Archived: Emberbrook Care Home

Updated 11 August 2015

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 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.

The inspection took place on the 23 June 2015 and was unannounced. The inspection team consisted of two inspectors, a specialist nurse advisor and an expert by experience. A specialist advisor is someone who has clinical experience and knowledge of the nursing care that was being provided. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we reviewed information that we held about the service which included the last inspection report, any notifications received and information from the local authority. A notification is information that the provider is required to send us by law which helps us decide when to inspect. We did not ask the provider to complete a provider information return (PIR) on this occasion. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This was because we had brought forward the inspection and they would not have had the opportunity to complete one.

We used different methods to understand the experience of people who used the service which included talking to people, their relatives and friends or other visitors. Where people were unable to tell us about the care they received we observed care being provided by staff. We also interviewed staff, looked at people’s care records, medicines administration records and other paperwork that related to how the service was being run and managed.

We spoke to 16 people who used the service, five relatives, nine nursing and care staff which included a physiotherapist and the manager. We looked at eight care plans, five staff recruitment files, policies and procedures in place and audits completed by the registered manager.

The service was last inspected on the 31 January 2014 where there were no concerns identified.

Updated 11 August 2015

The inspection took place on the 23 June 2015 and was unannounced.

Emberbrook Care Home is a nursing home that is registered to provide accommodation for up to 68 people who may require nursing or personal care. Some people who reside in the home may be living with dementia. The service has four units arranged over two floors and each person has their own bathroom. On the day of our inspection there were 55 people living in the service.

There was a new manager in post who had started working at the service in May 2015. They were in the process of applying to be 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.

People living with dementia did not always have a positive experience at mealtimes and equipment that would help them to eat independently was not always available. Staff did not always interact with people at mealtimes. Staff did not have a good understanding of the Mental Capacity Act 2005 (MCA) or the Deprivation of Liberty Safeguards (DoLS). Relatives we spoke to told us that staff were “Not trained enough in dementia” and we found that not all staff had received supervision with their line manager that would have enabled them to raise concerns or identify any training needs they may have. We have made a recommendation that staff receive additional and relevant training related to caring for people living with dementia.

People did not have access to activities that were personalised to them. People told us they were “Bored” and that the staff did not always have time to spend time with them. Relatives confirmed that activities were something that needed to be improved. Peoples care plans were not person-centred and there was limited information in them about people’s life and history.

Where people had identified risks to their health these were not always managed well, particularly in relation to their skin. Staff did not always recognise the signs where people were at risk of developing pressure sores. We have made a recommendation relating to this aspect of people’s care.

Staff did not always have a clear understanding of who they should contact if they wished to raise a safeguarding concern outside the service such as the local authority.

People told us that they felt safe living at Emberbrook Care Home and that the staff were “Vigilant”. Relatives told us that there were enough staff available to keep their family member safe. Recruitment processes were robust and had been followed to help ensure that suitable staff were employed. People got their medicines on time or when they needed them. Medicines were stored securely and administered by staff who were trained to do so. Records relating to medicines were accurate.

People told us that the staff knew them “Well”. People were referred for specialist advice if they had a particular health need that had been identified. Referrals were made in a timely way and healthcare professionals we spoke to told us that they had “No concerns” about the care that was provided.

Without exception people and their relatives told us that staff were caring. Comments included that staff were “Excellent”, “Wonderful” and that they “Always put you first”. Interactions between people and staff were respectful and people’s dignity and privacy was maintained by staff who understood the importance of doing so. The atmosphere in the service was welcoming and relaxed.

People and their relatives knew how to make a complaint and were “Not afraid” to do so. Complaints were dealt with informally wherever possible and had been resolved to people’s satisfaction. Complaints were clearly documented and acted upon by the manager. Staff responded promptly to people when they needed assistance and when a health need was identified this was acted upon quickly by nursing and care staff to improve their health.

The new manager understood the challenges the service faced to improve the delivery of care and was actively involved in the planned refurbishment. There were effective quality audits undertaken where action was taken to improve the service for people. Incidents and accidents were monitored to identify any patterns or trends. People and relatives told us they were pleased with the new manager and said “Things were looking up”.

We found two of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.