10 March 2023
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
The inspection was carried out by two inspectors, a pharmacist inspector, a specialist advisor and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Ernstell House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Ernstell House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used all this information to plan our inspection.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We spoke with 6 people who used the service about their experience of the care provided and spent time observing people. We spoke with 9 members of staff including the registered manager, clinical lead and homemakers. ‘Homemakers’ is how the service refers to care staff. We spoke to 1 professional. We also spoke to 6 relatives following our inspection visit.
We reviewed a range of records. This included 7 people’s care records and 12 medicines records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
10 March 2023
About the service
Ernstell House is a ‘care home’ which provides accommodation and personal care for up to 64 people who may be living with dementia. At the time of the inspection 44 people were using the service. The service is a purpose built home over 2 floors and divided into 4 separate units. Access to the upper floors is via a lift. All rooms are single and have en-suite facilities. There is a large garden area and a top floor balcony seating area.
People’s experience of using this service and what we found
People who lived in the service told us they were happy and safe. One person said; “Yes, it’s a perfect place - couldn’t be better” and another said; “Yes, I am well looked after.” A relative said; “Yes, she’s definitely safe at Ernstell House.”
People looked relaxed, happy and comfortable with staff supporting them. Staff were caring and spent time chatting with people as they moved around the service.
The environment was safe, regularly updated and there was equipment available to support staff in providing safe care and support. Health and safety checks of the environment and equipment were in place.
Medicines were ordered, stored and disposed of safely. We have made a recommendation on ensuring administration and assessments of ‘as required’ medicines is recorded to reflect each individual needs and preferences.
People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. Records were accessible and up to date.
Staff received appropriate training and support to enable them to carry out their role safely, including fire safety and mental health training. Staff were recruited safely in sufficient numbers to ensure people’s needs were met. However, some staff did not have a full employment history documented as needed. There was time for people to have social interaction and go out into the community. Staff knew how to keep people safe from harm.
Cleaning and infection control procedures had been updated in line with COVID-19 guidance to help protect people, visitors and staff from the risk of infection.
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.
Records of people's care were individualised and reflected each person’s needs and preferences. Risks were identified, and staff had guidance to help them support people to reduce the risk of avoidable harm.
People’s communication needs were identified, and where they wanted, people had end of life wishes explored and recorded.
People and staff told us the registered manager and the management team made themselves available and assisted them daily. They went onto say how they were approachable and listened when any concerns or ideas were raised. One person said; “I like it here, it’s well run.”
People and their families were provided with information about how to make a complaint and details of the complaint’s procedure were displayed at the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for the service under the previous provider was good overall, however there was a rating of requires improvement in well led. At this inspection we found improvements had been made and the services' overall rating is now good in all areas. (published 5 March 2019)
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.