We carried out a review of the data available to us about Erskine Hall Care Home 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 Erskine Hall Care Home, you can give feedback on this service.
Erskine Hall Care Home is a residential care home providing personal and nursing care to up to 74 people. The service provides residential and nursing support to both older and younger adults including people living with dementia. At the time of our inspection there were 62 people using the service.
The home was split across 2 floors. Each person had their own ensuite bathroom and there were additional communal bathrooms and toilets should people wish to use them. There were shared facilities on each floor including a cinema room, hair salon, activities room, lounges, dining rooms, gardens and laundry facilities.
People’s experience of using this service and what we found
People told us they were very happy living at Erskine Hall Care Home. One person told us, “If you ask me what the best thing is in this home, it is the standard of care and [staff]. They are fantastic hard-working people, polite and gentle and there to help. Genuinely nice [staff].”
People told us they were supported well with their medicines. Any discrepancies or errors were quickly identified by the senior staff team and action taken to address them and ensure people’s well-being.
People were supported to look at ways of reducing risks to their health and wellbeing and these were regularly reviewed. People were supported to access all relevant health and social care professionals when required, to meet their needs.
People and their relatives were involved in regular reviews of their care. Relatives could access care records remotely to stay updated on the daily life of their family member.
People told us staff encouraged them to make choices and do what they could for themselves to maintain their independence as much as possible. People’s care was planned to meet their individual likes and dislikes where their diverse range of preferences were respected.
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 told us the food was good and they could ask for alternative options and request extra snacks and meals or drinks day or night. They told us there was plenty to do for those who wished to be involved in events in the service. Alternatively, there were other less busy areas for people who chose to spend time quietly relaxing.
People and relatives told us relatives and friends could visit them unrestricted and were always made to feel welcome. They told us the service was well-run with an approachable registered manager and staff team.
People and relatives told us they could always make suggestions or raise a concern and have confidence they would be listened to and their views acted upon.
Professionals gave positive feedback about the management of the service, the care of the staff team and the successful partnership working. The registered manager ensured a variety of quality assurance tools drove a culture of continuous learning and improvement.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update: The last rating for this service was requires improvement (published 3 May 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last 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, which will help inform when we next inspect.
People’s experience of using this service:
• Since our last inspection the service had made improvements. However, there were still areas that required improvement.
• People liked living at the service and got on well with staff who knew them well.
• People were able to choose how to spend their time and were encouraged to make decisions about their care. However, these were not always clearly documented in relation to people’s capacity to make informed decisions.
• People told us they had enough to do and enjoyed the activities available.
• People told us were supported by enough staff and told us they felt their needs were met.
• People did not have individual risk assessments in many cases. As a result, there was a potential for unsafe care to be delivered.
• The provider had systems in place to provide good quality care and ensure staff were trained.
• The registered manager had started just shortly before the last inspection and people and staff were positive about them. They told us that he had made a difference to the home.
• The service met the characteristics for a rating of "Requires improvement" in four key questions and met the characteristics for a rating “Good” in one key question.
• More information about our inspection findings is in the full report.
Rating at last inspection: At our last inspection the service was rated as requires improvement.
Why we inspected:
• All services rated "requires improvement" are re-inspected within one year of our previously published inspection report.
• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Follow up: We will continue to monitor the service to ensure it provides safe and effective care. We will plan further inspections in the future.
Erskine Hall Care Home 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.
Erskine Hall Care Home accommodates up to 85 people in one purpose built building. At the time of our inspection there were 46 people living at the service.
At our last inspection in November 2016, the service was rated Requires Improvement.
At this inspection, the service remains rated Requires Improvement.
The service had a registered manager however they were no longer in post. A new manager had been appointed and had been in post for a period of six weeks. 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.
Quality assurance systems had not been consistently implemented to evaluate and monitor the quality of the service. However, since commencing work at the service the manager had completed a range of quality monitoring audits and these were being used to identify where actions needed to be taken to drive improvements in the service. Feedback on the service was encouraged and acted upon.
