Archived: Elkington House Care Home

This inspection took place on 31 August 2018 and 4 September 2018. We checked to see that the registered provider had made the required improvements. We found that the required improvements had been made and the service was now compliant with regulatory requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Southend Blind Welfare Organisation is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Southend Blind Welfare Organisation is registered to provide accommodation with personal care for up to 25 older people, people living with a visual impairment and others who may live with dementia related needs. Southend Blind Welfare Organisation is a large detached property situated in a quiet residential area in Westcliff on Sea and close to all amenities. The premises are set out on two floors with each person using the service having their own individual bedroom and adequate communal facilities are available for people to make use of within the service. There were 15 people receiving a service at the time of our inspection.

The service had a registered manager 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.

Our key findings across all the areas we inspected were as follows:

Suitable arrangements were in place to keep people safe. Policies and procedures were followed by staff to safeguard people and staff understood these measures and the actions to take if abuse was suspected. Risks to people were identified and managed to prevent people from receiving unsafe care and support. The service was appropriately staffed to meet the needs of the people using the service. People received their medication as prescribed and in a safe way. Recruitment procedures were now followed to ensure the right staff were employed and all records as required by regulation sought. People were protected by the registered provider’s arrangements for the prevention and control of infection. Arrangements were in place to learn from events when things go wrong.

Staff now received a thorough induction to carry out their role and responsibilities effectively. Staff had the right competencies and skills to meet people’s needs and received regular training opportunities. Suitable arrangements were also now in place for staff to receive regular formal supervision and staff employed longer than 12 months had had an appraisal of their overall performance. People’s nutritional and hydration needs were met and they were provided with drinks and snacks throughout the day. People received appropriate healthcare support as and when needed from a variety of professional services. The service worked together with other organisations to ensure people received coordinated 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; the policies and systems in the service supported this practice.

People were treated with care, kindness, dignity and respect. People received a good level of care and support that met their needs and preferences. Staff had a good knowledge and understanding of people’s specific care and support needs and how individuals wished to be cared for and supported.

Support plans were in place to reflect how people would like to receive their care and support, and covered all aspects of a person's individual circumstances. Social activities were available for people to enjoy and experience. Information about how to make a complaint was available and people told us they were confident to raise issues or concerns and assured these would be addressed.

Suitable arrangements were in place to assess and monitor the quality of the service provided. There was a positive culture within the service that was person-centred, open and inclusive. The service sought people’s and others views about the quality of the service provided.

Further information is in the detailed findings below.

Southend Blind Welfare Organisation is registered to provide accommodation with personal care for up to 25 older people, people living with a visual impairment and others who may live with dementia related needs. There were 18 people receiving a service at the time of our inspection.

The service had a registered manager 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.

Appropriate arrangements were not in place to recruit staff safely so as to ensure they were the right people and improvements were required. Not all staff had received training/refresher training to enable them to carry out their role and responsibilities to an appropriate standard. Although a rationale was provided by the registered manager as to why staff had not training, action was needed to address this. Additionally, although an induction programme was in place that prepared newly employed staff for their role, an induction had not been undertaken for the newest member of staff or for staff provided by an external agency. Improvements were also needed to ensure staff received formal supervision and an annual appraisal of their overall performance.

Whilst arrangements were in place to regularly assess and monitor the quality of the service provided, these measures were not as robust or effective as they should be. The registered manager was required to take proactive action to make the necessary improvements as detailed above.

People told us the service was a safe place to live and there were always sufficient staff available to meet their care and support needs. Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed to ensure their safety.

Medicines were safely stored, recorded and administered in line with current guidance to ensure people received their prescribed medicines to meet their needs. This meant that people received their prescribed medicines as they should and in a safe way.

Staff demonstrated a good understanding and awareness of how to treat people with respect and dignity. Staff were able to demonstrate a good understanding and knowledge of people’s specific support needs, so as to ensure theirs’ and others’ safety.

People who used the service and their relatives were involved in making decisions about their care and support. People’s capacity to make day-to-day decisions had been assessed.

The dining experience for people was positive and people were very complimentary about the quality of meals provided. Where people were at risk of poor nutrition or hydration, this was monitored and appropriate healthcare professionals sought for advice and interventions.

Care plans accurately reflected people’s care and support needs and people received appropriate support to have their social care needs met. People told us that their healthcare needs were well managed. Staff were friendly, kind and caring towards the people they supported and care provided met people’s individual care and support needs.

People and their relatives told us that if they had any concern they would discuss these with the management team or staff on duty. People were confident that their complaints or concerns were listened to, taken seriously and acted upon.

The premises were observed to be clean and odour free; and it was evident that policies and procedures relating to infection control were being followed so as to ensure compliance. Laundry facilities were appropriate for the needs and numbers of people living at the service.

We found at this inspection that the manager had introduced a number of improvements. These referred specifically to the introduction of medication audits and competency assessments for staff who administer medication to people who use the service. The manager had taken steps to ensure that night staff were provided with updated training and all staff had received at least two formal supervisions since December 2013.

We were concerned that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place for the safe recording and safe administration of medicines.

Further improvements are required to ensure that medication practices and procedures are developed so as to ensure positive outcomes for people. In addition improvements are required to ensure that all staff receive regular supervision. Effective quality assurance may assist the provider in recognising where there are gaps and areas for development.