CQC report explained · a residential care home
What the CQC found at Ellsworth House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- The home had enough staff, managed medicines safely and had safeguarding and incident systems. However, one fire exit had two locked doors, one person's possible allergy was unclear, and recruitment records had inconsistencies.
- Effective?
- Good
- People's needs were assessed and care was adjusted when needed. Staff training, support with food and access to health professionals were good, although some specialist support could take time.
- Caring?
- Good
- Staff were kind, patient and knew people well. They respected people's communication methods, privacy, dignity, choices and need for independence.
- Responsive?
- Good
- Care plans were personalised and people had activities, community opportunities and support to maintain relationships. Some care plan information contradicted itself or was not updated consistently.
- Well-led?
- Good
- The new manager had created a more positive culture and was driving improvements. Staff felt listened to, and systems were in place to monitor quality and involve people and their representatives.
What inspectors found, April 2020
Ellsworth House was rated Good overall, but inspectors found safety shortcomings and rated the safe key question Requires Improvement.
This was an unannounced planned inspection on 12 and 13 February 2020. One inspector observed care, spoke with people and staff, checked care records, medicines, staff files and safety systems, and contacted health professionals.
People appeared happy and settled. Staff knew people well, treated them kindly and supported their communication, choices, activities and independence. Inspectors found good care in the effective, caring, responsive and well-led areas.
The safe rating fell from Good to Requires Improvement. Inspectors found a fire exit with two locked doors, uncertainty about one person's possible allergy, and gaps in recruitment checks. The manager took immediate action on some issues, and the provider was given a recruitment recommendation.
Kind and familiar staff
Staff showed patience and compassion and understood how each person communicated and became anxious.
“People were supported by kind and caring staff who knew them well.” from the report
Choice and independence
People were supported to make choices, develop skills, take part in activities and use community facilities.
“People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.” from the report
Safe medicines systems
Medicines were stored securely, staff competency was checked and errors were reviewed.
“Medicines were managed safely. People's medicines were stored securely in their bedroom or a designated place.” from the report
Improving leadership
Inspectors found that the new manager was making improvements and that staff felt more supported and involved.
“The registered manager supported by the provider had worked hard to create a positive culture at the home since they had arrived.” from the report
Fire exit
seriousA route labelled as a fire exit had two locked doors. Inspectors said this could leave people and staff at risk of becoming trapped during a fire.
“There was a potential risk people and staff could get stuck in the house in the event of a fire.” from the report
Unclear allergy information
needs fixingOne person's care plan mentioned an allergy, but the manager did not know about it and there was no medical record confirming it. Staff were unsure whether it was accurate.
“The registered manager was unaware of this and there was no medical record of it.” from the report
Recruitment records
needs fixingTwo staff files contained differences between declared dates and reference dates. No further checks had been completed at that point, and the provider was given a recommendation to review its practice.
“In both staff files there were inconsistencies around the dates declared and on the corresponding completed reference.” from the report
Care plan contradictions
minorSome care plan guidance contradicted itself, and updates in one section were not always reflected elsewhere. The manager had identified this and was reviewing the plans.
“However, there were occasions when this information contradicted itself.” from the report
- 01Has the fire exit with two locked doors been made fully safe, and how was this checked?
- 02What was the outcome of checking the possible allergy and updating the person's medical records?
- 03Have the recruitment inconsistencies in the two staff files been corrected, and are any further checks needed?
- 04How are you making sure that updates to one part of a care plan are copied into all related sections?
- 05How quickly can specialist teams provide support when staff need help with behaviours that may challenge?
This was an unannounced planned inspection covering all five key questions; the previous rating was Good, published on 2 August 2017. This explanation was written from the published report of 7 April 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, August 2017
Rated Good overall; inspectors found safe, kind and personalised care, but mental capacity records needed improvement.
The inspection was unannounced and took place on 11 March 2017. One inspector spoke with one person and three staff, observed care, reviewed three care plans and checked records about staffing, training, recruitment, medicines and management.
The home was rated Good overall. Safe, Caring, Responsive and Well-led were rated Good. Effective was rated Requires Improvement because records did not fully show how decisions were made about restrictions on people's access to food and liquids.
The home had improved since the October 2015 inspection. The earlier problem with the premises and equipment had been addressed, and the home was no longer in breach of legal requirements.
Improved environment
The home had addressed the cleanliness, décor and equipment problems found at the previous inspection.
“At this inspection we found that the service had developed suitable arrangements to ensure the service was clean and that infection control audits were being undertaken” from the report
Safe medicines
Medicines were stored safely, records were up to date and staff who gave medicines had completed training.
“Medicines were stored safely. Stock checks were carried out when people arrived at and left the service with their medicines.” from the report
Kind and respectful care
Staff knew people well, supported different ways of communicating and protected people's privacy during personal care.
“We observed staff treating people with dignity and respect.” from the report
Personalised support
Care plans recorded people's preferences, routines, communication methods and goals. People were offered activities based on their interests.
“Support plans were highly personalised to ensure that staff were aware of people's preferences, life history, likes and dislikes and their daily schedules.” from the report
Quality monitoring
Regular audits covered areas such as infection control, support plans, training, staffing and incidents. Action plans were used where improvements were needed.
“To ensure continuous improvement the registered manager and provider conducted regular audits to monitor and check the quality and safety of the service.” from the report
Mental capacity records
needs fixingThe home used restrictive practices relating to basic rights, including access to food and liquids, but had not recorded the required mental capacity assessments and best interest decisions clearly enough.
“The service was however responsible for ensuring a mental capacity assessment was undertaken and a best interest decision recorded to ensure that people's rights were protected” from the report
- 01How do you now record mental capacity assessments and best interest decisions?
- 02What restrictions are currently placed on access to food or liquids, and how are these reviewed?
- 03How are DoLS applications and any changes in people's restrictions monitored?
- 04How often will my relative's support plan be reviewed, and how will our family's views be included?
- 05How do your audits check that records about restrictive practices are complete and up to date?
This was an unannounced inspection covering all five CQC questions; the report also checked whether the premises and equipment problems found in 2015 had been put right. This explanation was written from the published report of 2 August 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Ellsworth House
3 rated inspections over 4 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Goodstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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