Background to this inspection
Updated
7 September 2022
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 Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we could understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was carried out by two inspectors. An Expert by Experience made calls to relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Earlham 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.
There is not currently a registered manager in place, the new manager appointed in March 2022 is currently in the process of submitting an application to become the registered manager. The registered manager 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 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
We spoke with three people who used the service and two relatives about their experience of the care
provided. We spoke with four members of staff including the new manager, team leader, support worker and operations manager.
We reviewed a range of records. This included care records for four for people who used the service, including care plans, risk assessments and daily records of care. We also reviewed medication administration records for three people. We looked at three staff files in relation to recruitment and staff supervision as well as a variety of records relating to the maintenance of the building, including servicing contracts and records related to the running of the service.
Updated
7 September 2022
About the service
Earlham House is a residential care home which provides accommodation and personal care to up to eight
people with mental health needs. At the time of the inspection seven people were living at the service.
Earlham House is a care home set up in an adapted residential building over two floors with a garden.
People’s experience of using this service and what we found
Staff recruitment checks were verified by the provider, however, we have made a recommendation in
relation to the availability of recruitment records.
People and relatives told us they felt safe at the service. People were protected from the risk of abuse or harm because staff knew the action to take should they suspect or witness any abuse. Risks to people were assessed and appropriately managed to ensure people received safe care. Appropriate infection control practices were followed by staff. Learning from incidents was discussed and shared with staff.
Staffing levels were determined by the level of individual care required for people using the service. We had some concerns about staffing levels at night.
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.
Systems for monitoring the quality of the service were in place and regular audits took place. Continuous learning took place to improve the quality of the service provided to people. However, frequent management changes meant there was sometimes inconsistencies in the way the service was managed by different people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 25 February 2022).The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we made a recommendation in relation to staff training in relation to medicine competency. At this inspection we found the provider had made improvements, medicine competencies had been completed for staff administering medicines.
Why we inspected
We carried out an unannounced focused inspection of this service on 14 and 15 June 2022. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, fit and proper persons employed, need for consent and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. For the Effective Key Question, we checked whether the service had followed their action plan and now met the requirements of Regulation 11 (need for consent). As we only checked the part of this Key Question we had concerns about, the rating for Effective has not changed and remains requires improvement. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Earlham House on our website at www.cqc.org.uk.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.