Esplanade House

We found the following examples of good practice.

Staff donned, doffed and disposed of personal protective equipment (PPE) safely and in line with the relevant guidance. Throughout our inspection staff were wearing the required levels of PPE and maintaining social distancing as much as possible.

The manager had consulted with people and their relatives about how to facilitate visits and risk assessments had been completed, which determined the impact on each person and how they would maintain contact. Since the start of the coronavirus pandemic people had been supported to maintain contact with their relatives through video calls, phone calls and by meeting them outside when able to.

Clear processes were in place for any visitors which included a temperature check, hand sanitising, and support to use appropriate PPE correctly.

Esplanade House had systems in place to ensure regular testing of people and staff for Covid 19 and followed government guidelines for the frequency of tests.

The service had no vacancies and had not had any new admissions since the start of the pandemic. However, the manager understood government guidance about how safe admissions should take place, including self-isolation for 14 days, if they needed to do so. New staff employed completed a 14-day isolation period and testing, prior to commencing work in the home. This meant risks were reduced to people and staff at the service.

Staff had training and support to understand the fundamentals of infection control and Covid 19. There was a contingency plan for the service during an outbreak.

The home was clean and hygienic. Robust cleaning measure were put into place. For example, they had measures in place to make sure high touch areas maintain a high level of cleanliness.

The provider had developed policies, procedures and guidance for the home which had been implemented. Quality assurance audits were being completed during the COVID-19 pandemic to reflect best practice.

Staff understood the risks well and had followed full infection control measures to care for people. People living at the home had been supported to understand the risks around COVID-19, to help maintain their own safety

Esplanade 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.

Esplanade House provides accommodation for up to 13 people who have a learning disability. At the time of our inspection, there were 13 people living in the home.

There was 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.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Staff treated people with utmost kindness, respect and compassion. Staff had built exceptionally positive relationships with people and knew what mattered most to them.

Staff went the extra mile to ensure people were supported to maintain relationships with those important to them. The service had built strong, open relationships with people’s families.

Staff were highly motivated and showed dedication to improve people's lives, by supporting them to lead their lives as they wished. The service was committed to promoting people's independence in all aspects of day to day life.

People felt safe living at Esplanade House. Staff knew how to keep people safe and how to identify, prevent and report abuse. They engaged appropriately with the local safeguarding authority.

Thorough staff recruitment checks were carried out when a new staff member started working for the service. There were enough staff available to keep people safe at all times.

Individual and environmental risks were managed effectively. Risk assessments identified risks to people and provided clear guidance to staff on how risks should be managed and mitigated.

There were robust systems in place to ensure the safe management of medicines. People were supported to receive their medicines by staff who had been trained appropriately and medicine administration records were completed accurately.

Staff received a variety of training and demonstrated knowledge, skill and competence to support people effectively. Staff were supported appropriately by the registered manager and deputy manager.

People had access to health and social care professionals where required and staff worked together co-operatively and efficiently.

Staff were knowledgeable of the Mental Capacity Act 2005 and people’s rights were protected in line with the Act at all times.

People were supported by staff with their nutritional and hydration needs. People were offered choice at mealtimes and menus contained a variety of nutritious and healthy foods. Where people had specific dietary requirements, this was well documented and staff were aware of how to meet these needs.

People received personalised support in line with their wishes and preferences. Staff ensured that people received consistent care.

People’s communication preferences were explored and documented to ensure that staff were able to meet people’s needs. The service had used forms of technology to develop positive communication styles with people.

People had access to a wide range of activities within the service and in the local community. People were supported to follow their own interests and participate in regularly social occasions.

Care plans contained personalised and clear information about people’s needs, wishes and preferences around their care and support. Care plans were reviewed regularly and where relevant, people’s families were invited to express their views.

The service had a clear process in place to deal with complaints and we saw that concerns were dealt with in a timely and effective manner.

People, their relatives, visitors and staff members commented positively on the leadership of the service and felt that the service was well-led. The provider was engaged with the running of the service and was approachable to people and staff.

There were appropriate auditing systems in place, which ensured that issues were acted upon and ideas for improvement were responded too.

The inspection was unannounced and was carried out on 09 June 2016.

There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

People and their families told us they felt the home was safe. However, we found that the recruitment process did not always ensure that all necessary pre-employment checks were completed to ensure potential staff were suitable to work with the people living at the home. We recommend that the provider seek advice and guidance on adopting the latest best practice guidance relating to the recruitment of staff.

Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided sufficient information to allow staff to protect people whilst promoting their independence.

People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs. There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.

There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and assessments. Healthcare professionals such as chiropodists, opticians, GPs and dentists were involved in people’s care when necessary.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect. People were encouraged to maintain relationships that were important to them.

People were supported to have enough to eat and drink. Mealtimes were a social event and staff supported people, when necessary in a patient and friendly manner.

People who were not able to communicate verbally showed that they understood what was being said and were able to make their wishes known to staff. Staff were responsive to people’s communication styles and gave people information and choices in ways that they could understand. They were patient when engaging with people who could not communicate verbally and who used a variety of signs, noises and body language to express themselves. Staff were able to understand people and respond to what was being said.

People and when appropriate their families were involved in discussions about their care planning, which reflected their assessed needs. Each person had an allocated keyworker, who provided a focal point for that person and maintained contact with the important people in their lives.

There was an opportunity for people and their families to become involved in developing the service and they were encouraged to provide feedback on the service provided. They were also supported to raise complaints should they wish to.

People’s families told us they felt the home was well-led and were positive about the registered manager who understood the responsibilities of their role. Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the home.

There were systems in place to monitor quality and safety of the service the home provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

We viewed care plans and related records for three people. These were individual and showed people were receiving appropriate care and support. We spoke with staff on duty including the manager. Staff were aware of how people should be supported, individual likes and dislikes and the help they required. Staff stated they felt they had sufficient time to meet people's needs and had completed relevant training.

The home was clean and appropriate procedures were in place to reduce any risks of infection. There were systems in place to monitor the quality of the service provided.

Esplanade House is also registered to provide personal care to people living in their own homes. They were not providing this service when we visited. The regulated activity personal care was therefore not assessed during this inspection.

We spoke with six of the 11 people who were living at the home. They told us they could make decisions and the manager and staff were happy and nice. People told us that they were involved in day to day decisions such as what they wanted to eat and what activities they wanted to take part in. We were told that staff were always available when they needed them. People told us that they felt safe and happy at the home. People we spoke with had lived at the home for many years and clearly viewed it as their home. One person showed us their bedroom and told us how they were supported to shop for and cook their own meals.

We viewed care plans and related records for two people. These were individual, and showed that people were receiving the care and support they required. Nutritional needs were appropriately met and there were safe systems in place for the management of medicines. The environment was homely and well maintained. All necessary records were available and stored securely.