We carried out a review of the data available to us about Ebony House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Ebony House, you can give feedback on this service.
Ebony House is a residential care home providing personal care up to a maximum of 8 people. The service provides support to adults with a learning disability and autism. At the time of our inspection there were 8 people using the service. The home was spread across two houses next door to each other, bedrooms were located on the ground and 1st floor. There was outside space available with a seating area. Both kitchens and shared bathrooms were spacious.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People's experience of using this service and what we found
Right Support:
The home was suitable for people, people’s bedrooms were personalised and people told us they had been able to choose their own decorations, however some areas needed attention, the communal areas had worn or old furniture which needed replacing. The registered manager had an action plan in place to address this area. Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs. The provider had an effective system in place to ensure people’s consent was obtained in line with legislation.
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.
Right Care:
Care was person-centred and promoted people’s dignity, privacy and human rights. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People using the service were protected from abuse because staff had a good understanding of safeguarding and how to report concerns. People told us they were safe living at the service. Care records contained risk assessments with clear guidance for staff to follow. Medicines were managed safely, however staff had not recorded reasons for administering ‘as and when needed’ medicine. The registered manager had put additional checks in place following our inspection. Staff were recruited safely. People had individual activity plans in place that reflected people’s interests and preferences.
Right Culture:
The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives. People received good quality care and support because trained staff and specialists could meet their needs and wishes. People's needs had been assessed before using the service. Care plans reflected these assessments. Some relatives told us they were involved in people’s care planning and reviews. Staff were competent in their roles as they had the skills, experience and knowledge to provide quality care. Staff understood people's needs and worked well with healthcare professionals. The provider had effective auditing systems in place to monitor the quality of care. The service was well-led because the registered manager was knowledgeable and had good oversight of the service and the needs of people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 22 June 2021)
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.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Ebony House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Ebony House is a residential care home providing personal care to eight people at the time of the inspection. The service can support up to eight people.
People’s experience of using this service and what we found
People told us they felt the service was safe. Staff understood what action to take if they suspected somebody was being harmed or abused. Staff knew how to report accidents and incidents. People had risk assessments to keep them safe from the risks they may face. These were updated as needed and used to inform reviews of people’s care.
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.
People were supported by enough staff who had been recruited safely. The provider supported people safely with medicines.
The service was clean and odour free and staff followed safe infection control practices. Additional systems and guidance were in place to reduce the risk of infection during the pandemic. The service had been refurbished and personalised for people.
People’s dietary needs were met effectively. People had access to and a choice of fresh food and drinks.
Discussions with the registered manager and staff showed they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service.
People and staff told us the management of the service were supportive. Staff told us they felt well supported by the registered manager. The service had quality assurance processes in place. The service worked well with other organisations to improve people’s experiences.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement. (Report published on 4 June 2019).
Why we inspected
We carried out an unannounced focused inspection of this service on 8 May 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report covers our findings in relation to all the key questions which contain those requirements. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
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.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Ebony House is a residential care home that was providing personal care to eight people with a learning disability or autistic spectrum disorder at the time of the inspection.
People’s experience of using this service:
The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons, lack of choice and control, limited independence and limited inclusion.
The provider did not follow appropriate safeguarding procedures to ensure people were safeguarded from abuse and unlawful deprivation of liberty.
There were several health, safety and infection control issues which put people at risk of potential harm.
The provider did not deploy staff suitably to ensure their needs were met safely.
Risks to people's health, care and mobility needs were appropriately assessed and mitigated.
People were supported by staff who knew how to provide safe care.
Staff recruitment checks were carried out to ensure they were safe to work with people.
The provider lacked robust and effective systems and processes to ensure the quality and safety of service.
People and relatives told us they felt safe with staff. Staff knew how to safeguard people against harm and abuse.
People, relatives and staff told us the management was approachable.
Rating at last inspection:
Good (report published 15 August 2017)
Why we inspected:
The inspection was brought forward due to information of risk or concern.
Enforcement:
We identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 around safe care and treatment, safeguarding service users from abuse and improper treatment, and good governance. Details of action we have asked the provider to take can be found at the end of this report.
We made a recommendation in our inspection report, which we will follow up at our next inspection.
You can see what action we told the provider to take at the back of the full version of the report.
Follow up:
We will work with the provider following this report being published to understand and monitor how they will make changes to ensure the service improves their rating to at least Good.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
At the last inspection on 12 and 18 October 2016 we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009.. We issued two warning notices following the inspection.
