Enablement Care

Enablement Care is a residential care home providing accommodation and personal care to up to 23 people. The service provides support to younger and older adults. At the time of our inspection there were 22 people using the service. The home provides care over 2 floors with communal areas for dining and relaxation.

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

Staff did not receive sufficient training to be able to carry out their roles. Staff were mostly recruited safely and appropriate pre-employment checks were completed prior to employment. Recruitment records were not always complete in relation to employment history.

People’s care plans and risk assessment were inconsistent, some people’s risks were assessed whilst others were not identified. People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People received their prescribed medicines safely and correct infection and prevention control measures were followed, however medicines were not always managed safely. Accidents and incidents for the whole service were recorded, however individual incidents were not always analysed to identify people’s individual trends to minimise the risk of re-occurrence.

The culture of the service did not always promote positive person-centred care. Quality assurance systems and checks were in place to monitor areas of the service, however, did not always identify shortfalls in relation to care planning, consent and monitoring charts.

There was enough staff to meet people’s needs. People were protected from the risk of abuse. Most staff received safeguarding training and understood the procedures of how to raise a concern. People were supported to maintain a healthy diet and there was a choice available.

The provider engaged with external professionals to help achieve people’s outcomes.

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 11 January 2020).

Why we inspected

We received concerns in relation to staffing, training and governance. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the all sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to staffing and consent. 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.

Enablement Care is a residential care home. It is registered to provide accommodation and personal care to up to 22 younger and older adults. At the time of the inspection, the service was home to 21 people.

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

We had received information raising concerns about the availability of personal protective equipment (PPE) and the safety and quality of people’s care. We shared this information with the local authority safeguarding team. We inspected the service to speak with people about their care and check how people’s safety was being managed.

We found people were protected from the risk of acquiring infections. Personal protective equipment was readily available for staff. Staff were following latest guidance. Other actions to help ensure people’s safe care had been taken. For example, equipment such as hoists had been serviced and care plans and risk assessments were in place for people’s care needs.

Actions were taken to ensure people’s safety. However, some improvements were required to the way incident records were made and the assessment of whether incidents met with the local authority safeguarding thresholds.

Rating at last inspection

The last rating for this service was Good (published 11 January 2020).

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in response to concerns received about infection control risks. A decision was made for us to inspect and examine those risks.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We found no evidence during this inspection that people were at risk of harm from these concerns.

Please see the safe section of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for My Homecare Derby on our website at www.cqc.org.uk.

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.

Enablement Care is a residential care home providing personal and nursing care to 18 people aged under 65 and over at the time of the inspection. The service can support up to 22 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

Systems were in place to protect people from avoidable harm. People felt safe living at the home. Risks were assessed and monitored to reduce risks for people and for staff to manage risks effectively. Safe recruitment processes were followed to ensure staff were safe to work with people who used the service. People received their medicines as prescribed. The provider used an electronic system to record medicines to minimise errors. The staff followed policy and procedures related to infection control legislation. Lessons were learned when things went wrong.

The service was not purpose built, but people were able to navigate around the home independently. Repairs and redecoration had been implemented. Staff were fully supported to attend training and develop their skills and knowledge. Assessment of care was monitored and managed to ensure people received effective care. People received a balanced diet and made choices of what they wanted to eat and drink. The service worked well with other healthcare professionals and provided consistent care and support. The provider demonstrated an understanding of the need to consider people's mental capacity and followed the principles of the mental capacity act.

Staff were kind and considerate. They always treated people with respect and dignity. People were encouraged to share their views and access advocacy services where needed. People were encouraged to be independent and do things for themselves. People’s choices and wishes were respected by staff.

People received personalised care. Staff and the management team worked with passion and dedication and the people who used the service always came first. People were supported to maintain relationships and participate in activities that were relevant and important to them. Peoples communication needs were met in line with the Accessible Information Standard. The provider was open and transparent when dealing with complaints. People who wished to make advanced plans for their end of life care were supported to do so.

The service was consistently managed and well-led. The provider was meeting their responsibility to report incidents to us. Themes and trends were clearly identified when monitoring accident and incidents. The registered manager took a proactive approach to address issues and concerns. People were encouraged to be involved with how the service was run. The registered manager and staff worked well with external healthcare professionals to ensure people received good care and support.

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 supported this practice.

This service was registered with us on 10/12/2018 and this is the first inspection.

Why we inspected

This was a planned inspection based on the registration of the service.

The last rating for this service was requires improvement (published 08 October 2018). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating requires improvement to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned inspection based on the previous rating.

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.