About the service: Edgehill Care Home provides personal care and accommodation for up to 60 older people. 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. At the time of our inspection 48 people were living at the service. People’s experience of using this service:
People’s medicines were not managed safely. Safe systems were not in place to dispose of medicines which were no longer needed. There were gaps in some topical medicines administration records seen.
People told us they were happy with the cleanliness of their rooms. People’s equipment was not always cleaned. We also saw the environment was not always cleaned, this was caused in part by a lack of maintenance to toilets and bathrooms.
People’s risks were not routinely identified or measures put in place to keep people safe. Risks in the environment had also not been identified so that safe systems of work could be put into place.
People were not always supported to make their own decisions and were not involved in planning their care. People had their own care plan which was not always up to date.
People were supported by staff who were not always trained and regularly supported in their roles. Staff understood safeguarding responsibilities and told us they would report any concerns to their manager.
People were not provided with person-centred care and support. Routines were not personalised, there was a lack of activities provided to meet individual needs.
Quality monitoring systems were not robust and had not identified all our concerns. The registered manager did not have effective oversight of the service. They were not aware of all the issues found.
People had provided feedback but the provider had not always taken action to make improvements where needed.
Despite the shortfalls at this service, people told us they felt safe and the staff were kind. Some staff had worked at the service for a long time which people appreciated. People were able to see healthcare professionals when needed.
People had their own rooms which they had personalised. We observed staff knocked on people's doors before going into their rooms promoting privacy.
Mealtimes were relaxed and people told us they enjoyed the food. Snacks and drinks were available around the home.
People could have visitors when they wished. People and their relatives told us they knew how to make a complaint if they needed to. Complaints were documented and had been investigated.
People and their relatives were kept up to date with news from the home in a quarterly newsletter. The service also used social media to record activities and events.
Accidents and incident were reviewed and had been analysed. Action was taken to try to reduce the risk of re-occurrence.
Rating at last inspection: At our last inspection in January 2018 we rated the service as Requires Improvement. We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because medicines were not managed safely.
Why we inspected: This was a planned comprehensive inspection based on the rating at the last inspection.
Follow up: We have found one repeated breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. In addition, we have found five further breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following this inspection, we wrote a letter of intent to the provider to seek reassurance on how they would mitigate the immediate concerns and risks to people. The provider sent us a comprehensive response detailing the action they would take to mitigate the immediate concerns. We have asked the provider to send us a monthly action plan using Section 64 of the Health and Social Care Act 2008.
The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This means we will keep this service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect the service within six months to check for significant improvements.
The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as Inadequate for any of the five key questions it will no longer be in special measures.