Keychange Charity Erith House Care Home is registered to provide accommodation and personal care for up to 20 older people. Nursing care is not provided by the service. If nursing care is required this is provided by community nurses working for the local primary care trust.This unannounced inspection took place on 19 and 21 October 2016. The service was last inspected in December 2013 when it met the regulations that were inspected.
A registered manager was employed by the service. 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 registered manager of the service was registered to manage another Keychange Charity service in the local area. They were supported in their role by a deputy manager in each service.
We received a mixed response from people and staff when we asked if there were enough staff on duty at all times. Some people and staff felt there were enough staff available, while others felt there were times when there was not. During the inspection we saw people’s needs being met in a timely way and call bells were answered quickly.
We have made a recommendation relating to staffing levels.
People received individualised personal care and support delivered in the way they wished and as identified in their care plans. Although people’s care plans contained repeated information, they did have all the information staff needed to be able to care for the person in the manner they wished. Care plans were reviewed regularly and updated as people’s needs and wishes changed.
People’s needs were met by kind and caring staff. One person told us “I’ve never been happier, everything about it (Erith House) is right.” One relative told us staff “care about people as individuals.” We saw many ‘thank you’ notes from families, expressing their gratitude to staff. For example, one note said ‘A heartfelt thanks for the exceptional care you gave our mum over the years.’ People’s privacy and dignity was respected and all personal care was provided in private.
Risks to people’s health and welfare were well managed. Risks in relation to nutrition, falls, pressure area care and moving and transferring were assessed and plans put in place to minimise the risks. For example, pressure relieving equipment was used when needed. People’s medicines were stored and managed safely. People were supported to maintain a healthy balanced diet and they told us there was a good choice of food. People were supported to maintain good health and had received regular visits from healthcare professionals.
Not everyone wanted to be involved in planning their care. We saw that where people or their relatives wished to take part in planning care they could. Relatives told us that staff always kept them informed of any changes in their relative’s welfare.
Activities and outings were on offer if people wished to participate. One person told us they did not want to participate and preferred reading in their room or the garden. Other people told us how much they enjoyed the visiting entertainers. One visitor told us they were pleased their relative had the choice about taking part in activities. They said they felt the service “encouraged but did not pressurise” their relative to join in.
Staff confirmed they received sufficient training to ensure they provided people with effective care and support and meet their needs. There was a comprehensive staff training programme in place and a system that indicated when updates were needed. Training included caring for people living with dementia, first aid and moving and transferring.
People’s human rights were upheld because staff displayed a good understanding of the principles of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards (DoLS).
Staff knew how to protect people from the risks of abuse. They had received training and knew who to contact if they had any suspicions people were at risk. Robust recruitment procedures were in place. These helped minimise the risks of employing anyone who was unsuitable to work with vulnerable people.
The registered manager was very open and approachable. People were confident that if they raised concerns they would be dealt with. People, relatives, staff and healthcare professionals spoke highly of the registered manager. People and staff the registered manager was good, approachable and would listen to them. One person told us that although the home was well managed, they missed seeing the registered manager as much now they had two services to look after. They said they “feel better when she is around.”
There were effective quality assurance systems in place to monitor care and plan on-going improvements. Monthly audits were undertaken including medicines, care plans and accidents and incidents. Records were well maintained.