This was because people were not safe at the service. There were poor arrangements for managing and administering medicines. Staff did not always receive up to date training. Records were not always fully completed and quality checks did not identify some of the issues we found during the inspection.
We inspected Ebony House on 21 June 2017. This was an unannounced inspection. At this inspection we found the service had made the required improvements.
At the last inspection on 12 and 18 October 2016 the service did not have a registered manager. At this inspection the service had appointed a registered manager. 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.
Relatives of people using the service told us they thought it was safe. Staff knew how to report safeguarding concerns. Risk assessments were completed and management plans put in place to enable people to receive safe care and support. There were systems in place to maintain the safety of the premises and equipment. We found there were enough staff working at the service and recruitment checks were in place to ensure new staff were suitable to work at the service. Medicines were administered safely.
Staff received supervision and appraisals and training in line with the provider's policies and procedures. Staff had a clear understanding of application of the Mental Capacity Act 2005. Appropriate applications for Deprivation of Liberty Safeguards authorisations had been made. People using the service had access to healthcare professionals as required to meet their needs. People were offered a choice of nutritious food and drink.
Personalised support plans were in place for people using the service. Staff knew people they were supporting including their preferences to ensure personalised support was delivered. People using the service told us the service was caring and we observed staff supporting people in a caring and respectful manner. Staff respected people's privacy and dignity and encouraged independence. People using the service knew how to make a complaint.
Regular meetings took place for staff and people using the service. The provider sought the views of people and their relatives. The provider had quality assurance systems in place to identify areas of improvement. Staff told us they felt part of a team and that the registered manager was supportive and approachable.
Risk assessments did not always include risks associated with people’s medical conditions. The provider did not always notify the Care Quality Commission of Deprivation of Liberty Safeguards applications and decisions and of incidents that occurred in the service. Accurate records were not always kept of how the service monitored, learnt from incidents, handed over information to staff and monitored people’s needs following an incident. Refresher training in first aid for staff was not up to date. We imposed conditions on the provider’s registration.
At this inspection we found the provider had addressed some of these issues. However we found the provider was in breach of three regulations of the Health and Social Care Act 2008 (regulated activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009 Notification of Other Incidents. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after representations and appeals have been concluded.
The service was registered to provide personal care and support for people with learning disabilities. The service is registered for nine people. At the time of our inspection they were providing care and support to seven people. The service is a large property arranged over two floors. All bedrooms are single occupancy.
At the time of our inspection the service had a team leader in post who was in the process of applying to become the registered manager. 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 was not always safe. Medicines were not safely managed or administered. Relatives of people using the service had mixed views about the safety at the service. Staff training was not up to date in line with the providers statutory training requirements. Records were not always fully completed and quality checks did not identify some of the issues we found during the inspection.
We found there were enough staff working at the service and checks were carried out on staff before they commenced working. The premises were found to be clean and secure. Support plans and risk assessment were in place and provided guidance on how to support people.
People using the service and their relatives told us the service was caring and we observed staff supporting people in a caring and respectful manner. People were able to participate in a programme of varied activities. There was a choice of food and drinks available.
Relatives of people using the service felt the service met their relative’s needs. The service had a complaints procedure and relatives of people using the service knew how to make a complaint.
Staff told us they felt part of the team working at the service and found the management team approachable.
The service was registered to provide personal care and support for people with learning disabilities. The service is registered for nine people. At the time of our inspection they were providing care and support to six people. The service is a large property arranged over two floors. All bedrooms are single occupancy.
The service did not have a registered manager in place at the time of our inspection. 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.
Risk assessments did not always include risks associated with people’s medical conditions. The provider did not always notify the Care Quality Commission of the outcome of Deprivation of Liberty Safeguards applications and of incidents that occurred in the service. Accurate records were not always kept of how the service monitored, learnt from incidents, handed over information to staff and monitored people’s needs following an incident. Refresher training in first aid training for staff was not up to date.
People and their relatives told us they felt safe using the service. We found there were enough staff working at the service and checks were carried out on staff before they commenced working. The premises were found to be clean and secure. Support plans and risk assessment were in place and provided guidance on how to support people.
People using the service and their relatives told us the service was caring and we observed staff supporting people in a caring and respectful manner.
Relatives of people using the service had mixed views about how the service met their relative’s needs. People were aware of how to make a complaint.
Staff told us they felt part of the team working at the service and found the management team approachable.
The service was found to be in breach of three Regulations of the Health and Social Care Act 2008(Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. You can see what actions we have asked the provider to take at the end of the full version of this report.
