Evendine House Residential Home

People’s experience of using this service:

• People enjoyed living at the home and were complimentary about the way it was managed.

• People, relatives and staff told us they saw the provider and registered manager regularly and found them approachable.

• Staff understood risks to people’s safety and supported them to stay as safe as possible.

• There were enough staff to care for people at times people wanted assistance.

• People were supported to have their medicines safely and checks were undertaken to ensure these were administered as prescribed.

• The risk of infections and accidental harm was reduced, as staff used the knowledge and equipment provided to do this.

• Staff spoke affectionately about the people they cared for. People were confident to request support and reassurance from staff when they wanted this, and staff took time to provide this in the ways people preferred.

• People told us staff respected their rights to make their own decisions about their lives and care. Where people needed support to make some decisions staff assisted them, using people’s preferred ways of communicating.

• Staff had received training and developed the skills they needed to care for people, through induction and on-going training. People told us staff knew how to help them and knew what to do if they suspected anyone was at risk of harm.

• People had good access to other health and social care professionals and staff followed any advice given.

• 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.

• Staff ensured people had opportunities to do things which they enjoyed, and people were supported to keep in touch with others and religious practices that were important to them.

• The views of people, relatives and other health and social care professionals were considered when people’s care was assessed, planned and reviewed, so people’s needs continued to be met, and based on people’s preferences.

• Procedures were in place to take any learning from complaints and to further improve people’s care.

• People’s wishes for their care at the end of their lives had been planned and the views of their relatives considered.

• The registered manager and provider checked the quality of the care provided and encouraged suggestions from people and staff to improve people’s care further.

• The registered manager kept up to date with best practice developments, so they could develop the care provided further.

Rating at last inspection: At our last published inspection on the 24 January 2018 the provider was rated as Requires Improvement.

Why we inspected This was a planned inspection based on the ratings at the last comprehensive inspection. The rating has improved to Good overall.

Follow up: We will continue to monitor the service through the information we receive until we return, as part of the inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Evendine House Residential 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. This service provides accommodation and personal care for up to 20 people. At the time of this inspection, there were 18 people living at the home, a number of whom were living with dementia.

There was not a registered manager in post at the time of our inspection, but the acting manager had applied for registration. 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.

At the time of our last inspection undertaken in April 2016, we rated the service as Good. At this inspection, we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to safeguarding service users from abuse or improper treatment, and notification of incidents.

People had not always been protected from harm or abuse. Two incidents of physical abuse had occurred at the home in January 2018, but staff who had witnessed the first incident had failed to report this to the provider, or to the Care Quality Commission and the Local Authority. This inaction placed people at risk of further harm and abuse.

The provider's safe recruitment processes had not always been adhered to, which meant there were members of staff working at the home who had not undergone complete reference checks or been subject to a formal interview.

Not all staff working at the home had received an induction when they had started. Not all staff had received training in safeguarding, which the provider addressed during the course of our inspection.

The physical environment for people was not always dementia-friendly, with a lack of signage and information about the date and time. Plans were in place to remedy this.

The provider had not always submitted statutory notifications to the Care Quality Commission, as required by law. Statutory notifications are forms the provider must complete and submit to the Care Quality Commission when notifiable incidents occur at the home.

There were enough staff to meet people's physical and emotional needs. Staff had time to spend with people, and there was a relaxed and homely atmosphere throughout the inspection.

People were protected from the risk of infection. There were individual risk assessments in place which set out how to safely meet people's needs. People's medicines were stored in accordance with the prescriber's instructions.

People enjoyed the choice and variety of food provided. People were encouraged to try different foods, and were supported to try to maintain a healthy weight. People had access to a range of healthcare professionals.

Staff knew people well, which enabled them to detect any changes to people's health and wellbeing needs, and how to communicate with them in a way which would provide reassurance and comfort.

People were able to enjoy their individual hobbies and interests, and had the opportunity to take part in internal and external social and leisure opportunities. There was a system in place for capturing and responding to complaints, comments and suggestions.

