant there was a risk that people's legal and human rights may not be respected.

People had access to healthcare professionals, though records did not always consistently show that health needs were monitored and what actions had been taken when required.

People were mostly treated with kindness and compassion though there were examples were staff did not approach people in a caring manner.

We saw that improvements had been made to the systems in place to monitor quality and that the registered manager took actions to make improvements when required. However, there were some issues that had not been identified during quality checks.

People felt safe and were protected from avoidable harm and abuse by staff who knew how to recognise potential signs of abuse and how to report them appropriately. We saw that systems were in place and were followed to ensure that safeguarding adult’s investigations took place when required.

There were enough staff to meet the needs of people who used the service and staff were recruited safely. People's medicines were managed safely so that they received them as required.

People were provided with enough food and drink to maintain a healthy diet. People had choices about their food and drinks and were provided with support when required to ensure their nutritional needs were met.

People were provided with personalised care to meet their needs and preferences. Care plans included life history information and staff knew people's preferences. People's dignity was respected and they were encouraged to be involved in developing their care plans.

People knew how to complain if they needed to. A complaints procedure was in place and we saw that complaints had been dealt with in line with the provider’s procedure. People and their relatives were encouraged to give feedback on the care provided via questionnaires and meetings. The registered manager responded to feedback and changes were made to improve the quality of the service provided.

People, relatives and staff felt the registered manager was approachable and responsive. The registered manager understood the requirements of their registration with us.

We inspected this service on 2 and 3 September 2015. This was an unannounced inspection. Our last inspection took place on May 2013 where we found that the provider was meeting the Regulations that we inspected them against.

The service was registered to provide accommodation and personal care for up to 85 people. People who use the service tend to be over 65 years old and have physical and/or mental health diagnoses. There are five units at the service. These comprise of a residential unit for people with low level needs, a nursing unit, a unit for older people with mental health needs and two single gender units for people with behaviours that challenge. At the time of our inspection 76 people were using the service.

The service had a registered manager. 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 and associated Regulations about how the service is run.

During this inspection we identified a number of Regulatory breaches. You can see what action we told the provider to take at the back of the full version of the report.

Preventable incidents had occurred because risks to people’s health and wellbeing were not consistently identified or managed to promote their safety. We found there were not always enough staff available to deliver people’s planned care or keep people safe.

People were not always protected from potential abuse because staff did not report incidents of alleged abuse in accordance with local safeguarding procedures. Effective systems were not in place to ensure medicines were administered in a consistent and safe manner.

People did not always get the support they needed to eat and drink and suitable quantities of food were not always available. This meant some people’s meal preferences and nutritional needs were not met.

The provider did not have effective systems in place to consistently assess, monitor and improve the quality of care. This meant that poor care was not always being identified and rectified by the registered manager and provider. People’s feedback was not always acted upon to improve their care experiences.

People and their relatives were not always involved in planning their care. This meant staff did not always know people’s care preferences. There was a risk that people would not receive end of life care in accordance with their preferences. This was because effective, personalised end of life care plans were not in place.

People were not always given the opportunity or supported to make choices about their care. Social and leisure based activities were not consistently promoted and people told us they were often bored.

There was a homely and relaxed atmosphere and people were treated with care and compassion. However, staff told us they needed more time to give people consistent positive care experiences.

People’s health and wellbeing needs were monitored and advice was sought from health and social care professionals when required. However, a lack of resources meant that some people could not regularly or consistently experience the positive health effects of sitting out in a chair.

Staff sought people’s consent before they provided care and support. When people did not have the ability to make decisions about their care, the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were followed. These requirements ensure that where appropriate, decisions are made in people’s best interests when they are unable to do this for themselves.

Staff received training and support that provided them with the knowledge and skills required to work at the service. Training gaps had been identified and plans were in place to address these gaps.

People knew how to complain about their care and complaints were managed in accordance with the provider’s complaints policy.

Ernvale House consists of three distinct units. The Park; provided accommodation and personal care for people who were relatively independent. The Lodge; provided accommodation for people with dementia or mental health needs and the nursing unit; provided accommodation for people who need a higher level of care or nursing.

We saw that people were treated with respect by the staff who cared for them. People told us they were treated with dignity and respect. One person said, "They are very good. I have my door open during the day but if I need anything they close the door before seeing to me".

We found that care records we checked were personalised and contained assessments and information to enable staff to keep people safe and provide them with appropriate care.

Systems were in place to ensure that people who used the service had a diet appropriate to their needs. A person who used the service said, "The food is lovely".

We saw that medicines were stored correctly and people received the correct medication at the correct times. We did identify some minor issues with recording and administration of medicines.

Staff we spoke with told us that they liked working at Ernvale House. Staff said they were happy with the training and supervision they received.

The service had a comprehensive complaints policy which enabled people to raise issues and receive feedback openly.

Archived: Ernvale House Care Centre

All Inspections

2 February 2016

During a routine inspection

2 and 3 September 2015

During a routine inspection

8 May 2013

During a routine inspection