Archived: Eliot Gardens

Updated 2 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is 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 15, 26 and 29 November 2018. The first and third day was on site, the second day involved making telephone calls to relatives and service commissioners.

The inspection was announced 24 hours in advance because the service is small and we wanted to be sure the registered manager was present to support us with our inspection.

The inspection team consisted of one adult social care inspector from the Care Quality Commission (CQC).

Before the inspection we reviewed information we held about the service in the form of notifications. Statutory notifications are notifications that registered persons must send us by law in relation to significant events such as safeguarding, serious injuries, deaths and police incidents.

We used information contained in the provider information return (PIR) submitted by the service to help plan the inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with commissioners and the quality assurance team from Wigan. This would indicate if there were any particular areas to focus on during the inspection. No concerns had been identified.

During the inspection we spoke with a wide range of people, including; the registered manager, the area manager, the activities coordinator, four care staff and four people who received care and support. We telephoned the relatives of two people using the service.

Records looked at included four care plans and medicine administration records (MAR), additional information relating to the person-centred plans of three further people. We reviewed three staff personnel files which included staff who had been employed since the service registered in December 2017. We checked; training records, and any relevant quality assurance documentation. This helped inform our inspection judgements.

Updated 2 February 2019

This inspection took place on 15, 26 and 29 November 2018. This was the first inspection since the service had registered in December 2017. Eliot Gardens provides extra care housing to older people, some of whom may also have; learning disabilities, physical disabilities or mental health needs. The service also supports people under 55 if, following assessment, they were felt likely to benefit from the service.

People who were living in Eliot Gardens were identified as person supported, we have therefore used this term throughout this report. There were 35 people supported, living in the service. Not everyone received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of this inspection there were 18 people in receipt of a regulated activity. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people's personal care service.

Eliot Gardens consists of 35 ground floor apartments ranging in size from studios, to one or two bedrooms each with their own bathroom and kitchenette. There were five units each consisting of a lounge area with seven apartments adjacent to each one. Each unit had a small kitchen which people could use if they wished to prepare their own meals. There was a communal dining area, laundry facilities and accessible bathrooms. There were large accessible secure gardens.

There was a registered manager. 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.

Without exception, people living in Eliot Gardens and their relatives told us they felt the service was safe.

Safeguarding policies and procedures were in place and had been followed which ensured people were protected from the risk of harm and abuse. Staff were knowledgeable about what might indicate a person was experiencing harm or abuse.

The amount of support people needed was commissioned on an individual basis staffing levels fluctuated according to the level of need people had. Supported people and staff felt there was enough time to provide safe levels of support.

The staff team supported people to manage the risks in their daily lives in exceptional ways which had empowered them to achieve their goals and increase their independence through the use of positive risk taking strategies.

The service had robust recruitment practices in place. All staff had been newly appointed following the service registering in December 2017. We found all necessary documentation was in place.

Medicines had been managed safely. There was a medicines champion who provided additional guidance and support.

Infection control policies and procedures were in place. Staff were observed to use gloves and aprons when supporting people with personal care.

Accidents and incidents had been recorded and we saw how the service investigated each event to establish the cause and avoid reoccurrence.

The building was very well maintained and decorated and furnished to a high standard.

The service supported people to develop their own personal emergency evacuation plans, (PEEPS). These provided specific information about the support the person would need to evacuate, for example, in a fire.

People and their relatives had been involved in the initial assessments of their needs and preferences prior to moving in to the service. Assessments were thorough and addressed all areas of the person's health and social care needs. Other professionals input had also been included.

The service were working within the principles of the Mental Capacity Act (MCA). People were supported to make decisions about their care staff ensured people had consented to care and support.

Staff received comprehensive training which ensured they had the skills and knowledge to support people effectively. Supported people and their relatives praised the skills of the staff team and identified how they had achieved exceptional outcomes for their relatives.

People had been supported to maintain their nutritional needs. At the time of this inspection there was no one who needed a modified diet.

Wi fi was available throughout the building. The service were using technology to enhance people's support and increase their independence.

The service had been innovative in it's approach to supporting people to live healthier lives. They had addressed this holistically by understanding how people's lifestyles and feelings had impacted on their health and wellbeing. This had resulted in positive outcomes for people.

People's emotional needs had been carefully considered as part of their holistic assessment and care plan. The service saw supporting people emotionally as an essential part of their role. By supporting people to build their confidence we could see evidence of people becoming more independent and more confident.

Everyone we spoke with praised the kindness and the caring support provided by the staff. We observed staff throughout the inspection and saw they were polite and respectful to the people living in the service and to each other. Visiting professionals had also praised the calm and caring atmosphere in the service.

People had been fully involved in making decisions about their care and support. Staff understood the importance of maintaining people's dignity and respect. People we spoke with said staff followed their wishes. One of the relatives we spoke with told us the staff really went the extra mile and were extremely caring.

The service had developed an activities programme in response to people's interests and wishes. People who lived in the service were encouraged to share their skills and were organising and leading activities which they had been interested in prior to moving into the service.

People's care plans were exceptionally person centred and responsive to their needs. A visiting professional told us the staff really knew every one very well and this had resulted in very positive outcomes. Care plans were reviewed and updated at regular intervals. We saw people had been referred to other professionals when required.

Compliments had been shared with staff in team meetings and through a secure internal social media platform. In addition supported people and staff were nominated internally for awards which celebrated their achievements.

Information about how to complain was displayed in the communal areas and included in the service user guide. Everyone we spoke with said they had nothing to complain about and could not identify anything that could be improved.

The home was exceptionally well led. People supported, their relatives and staff praised the management and leadership. They identified the innovative and positive impact they had on the service and the significant improvements that had been achieved.

Effective governance systems ensured the registered manager had clear oversight of the service. Regular audits had been completed and action plans developed which ensured any identified concerns had been addressed.

The home continued to work in partnership with several organisations and attended forums where knowledge and experience were shared. There were clear examples of these partnerships resulting in positive outcomes for supported people.