Background to this inspection
Updated
5 May 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.
Inspection team
The inspection was carried out by 3 inspectors, an inspection manager and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Enham Trust - Care Home Services (Michael/Elizabeth & William Houses 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. Enham Trust - Care Home Services (Michael/Elizabeth & William House is a care home where CQC regulates both the premises and the care provided, and both were looked at during this inspection. The provider told us Michael and William House will remain as a care home and Elizabeth House will transition into a supported living service.
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 was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last 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 the providers action plan and information we held about the service. We used all this information to plan our inspection.
During the inspection
We spoke with 12 people who used the service and 11 relatives about their experience of the care provided. We spoke to 11 members of staff including the registered manager, 3 house managers, the activities coordinator, the nominated individual and the maintenance team. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records including people's care and support documents and staff files in relation to recruitment. We also reviewed a variety of records relating to the management of the service. After the inspection we obtained feedback from 4 additional relatives.
Updated
5 May 2023
About the service
Enham Trust - Care Home Services (Michael/Elizabeth & William Houses) is a residential care home providing care for up to 60 people who may be living with a learning and/or physical disabilities.
The service was a campus setting. Campuses are group homes clustered together on the same site and usually sharing 24-hour staff. At the time of the inspection, 16 people were living in Michael House, 15 people were living in William House and 8 people were living in Elizabeth House. People’s experience of using this service and what we found.
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.
Campus settings for people with learning disabilities and/or autism are not in line with current best practice. The provider was reviewing their service model in accordance with the principles of ‘Right support, right care, right culture’ and with input from commissioners, people and their relatives.
Despite the service’s size we found people were supported in a way that was person-centred, and promoted choice, inclusion, control and independence.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care and right culture.
Right support:
¿ The model of care provided people with the appropriate opportunities to maximise their choices.
Right care:
¿ Care was provided in a person-centred manner and people told us they felt supported.
Right culture:
¿ The leadership in the service created a culture of inclusion which empowered people’s lives.
Significant improvement had been made in respect of the premises, the care people received and the leadership within the organisation since the last inspection. People were supported to make choices about their future, including where they lived and who they were supported by.
Staff had received regular training in safeguarding and were aware of their safeguarding responsibilities. People told us staff responded to requests for support. Medicines were stored and administered safely, and people raised no concerns about their medicines. Staff had good knowledge of how to respond to accidents and incidents.
People's needs were assessed when they moved into the service. People were happy about the support they received. Staff had received training that was relevant to their role. People's nutritional and hydration needs were being met and they were offered a varied choice of foods.
Staff had good knowledge of people’s communication needs. The service offered activities daily to people in communal areas or in their own rooms. People were supported to maintain relationships with their loved ones. People's wishes for end-of-life care were identified by the service.
Staff had good knowledge of people’s needs. We observed staff speaking to people in a caring and empathic way. Relatives felt staff cared about their loved ones. People were actively engaged in developing the care they received. Quality assurance systems were in place which were effective in driving improvement.
People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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 rated inadequate (published 28 June 2022)
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
Why we inspected
We undertook this comprehensive inspection to check they had followed their action plan and to confirm they now met legal requirements.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.