Archived: The Liberty of Earley House

Updated 2 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 20, 21 and 25 June 2018. Day one was unannounced, with days two and three being announced. The inspection was carried out by one inspector.

The service had submitted a provider information return (PIR), in January 2018. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the information provided in the PIR and used this to help us plan the inspection.

Prior to the inspection we reviewed the information we held about the service. This included any notifications that we received. Notifications are reports of events the provider is required by law to inform us about.

During the inspection we spoke with four people using the service, two relatives, the registered manager, the administrator and five other staff. We examined a sample of five care plans and other documents relating to people’s care. We looked at a sample of other records to do with the operation of the service, including, training and supervision records and medicines recording. We observed interactions between people and staff during lunch on the first day and at intervals throughout the inspection.

Updated 2 August 2018

This inspection took place on 20, 21 and 25 June 2018 and was unannounced on the first day, with days two and three being announced.

At the previous inspection in January 2017 we found breaches of Regulation 12 regarding medicines management, Regulation17 regarding governance and oversight and Regulation 18 regarding staff support.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions, Safe, Effective and Well-led, to at least good. The service submitted an action plan which detailed the steps proposed to address the breaches identified.

At this inspection we found the majority of these actions had been carried out or were in process, although the service had not recruited a deputy manager as stated in the action plan. This placed additional burdens on the registered manager to maintain effective overview of the service. The trustees had provided some additional support through a series of six-weekly meetings with the manager to provide an opportunity for issues to be brought to their attention and discussed.

Improvements had been made to medicines recording and administration practice to significantly reduce the number of reported errors and omissions. Identified health and safety-related environmental works had been completed. Staff had been provided with regular support through supervision and the majority had now had a performance appraisal to explore their progress and learning needs. Sufficient improvements had been made that there were no longer breaches of these regulations. However, the provider needed to evidence their ability to sustain the improvements.

Some issues identified during this inspection were dealt with immediately following the inspection. The trustees and registered manager should identify ways to ensure they do not recur. These issues are referred to within the body of the report.

The Liberty of Earley House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service provides support for up to 35 people with needs associated with old age. People each have their own bedsit or flat with kitchenette and en-suite toilet/shower. Facilities are arranged over two floors served by a passenger lift. At the time of this inspection there were 19 people receiving support.

A registered manager was in post as required. 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 generally safe in the service. Appropriate risk assessments had been carried out, with one exception, to identify potential risks and action had been taken to mitigate them. Better oversight of health and safety matters had been exercised since the previous inspection, as evidenced by the prompt response to the Legionella risk assessment, received during the inspection.

People felt safe and said staff treated them with kindness. No one raised any concerns about staff approach or attitude as had been the case at the previous inspection.

People and staff regularly commented that at times they felt staffing levels were not sufficient to meet people’s needs. People noted that at times they had to wait too long for a response to their call bell.

The service had a robust staff recruitment process which included all required actions. However, we identified some gaps in required records which could have put people at risk. These were addressed following the inspection.

People felt the service met their needs and provided them with effective care. They gave us positive feedback about the approach of staff, who they said supported them to do as much as possible for themselves. 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’s rights, privacy and dignity were respected by staff. Their spiritual and other diverse needs were provided for.

People were provided with effective support to meet their dietary and healthcare needs and were consulted when planning menus.

People’s views about the service were sought and acted upon. People felt they had opportunities to raise any concerns and that they would be listened to.

A range of suitable activities and events were provided which people could chose to take part in if they wished. People’s views and suggestions about activities were sought during regular residents' meetings.

The registered manager failed to notify the Care quality Commission as required by law, of one incident, although it was investigated at the time. The notification was provided retrospectively after the inspection. Other matters requiring notification had been reported.

The registered manager had a range of systems in place to monitor the day to day operation of the service and reported on a six-weekly basis to the trustees. This helped ensure improved governance over the service’s operation.

Staff understood the ethos of the service as it had been established. However, the increased dependency of more recent admissions put additional pressures on aspects of their work such as monitoring of people’s well-being in their flats.

This is the second consecutive time the service has been rated 'Requires Improvement'.