People, relatives and staff were positive about the management team. The provider and acting manager had quality assurance measures in place, which they used to monitor the quality and safety of care provided. The provider and manager had investigated the allegations of abuse as soon as they had been made aware, and had taken action to ensure people's immediate safety.

The inspection took place on 26 April 2016 and was unannounced.

There was a registered manager at this home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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 kept safe by staff who knew people’s needs and how to meet these. People were kept safe by having sufficient staff on duty to respond promptly when assistance was required. People received their medicines from suitably trained staff, and as prescribed by their GP.

People were respected by staff and were given choices about how they wanted to be cared for. People enjoyed positive interactions with staff and were treated with dignity and respect by them.

People’s consent was sought before assisting them with personal care. People were given explanations to help them make informed choices. People’s right to refuse was respected. People’s nutrition needs were met by staff and people were supported to eat a varied and interesting diet. People had access to other health professionals when required.

People chose the activities they wanted to take part in and were encouraged and supported to retain their interests, hobbies and aspirations. People knew who the registered manager was and how to voice any complaints, suggestions or concerns. Where people had made suggestions, these had been acted upon.

People benefited from a service which was regularly monitored and reviewed by the registered manager and provider. People were able to express their views on the service through monthly meetings, and also by approaching the registered manager or provider.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found.

Is the service safe?

The people who lived in the home and their relatives told us they were pleased with the care provided. They said that their views were respected and listened to.

We saw that people's medication was managed appropriately so that they received the right medication at the right times.

We saw that there were enough staff to attend to people's needs.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.

Is the service effective?

People told us that they were happy with the care they received. They told us that the registered manager and the staff had asked them what their needs were and how they would like them met. A relative said, 'They include me in decisions about XXX's care'.

Care records confirmed people's needs and preferences had been recorded and care and support had been provided in accordance with their wishes.

People said they were happy to discuss their personal problems and preferences with staff. They said that staff obtained help for them if they were ill. This meant people were supported to keep in good health, have access to health care services and received ongoing support.

We found that the staff received the support and training that enabled them to meet the needs of the people living in the home.

Is the service caring?

People we talked with told us their choices and wishes were respected and they were able to live their lives as they wished. Staff took the time to find out about people's background. Staff knew people's needs well and how they wished to be cared for. This meant that staff cared about the person as an individual and were concerned about their well-being.

People that we talked with told us that they found the registered manager and the staff easy to approach about any issues they had. This meant that people were listened to and they felt that their views mattered.

Is the service responsive?

People had been assessed before they moved into the home so that arrangements could be made to meet their needs.

People and their relatives told us they talked with the registered manager and the staff about what was important to them. They talked the about activities they took part in and their meals. They told us that their care packages had been changed to include their wishes.

Is the service well led?

We found that the management and staff treated people with compassion, dignity and respect. Staff we talked with showed they understood those values as they discussed their role and responsibilities in their work. This meant the service promoted an open culture that was centred on the individual and empowered them to take control of their life as much as they were able.

The provider had systems in place to assess and monitor the home so that potential improvements in meeting people's care needs could be identified and put into place.

People told us that staff were, "very kind", "delightful", and, "really good at their jobs". They said that staff responded promptly when needed. Records showed that people's care was planned and reviewed so that the information in care plans was up to date and accurate.

Staff received a range of training to give them the skills and knowledge they needed for their work. There were effective systems in place for assessing and monitoring the quality of the service. Records throughout the home were easy to locate and were accurate. Sensitive and confidential information was stored securely.

Records showed that staff knew people's likes and dislikes, and that people's wishes were respected. We saw that staff were spending individual time with people and supporting them in an appropriate way. The care files we saw were detailed and clearly written. Staff said they found the care plans easy to refer to.

People told us that they felt safe at the home. Records showed that all staff had received training in how to protect people from abuse or neglect.

People told us that there were always enough staff to meet their needs. They said 'they come straight away if you need them'.

People told us that they would feel comfortable raising any concerns with the manager. People told us that they found the manager very approachable. We saw copies of the most recent satisfaction survey completed by people and their relatives. These showed that people felt comfortable suggesting ways in which the home could continue to improve.