Background to this inspection
Updated
8 January 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 carried out by one Inspector.
Service and service type
Eleni House is a ‘care home’. 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
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 sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this 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 took this into account when we inspected the service and made the judgements in this report.
During the inspection
Due to their complex needs, we were unable to speak with people using the service about their views and experiences. We therefore spent time observing the care and support they received.
We spoke with the registered manager, deputy manager, and team leader and four support workers. We also spoke with an independent advocate who provided an advocacy service to those using the service on a regular basis and two relatives.
We looked at a range of records which included two people’s care records, three staff recruitment files, training records and records in relation to the quality and safety management of the service.
After the inspection
Following our visit to the service we spoke with two relative’s and received feedback from a professional who regularly visits the service.
Updated
8 January 2020
Eleni House is a residential care home that provides care and support for up to eight people who have a learning disability, complex needs and/or autistic spectrum disorder. At the time of our inspection there were seven people living in the service.
Services for people with learning disabilities and or autism are supported
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
The service did not have effective measures in place to ensure the environment people lived in was safe. We identified shortfalls in recruitment and medicines administration which had not been identified and addressed in a timely way.
Staff were trained, and competency assessed to administer people's medicines safely. However, staff did not always follow the provider’s policy when administering medicines. We recommended further work is carried out to improve the current system in place for auditing medicines to ensure the identification of medicines errors.
Staff understood how to recognise and report any concerns they had about people's safety and well-being. There was not always enough staff due to current vacancies, but this was being addressed. The provider’s policy in relation to safe recruitment practices had not been followed which meant not all safety checks had been carried out.
Staff were provided with a variety of training relevant to their roles. We identified further work was needed to ensure staff were provided with accredited training with competency assessment to ensure they were able to mobilise people safely.
Staff monitored people's weight for signs of changes and where necessary referred people for specialist advice and support. Most people had been assessed at high or medium risk of choking. However, not everyone had a care plan in place to guide staff in the steps they should take to keep people safe.
People's records provided information reflective of their personal histories and backgrounds. This included information in assessment of people's diverse, religious and cultural needs. Where religious and cultural needs had been identified further work was needed to ensure care plans described what action staff should then take to meet these diverse needs.
People using the service were older adults. We recommended further work be carried out to assess people’s needs and wishes in the event of sudden death or the need for palliative care support. The registered manager was in the process of implementing a new system of care planning to address these shortfalls.
People's capacity in relation to day to day decisions had been assessed. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported support this practice.
The service worked with other organisations and people were supported to access a range of healthcare services. People had access to specialist advice and support to meet their health care needs when needed.
Most people using the service have limited verbal communication skills and some complex health care needs which meant they were unable to verbally communicate when in pain. We recommended work be carried out to implement pain assessment tools for people with limited ability to verbally express themselves.
The registered manager had a system for recording and managing complaints but had not received any since the last inspection.
The service consistently applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection The last rating for this service was Good (published 26 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.