A potential safeguarding concern had not been referred to local authorities. Staff told us they understood their responsibilities with regards to safeguarding people and they had received training.
People felt safe and secure in the service. There were personalised risk assessments in place that offered guidance to staff on how individual risks to people could be minimised. Medicines were stored appropriately, managed safely and audits completed.
There were consistent numbers of staff on duty to meet people's needs however people told us that they experienced some delays in receiving their care. Robust recruitment processes were in place and the required recruitment checks had been completed to ensure that staff were suitable for the role they had been appointed to prior to commencing work.
Staff received training to ensure they had the skills and knowledge to support the people living in the service. Staff felt supported in their roles and received regular supervision. New members of staff received an induction. Staff were positive about the training they received.
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 had been in involved in deciding the way in which they wished to receive care. People’s consent was gained before any care was provided.
A varied, balanced diet was offered at the service and people were complimentary about the meals provided to them. People's health care needs were being met and they received support from health and medical professionals, when required.
People and their relatives spoke positively about staff. They told us that staff were caring, kind and respectful. People's privacy and dignity was promoted throughout their care.
People’s needs had been assessed prior to their admission to the service. Care plans took account of people’s individual needs, preferences and choices and had been regularly reviewed.
People were encouraged and supported to participate in a range of activities and received relevant information regarding the services available to them.
There was an effective complaints system in place. People and staff knew who to raise concerns with and there was clear line of accountability amongst senior staff.
People, relatives and staff spoke positively about the manager. The management team were approachable and were a visible presence in the service.
The service provides care and treatment to older people with chronic health conditions, physical disabilities, and those who require palliative or end of life care. At the time of the inspection, 62 people were being supported by the service.
When we inspected the service in October 2015, we found staff training was not up to date, food and fluid charts were not always completed fully to evidence that people were eating and drinking enough. Also, wound care was not always evidenced in people’s care records. Although we found improvements had been made to staff training during this inspection, staff were still not always keeping up to date records of what support they had provided to people. However, we saw that the manager had put processes in place to improve this.
There was no registered manager in post, but a manager who had been in post since June 2016 had started the process to register with the Care Quality Commission. 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 provider had effective systems in place to safeguard people and staff had received safeguarding training. There were individual risk assessments that gave guidance to staff on how risks to people could be minimised. People’s medicines had not always been managed safely, but improvements had been made in the medicine management systems to ensure that people received effective treatment.
The provider had effective recruitment processes in place, but people did not feel that there was always sufficient staff to support them safely. More staff had been recruited so that a consistent group provided continuity of care. The manager and staff understood their roles and responsibilities in ensuring that people’s care was provided in accordance with the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). Staff training was now up to date. Staff were supported in the form of supervision and team meetings that enabled them to provide appropriate care to people who used the service.
Although people’s needs had been assessed and they had care plans that took account of their individual needs, preferences and choices, people had not always been supported quickly when they rang their call bells. However, the manager has put processes in place to improve this. People were supported to have sufficient food and drinks, and had access to health services when required in order to maintain their health and wellbeing.
Staff were kind and caring towards people they supported. They treated people with respect and supported them to maintain their independence as much as possible. A variety of activities had been provided to occupy people within the home and people had been given opportunities to pursue their hobbies and interests outside of the home.
The provider had a formal process for handling complaints and they responded quickly to people’s concerns. They encouraged feedback from people and their relatives, and acted on the comments received to improve the quality of the service.
Although the manager and other senior staff provided support to staff, some staff did not feel that they worked well together as a cohesive team. The manager regularly assessed and monitored the quality of the service provided, but more work was required to ensure that they provided consistently safe and effective care that met people’s needs and expectations.
This inspection took place on 14 and 15 October 2015 and was unannounced. The service provides accommodation, personal and nursing care for up to 85 older people. On the day of the inspection, there were 76 people living in the home.
