Edward House

Updated 4 September 2020

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 Care Act 2014.

Inspection team

The inspection was undertaken by two Inspectors.

Service and service type

Edward House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home had a manager who was registered with the Care Quality Commission. This means they and the provider are legally responsible for how the home is run and for the quality and safety of the care provided.

Notice of inspection

The inspection was announced.

What we did before the inspection

We reviewed information we had received about the home since the last inspection. We contacted a social care professional for their feedback. We had not asked the provider to submit a provider information return (PIR). A PIR is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We took this into account, alongside the evidence gathered, when making our judgements in this report . Prior to the site visit, we requested care plans and associated risk assessments for six people as well as documents relating to quality assurance and oversight. We spoke with four relatives and four staff.

During the inspection

At the site visit, we observed the care and support people received. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with two people, the registered manager and the regional operations manager. We reviewed a range of records about people’s care. These included the individual care and medicine administration records for six people. We looked at staff rotas and staff files in relation to competency assessments.

Updated 4 September 2020

About the service

Edward House is a residential care home based in Burgess Hill, West Sussex. It provided personal care to 12 older people at the time of the inspection. Some of whom were living with dementia and other health conditions which included diabetes. The home is registered to support up to 22 people. The home accommodated people over two floors. People had individual rooms and had access to communal bathrooms, lounges and a dining room.

People’s experience of using this service and what we found

Oversight of risks, although improved, required further embedding in practice to ensure all risks, for all people, were minimised. This related to the oversight of people’s fluid intake, infection, prevention and control practices of senior staff and the accuracy of records to document staff’s actions and provide assurances of the care people had received.

The leadership and management of the home had significantly improved. The registered manager had improved oversight of people’s care and the running of the home. Actions were taken in a timely manner when there were issues or concerns. There was increased emphasis on improving the culture to improve people’s experiences and care. People, relatives and staff were involved in on-going discussions and were complimentary about the changes made. They told us the atmosphere was happier, and more pleasant. The registered manager welcomed feedback and used this to drive improvements within the home and to people’s care. Staff worked alongside external healthcare professionals to ensure people received appropriate and coordinated care.

People’s care and the management of risks associated to it, had improved since the last inspection. People and relatives told us people felt safe and there were enough staff to meet their needs, and our observations confirmed this. People were supported by suitably qualified staff and received safe and appropriate support which included access to their prescribed medicines. Incidents and accidents were analysed and lessons learned to inform changes in people’s care. When there were concerns about people’s well-being, the registered manager had liaised with the local authority for them to consider as part of their safeguarding duties.

People’s care was person-centred and tailored to their needs and preferences. Staff were provided with improved information about what was important to the person and what they enjoyed doing. Changes had been made to the environment and they spent time in the garden enjoying the outside space. Events had been organised to increase people’s social experiences such as barbecues and themed events. People received care that met their interests and preferences and told us they were happy living at the home.

Rating at last inspection and update

The last overall rating for the home was requires improvement (Supplementary report published 29 May 2020). The home was rated as Inadequate in the key question of Well Led and has been in Special Measures since 28 June 2019. During this inspection the registered manager demonstrated that improvements have been made. The home is no longer rated as Inadequate in any of the key questions. Therefore, the home is no longer in Special Measures.

Why we inspected

We carried out an announced focused inspection on 22 July 2020. We contacted staff and relatives on 20, 21 and 22 July 2020 and undertook a site visit to the home on 22 July 2020. We gave the registered manager and provider notice of the inspection to enable CQC and the registered manager to consider any infection prevention and control protocols due to the COVID-19 pandemic. We also established if people had COVID-19 or associated symptoms.

The provider completed an action plan after the last inspection to show what they would do and by when to improve in relation to the breaches of Regulations 9 (Person-centred care) and 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, we checked they had followed their action plan. We also checked they had met the Warning Notice we previously served in relation to Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and they were now meeting legal requirements. This report only covers our findings in relation to the key questions of Safe, Responsive and Well-led.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained Requires Improvement. This is based on the findings at this inspection.

In June 2019, the previous registered manager notified us of an unexpected death of a person who had fallen and sustained a head injury. This incident is subject to a potential criminal investigation. As a result, this inspection did not examine the circumstances of the incident.

Enforcement

We have identified a breach in relation to safe care and treatment at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow-up

We will continue to monitor the intelligence we receive about the home until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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