Archived: Epworth House Care Centre

Updated 10 May 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 27 March 2017 and was unannounced. The inspection team consisted of two adult social care inspectors and an expert by experience with expertise in the care of older people and people living with dementia. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

At the time of our inspection there were 29 people living in the home. During the inspection we spent time observing care and speaking with people about their experience of the care provided. We spoke with seven people who used the service and five of their relatives who were visiting the home.

We also spoke with the manager, the deputy manager, four care staff, the cook and kitchen assistant, the laundry assistant and the activity coordinator. We spoke with a healthcare professional who was attending to people on the day of our inspection. This helped us evaluate the quality of interactions that took place between people living in the home and the staff who supported them.

Prior to the inspection visit we gathered information from a number of sources. We looked at the information received about the service from notifications sent to the Care Quality Commission by the manager. We also spoke with the local council quality assurance officer who also undertakes periodic visits to the home. They told us they had no concerns about how the service was run.

We looked at documentation relating to people who used the service, staff and the management of the service. We looked at four people’s written records, including the plans of their care and the systems used to manage their medicines, including the storage and records kept. We looked at six staff files, including recruitment and training information. We looked at the quality assurance systems to check if they were robust and identified areas for improvement.

Updated 10 May 2017

The inspection was carried out 27 March 2017 and was unannounced, which meant the provider and staff did not know we would be visiting. The service was last inspected in August 2016 at which time the service was not meeting the requirements of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The service had a history of breaches of regulation. We checked to see if any improvements had been made with the breaches identified at the last inspection, which included, Regulation 11 Need for consent, Regulation 12 Safe care and treatment, Regulation 13 Safeguarding service users from abuse and improper treatment and Regulation 17 Good governance. We checked and found improvements had been made, sufficient to meet regulations.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Epworth House’ on our website at www.cqc.org.uk’

The registered provider was placed into special measures in December 2015 by CQC. The service has been in administration since November 2016 and was being run by Care Regeneration Services a company appointed by the administrators.

There was no registered manager in post; however there was a temporary manager who was responsible for the day to day running of 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.

At this inspection we found improvements had been made sufficient to meet regulations. However, the registered provider must evidence to the commission that they can sustain the improvements made so that the service remains compliant with all regulations.

Epworth House Care Centre is a care home registered to provide personal care and accommodation for up to 67 older people. The home is separated into two units. One unit is for people living with dementia and is sited on the first floor. The second unit is for people who have personal care needs with the main living accommodation sited downstairs. At the time of our inspection 29 people were living at the home.

People who used the service told us they felt safe living in the home. Their relatives spoke positively about the standard of care and support their family member received.

Systems for the safe administration of medicines were in place. The manager must continue to closely monitor and audit medicines so that mistakes or omissions are dealt with promptly.

Staff were knowledgeable about safeguarding people from abuse, and were able to explain the procedures to follow should there be any concerns of this kind.

Procedures in relation to recruitment and retention of staff had improved and were robust which ensured only suitable people were employed in the service. We found staff were skilled and experienced and there was a programme of training. Supervisions and appraisals were scheduled to take place throughout the year and staff told us they felt supported by the manager and deputy manager.

Staffing levels were appropriate to meet the needs of people who used the service. We saw staff engaging with people in an inclusive manner by encouraging them to join in conversations and activities.

The manager was aware her legal responsibilities with regard to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). There were policies and procedures in place and key staff had been trained. This helped to make sure people were safeguarded from excessive or unnecessary restrictions being place on them. The service had made improvements to the way they obtained consent to people’s care and treatments and we saw evidence of authorised DoLS in place for some individuals.

People’s health was monitored and reviewed as required. This included appropriate referrals to health professionals. Individual risks had also been assessed and identified as part of the support and care planning process.

Staff were aware of people’s nutritional needs and made sure they supported people to have a healthy diet, with choices of a good variety of food and drink. People we spoke with told us they enjoyed the meals and there was always something on the menu they liked.

Staff and people who used the service were mutually respectful. People were seen enjoying the company of staff and staff spoke with people in a polite and caring way.

A varied activity programme was on offer to people. We saw people thoroughly enjoying the activities available on the day of the inspection.

Staff told us they felt supported and they could raise any concerns with the manager and felt that they were listened to. Relatives told us they were happy to raise any concerns directly with the manager.

There was a new manager in place who was working in partnership with other professionals to improve the quality of the service.

We found minor shortfalls in some areas and were provided with evidence that confirmed improvements to these were on going. Further improvements were required to make sure the service continued to improve. Systems in place to assess and monitor the quality of the service needed to be maintained and fully embedded into practice so that improvements were sustained.