The service is required to have 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. The manager took up their post in June 2015 and was not yet registered with the commission. They were awaiting for their application for registration to be processed.
People were safe and there were systems in place to safeguard them from the possible risk of harm. There were risk assessments that gave guidance to staff on how risks to people could be minimised. Risks to each person had been assessed and managed appropriately.
The service followed safe recruitment procedures and there were sufficient numbers of suitable staff to keep people safe and meet their needs. There were safe systems for the management of people’s medicines and they received their medicines regularly and on time.
People were supported by staff who were trained, skilled and knowledgeable on how to meet their individual needs. Staff received supervision and support, and were competent in their roles.
Staff were aware of how to support people who lacked mental capacity to make decisions for themselves and had received training in Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguards. People at risk of not eating and drinking enough were not always effectively monitored. People were supported to access other health and social care services when required, but there was not always sufficient information to ensure that their health care needs were appropriately met.
People were treated with respect and their privacy and dignity was promoted. People were involved in decisions about their care and support they received.
People had their care needs assessed, reviewed and delivered in a way that mattered to them. They were supported to pursue their social interests and hobbies and to participate in activities provided at the home. There was an effective complaints procedure in place.
There were systems in place to seek the views of people, their relatives and other stakeholders. Regular checks and audits relating to the quality of service delivery were carried out. There were effective systems in place to monitor the quality of the service.
Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and looking at records. If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
People we spoke with all said that they felt that the carers provided safe care and that they felt safe living in the home. People told us that they felt their privacy and dignity were respected by the care staff. Risk assessments had been undertaken to help minimise potential risks to people who used the service. The manager had undertaken a un- announced night check to ensure that people were being cared for in an appropriate and safe way.
Is the service effective?
We looked at the care plans of eight people who used the service. We found these provided details of what support people needed. We noted that the care plan showed people's preferences, likes and dislikes. People told us that they were happy with the care that they had received.
However, we found that records pertaining to some peoples 'positional change' charts were either missing or not completed correctly which meant that the records were not accurate and therefore could not be relied upon.
We asked the provider to tell us what they would do to meet the requirements of the law in relation to record keeping.
Is the service caring?
People we spoke with all stated that staff were caring and supportive. One person said, 'You get good care and attention from the staff'. Another person said, 'Staff are wonderful'.
Is the service responsive?
People we spoke with all told us that staff responded within a reasonable time scale when they requested assistance via the call bell.
The home had a complaint policy and procedure displayed in the reception area. The manager had kept a record of all complaints made. We were told that there had not been any complaints since December 2013.
Is the service well-led?
The provider had a quality assurance system in place that sought the views of people who used the service. Regular audits of care plans were undertaken to ensure that people were safe.
Some staff meeting had been held but all staff were not given the opportunity to participate and/ or contribute to the meeting. Regular residences and relative meetings were held and people were given the opportunity to discuss issue and any concerns they may have.
People we spoke with were very complimentary about staff and the management team. One relative we spoke with said 'The manager always keeps me informed, always rings me and lets me know what's going on. The care is not just good, the care is fantastic'.
On the day of our inspection the provider did not have a registered manager in place; however, the current manager had submitted an application to CQC to become the registered manager. Although there was not a registered manager in place, we found that the service was well-led. The leadership, management and governance of the organisation assure the delivery of high-quality person-centred care, in an open and fair culture.
During our inspection we observed that medication was not given to people at the required time. The home had a robust recruitment system in place which ensured that staff were qualified and suitable to provide care to people who resided in the home. We saw that the home had some systems in place to check the quality of the service they provided
People looked clean and smart. The people we spoke with and their relatives confirmed that the personal care they needed, had been provided that morning. They confirmed that care was provided in a timely way, apart from 'the odd blip which was to be expected'. We observed people having their lunch, and noted there was a choice of food, and weekly and daily menus were displayed.