Edwin House

Updated 10 November 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was completed by 3 inspectors and a nurse specialist advisor.

Service and service type

Edwin House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Edwin House is a care home with nursing care provided in one of two buildings. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there were two registered managers in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We reviewed information we had received about the service since registration. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also contacted the Home Office to gain information about the issues regarding the staff.

We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service and asked them about their experience of the care provided. We spoke with 5 support staff, a team leader, advanced nurse practitioner, 2 registered nurses, partnership manager, 2 therapy workers, 2 registered managers, operations manager and service director who was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also contacted external health and social care professionals and asked them for their views of the quality of the service provided. We used all this information to help form our judgements detailed within this report

We asked the registered managers to provide us with a variety of policies and procedures and additional information. All information was sent within the required timeframe. We reviewed a range of records. This included all or parts of 7 people’s care records, medication administration records and the daily notes recorded by care staff. We looked at 3 staff files in relation to recruitment and staff supervision and a variety of records relating to the management of the service, including policies and procedures and training records.

Updated 10 November 2023

About the service

Edwin House is a residential care home providing accommodation for persons who require

personal care and/or treatment for substance misuse. A maximum of 63 people are permitted to stay at the service.

The service provides support to people with a wide range of ages with varying levels of treatment and support required for their substance misuse. This is provided across two separate buildings. Edwin House focuses on providing up to 43 people with the initial accommodation required. The Level is a medically managed inpatient detox unit that provides individually tailored programmes of treatment and care for people who need medically assisted stabilisation or detoxification from alcohol or other substances. The Level accepts referrals from specialist community drug and alcohol teams located throughout the UK, and accommodates up to 20 service users.

At the time of the inspection 31 people resided at Edwin House and 8 at The Level.

People’s experience of using this service and what we found

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 they received safe care and treatment. Measures were in place to protect people from the risk of abuse. Risks to people's health and safety were assessed, monitored and changes acted on. People were supported through a robust programme that assisted them with trying to end their substance misuse.

There were enough skilled, trained, and experienced staff to provide safe care. Recruitment was on-going at Edwin House. It was acknowledged that agency staff use was high, but plans were in place to address this. There was no impact on the quality of care provided. Medicines at The Level were well managed. Edwin House had similar measures in place to manage people’s medicines safely, although there were some issues with the administration and management of ‘when required’ medicines. This was rectified during the inspection and will be checked at our next inspection.

At Edwin House, some people’s bedrooms were unclean and posed an infection control risk. However, the people affected had the capacity to make their own decisions. Records showed staff had on numerous occasions attempted to work with people to clean their bedrooms. This attempted support continues. There were no concerns with people’s bedrooms at The Level.

Communal areas at Edwin House and The Level were clean and tidy and procedures were in place to reduce the risk of the spread of COVID-19 and other infections. Learning from accidents and incidents took place, appropriate notifications were forwarded to the relevant authorities.

There was a clear structure in place for monitoring risk, assessing staff performance, and driving improvement and development. There were two registered managers in place, one for Edwin House and one for The Level. They were supported by senior management to carry out their role. The registered managers understood and adhered to the regulatory requirements of their role. They were well liked by the people they supported and staff. The provider acted on feedback from people and staff.

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 good (published 19 September 2019)

Why we inspected

We received concerns in relation to the cleanliness of people’s bedrooms and the support people received with personal care at Edwin House. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained as good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe and Well-led sections of this full report.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections event if no concerns or risk 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 Edwin 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.