We inspected Ebony House on 24 March 2015. This was an unannounced inspection.
Ebony House is a care home providing personal care and support for people with learning disabilities. The service is registered for nine people. The service is a large property arranged over two floors. All bedrooms are single occupancy. At the time of the inspection they were providing personal care and support to six people.
There was a registered manager at the service at the time of our inspection. 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 supported to make their own decisions where they had capacity. Where people
lacked capacity, proper procedures were followed in line with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).
People were provided with a choice of food and drinks ensuring their nutritional needs were met.
A safe environment was provided for people who used the service and staff supporting them. The staff were knowledgeable in recognising signs of abuse and knew how to report concerns. We found people were cared for by sufficient numbers of suitably qualified, skilled and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Medicines were managed safely and incidents were reported and managed in an appropriate way.
People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. The care plans contained information setting out how each person should be supported to ensure their needs were met. Care and support was tailored to meet people’s individual needs and staff knew people well. Risk assessments addressed the risks to people using the service.
Staff had good relationships with people living at the service. We observed interactions between staff and people living in the service and staff were caring and respectful to people when supporting them.
Staff knew how to respect people’s privacy and dignity. People were supported to attend meetings where they could express their views about the service. We found that people using the service pursued their own individual activities and interests, with the support of staff.
There was a clear management structure at the service. People who lived at the service, relatives and staff felt comfortable about sharing their views and talking to the manager if they had any concerns. The registered manager demonstrated a good understanding of their role and responsibilities, and staff told us the manager was always supportive. There were systems in place to routinely monitor the safety and quality of the service provided.
Relatives we spoke with told us they were happy with the care relatives received. One commented 'I am happy with how they look after them. They take them out a lot and know what they like.'
We saw that people were offered drinks and snacks throughout the day during our inspection.
The premises were clean and adequately maintained, with all ordinary and homely facilities such as laundry and a well maintained garden. One person living in the home told us they ate their food outside during the summer.
We looked at the recruitment records of the most recently recruited staff. We found that robust recruitment checks such as references and checks with the Disclosure and Barring Service (DBS) were carried out in each case, prior to staff being employed at the home.
Staff records and other records relevant to the management of the services were accurate and fit for purpose. All records were kept securely and could be located promptly when needed.
We were told that everyone that lives at the home goes out every week. One person told us they liked going out. Another person told us they work at the caf' in the daycentre.
We were told by the manager that all staff had received training in breakaway, de-escalation and diversion techniques. We checked staff training files which confirmed this
We saw that all staff had received an annual appraisal which clearly documented their training needs. Staff we spoke to told us they felt well supported by the manager and the organisation.
We saw the provider had sought feedback from relatives and stakeholders in November 2012. One relative had commented 'Just keep doing the same thing. Special thank you to the home.'
There was speech and language therapist at the home when we visited and they told us this was their second visit in two weeks and that they had carried out an assessment of the food preparation needs of one user. They said they had discussed with staff their findings and would support staff to put a procedure in place and that they would monitor progress.
Some staff had received training in Makaton and we saw evidence that provider would be training all staff at the home.
Some people were not supported in promoting their independence and community involvement. It had been identified that some people liked to go out of the home and into the community. However, two people had not left the home in several months. Staff also told us that some people who use the service 'shout a lot when they are out and are difficult to calm down.' We looked in files and found that most care plans were signed by people who use the service. However some people using the service had complex needs and limited communication skills and there was no evidence to demonstrate how staff ensured they fully understood what they were agreeing to.
There was a complaints and compliments book at the service. However people who use the service told us they have never made a complaint and would not know how to. They said if they had a complaint they would talk to the manager.
One person said they felt safe there and said if he saw any abuse he would tell the staff.
We saw that arrangements were in place for quarterly audits to be carried out by the provider's senior management team. The audit in July had also highlighted concerns in the areas of community involvement, activity plans and staff supervisions. We did not see any evidence that this had been addressed.
People who used the service require high staffing levels due to their level of need. We saw that staff encouraged and supported people to engage with relevant social activities dependent on their level of need and individual goals set out in their support plan.
People we spoke to said they were able to express their views, exercise choice and they felt safe in their living environment.
We spoke with two people who used the service, who both told us that they were satisfied with the care and support provided. They were treated with dignity and respect and their independence was promoted.
People who used the service require high staffing levels due to their level of need. We saw that staff encouraged and supported people to engage with relevant social activities dependent on their level of need and individual goals set out in their support plan.
People we spoke to said they were able to express their views, exercise choice and they felt safe in their living environment.