Elreg House

Updated 12 December 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 was 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 19 November 2018 and was unannounced. The inspection was carried out by one inspector 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 service.

Before the inspection we checked information that we held about the home and the service provider. This included information from other agencies and statutory notifications sent to us by the registered manager about events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We did not ask the provider to compete a Provider Information Return. This is information we require providers to send us at least once annually 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 20 people who lived at the home and to eight relatives or friends of people. We spoke with two care staff and the registered manager.

We spoke to a community nurse and a GP who were at the home at the time of the inspection. We spoke to a support worker from the Alzheimer’s Society who visited one person on a regular basis. We also received feedback from a local authority commissioning team regarding the quality of the service.

We spent time observing the care and support people received in communal areas of the home. We used the Short Observational Framework for Inspection (SOFI) which is a way of observing care to help us understand the experiences of people who could not talk with us.

We looked at the care plans and associated records for five people. We reviewed other records, including the provider’s internal checks and audits, staff training records, staff rotas, accidents, incidents, records of medicines administered to people and complaints.

Updated 12 December 2018

This inspection took place on 19 November 2018 and was unannounced.

Elreg House 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. The home is registered to provide accommodation and personal care for up to 32 older people, including those living with dementia. At the time of the inspection there were 30 people living at the home. Elreg House is a detached property in a suburban area of Shoreham. It has been adapted and extended from a domestic house. Accommodation is provided over two floors. The first floor can be accessed by a stairlift for those with mobility needs. All bedrooms were single apart from one which could be used as a double. Twenty-four bedrooms had an en suite toilet. People were observed using communal areas, which included a lounge, a conservatory and a dining room. There was a garden with seating for people.

At our last inspection on 22 March 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The home was found to be clean and hygienic although we identified greater attention to cleaning was needed in two bedrooms where there was an unpleasant odour. The registered manager was aware of this and said action would be taken to address this. We have made a recommendation about this.

The provider ensured safe care was provided to people. Risks to people were assessed and measures taken to mitigate these. The premises and equipment were safely maintained. Checks were made to ensure staff were suitable to work in a care setting. Medicines were safely managed. Incidents or accidents were reviewed and action taken to reduce the likelihood of any reoccurrence. People and their relatives said they were satisfied with the standard of care provided.

The registered manager ensured current guidance and legislation was followed regarding people’s care and treatment. Staff were well trained and supervised. The staff felt supported and valued.

People’s nutritional needs were assessed and people were supported to eat and drink. People said they liked the food. Health care needs were monitored and referrals made to other services to ensure there was a coordinated approach to people’s care. Health care professionals said people received a good standard of care and that the staff worked well with health care services to meet people’s needs. 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 kindness, respect and compassion. People and their relatives said they were treated with respect. For example, one person told us, “The staff are lovely, they are affectionate and always speak to me with respect.” Care was individualised and people were able to make choices in their daily lives. People’s privacy was promoted.

People received personalised care which was responsive to their needs. Assessments and care plans were comprehensive. People’s care needs were reviewed and people, or their representative, were consulted. The provider identified and met people’s communication needs. The provider had an effective complaints procedure and people said they knew what to do if they had a concern. Whilst there no people in receipt of end of life care at the time of the inspection the provider had policies and procedures for this. Staff were trained in end of life care. Records showed people’s preferences and needs regarding end of life care were assessed and planned for.

The service was well led and provided person centred care. The registered manager was motivated and kept herself and the staff team updated with training and current practice guidance. The provider had a policy statement on promoting equality for all people and staff. People and their relatives’ views about the service were sought as part of the provider’s quality assurance process. There were comprehensive audits and checks on the quality and safety of the service with corresponding plans to make changes where this was identified. The registered manager was open to making improvements to the service.

Further information is in the detailed findings below.