10 March 2023
During an inspection looking at part of the service
Emsworth House Care Home with Nursing is a care home. The home is registered to provide accommodation and nursing care for up to 79 people. At the time of the inspection, 66 people were living at the home. The home comprises single room accommodation arranged in two separate sections; the residential unit provides accommodation with personal care and the nursing unit provides accommodation with nursing care. Each unit also has a wide range of communal areas where people can spend time and socialise.
People’s experience of using this service and what we found
Quality assurance systems had not been effective in identifying the concerns we found at inspection or driving the necessary improvement. When the registered manager was made aware of any issues, they acted to address them and told us of their plans to further improve.
There were not enough staff deployed to safely support people throughout the day and ensure their needs were always met. Risks to people were not always assessed, monitored or mitigated effectively. Medicines were not always managed safely.
The provider had effective safeguarding procedures in place and people were protected from the risk of abuse. Recruitment practices were safe. The home was clean overall, and the provider had effective processes in place to prevent the spread of infection.
Not all staff had received appropriate training to ensure they had the skills and knowledge to effectively support people.
People were supported to have maximum 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 this practice. However, improvements were needed with The Mental Capacity Act 2005 (MCA) records, and we have made a recommendation about this.
People received enough to eat and drink and told us the food was satisfactory. Improvements were needed to ensure people had the right support at mealtimes to make it a more enjoyable experience. The service had good relationships with external professionals to ensure joined up care and good health outcomes for people.
People and their relatives provided positive feedback about the caring nature of the permanent staff, and we saw kind and caring interactions during our observations. The registered manager was working on developing a more person-centred culture in the service.
The registered manager was open, honest and told us they were committed to make the necessary improvements to ensure the service provided safe, compassionate and well-led care.
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 requires improvement (report published 5 September 2019). This service has been rated requires improvement for the last three consecutive inspections. We will describe what we will do about the repeat requires improvement in the follow up section below.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. Please see the full details of the report which is on the CQC website at www.cqc.org.uk
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to staffing, risk management, medicines management, training and governance at this inspection. We have also made a recommendation in relation to MCA records.
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.