About the service:

Eden Mansions is a care home and was providing personal and nursing care for up to 106 people. At the time of the inspection there were 100 people living at the service, some of whom were living with dementia. Accommodation was provided across four separate ‘villas’ within the main building.

People’s experience of using this service:

People continued to be protected from abuse and avoidable harm. There were sufficient staff to meet people’s needs and safe recruitment procedures were followed. Medicines were administered and managed safely and staff used personal protective equipment [gloves and aprons] effectively to prevent and control the spread of infection.

The service continued to be effective. People’s needs were assessed and personalised care plans developed to ensure that effective care was delivered in line with legislation and good practice. People were supported by well trained and knowledgeable staff. A choice of nutritious food was offered which people were complementary about. When people were unable to make decisions about their care and support, the service was working within the principles of the Mental Capacity Act 2005. People were supported to access a range of health and social care services to maintain their health and well-being.

People and visitors told us that staff were kind, treated them with respect and without discrimination. Visitors were made to feel welcome within the home. People had access to advocacy services when needed to ensure their rights were protected.

People were supported by staff who had a good understanding of their care and support needs and personal preferences. Each person had a personalised care plan so that the care delivered was tailored to their needs. An activities team co-ordinated a daily programme of activities based upon the likes and interests of the people living at Eden Mansions. People and visitors we spoke with knew who to speak with if they had any concerns or complaints.

Although there had been changes to the management team since the last inspection, the service continued to be well-led. There was a process to assess and monitor the quality of the service. Staff and the management team promoted a person-centred and open culture, working well with other agencies.

Rating at last inspection:

At the last inspection the service was rated Good. [5 September 2016].

Why we inspected: This was a planned inspection based on the previous rating.

This inspection took place on 6 & 7 July 2016 and was an unannounced inspection.

Eden Mansions Nursing Home is a purpose built home registered to provide residential and nursing care for up to 101 people. There are four separate units within the home for nursing, residential and people living with dementia. There is a passenger lift for ease of access and the home is fully wheelchair accessible. There are communal lounges, dining rooms, a reception area, hairdressing salon. There are garden areas around the home with seating. Limited parking is available at the front of the building. At the time of the inspection 96 people lived at the home.

At the last inspection in November 2013. The service was meeting the requirements of the regulations that were inspected at that time.

There was a registered manager in place. 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 told us they felt safe living at Eden Mansions nursing home. The management team had procedures in place and there was an open and transparent culture in the home. Staff had all received safeguarding training and knew what to do if they saw or suspected abuse. We saw almost all care was good, with staff showing kindness, patience and sensitivity to people who lived in the home. However a relative raised concerns about the standard of care while we were completing the inspection. We did not see the issues raised by the relative on the inspection but we raised their concerns with the local authority as a safeguarding alert.” The safeguarding team investigate safeguarding issues and decide what action, if any to take in response to this.

Major building work to increase facilities at the home was on-going. Risk assessments were in place including those around the added risks caused by the building work. These reduced the risk of minimised inconvenience to people who lived at Eden Mansions whilst it was on-going.

Staff managed medicines competently. People told us they felt staff gave them their medicines correctly and when they needed them. We saw they were given as prescribed and stored and disposed of correctly.

The home was clean and hygienic when we visited. There were no unpleasant odours. People we spoke with said they were pleased with the standard of hygiene in place and it was always clean and fresh smelling.

We looked at how the home was being staffed. We saw there were enough staff on shifts to provide safe care. People we spoke with were satisfied with staffing levels.

People we spoke with told us staff were caring and helpful. They said their health needs were met and any changes in health were managed in a timely manner. Staff responded to any requests for assistance promptly. One person said, “It is not often that I have to wait when I ring for staff.”

Recruitment and selection was carried out safely with appropriate checks made before new staff could start working in the home. By doing this the management team reduced the risk of employing unsuitable people. Staff had been trained and had the skills and knowledge to provide support to the people they cared for.

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS). Applications had been submitted where needed. This showed us staff were working within the law to support people who may lack capacity to make their own decisions.

People said the food was varied and tasty and they had no problems getting snacks or drinks outside of meal times. People were offered a choice of healthy and nutritious meals. Staff made sure people’s dietary and fluid intake was sufficient for good nutrition.

We saw staff were familiar with people’s care nee

We sampled 12 care files in total, three from each of the four units within the home. We found the care files to be extremely comprehensive, containing a wide range of information about each person and the care and treatment required.

Relatives we spoke with during the visit spoke highly of the care provided. Comments included: “My X has been really happy here, he is well looked after" and "Being here gives me piece of mind that my X is being cared for where they have time and experience to know what they are doing and do it well".

Nutritional assessments were undertaken to ensure any risks for people who used the service were highlighted and acted upon.

People were provided with a choice of suitable and nutritious food and drink and were appropriately assisted.

Eden Mansions had systems in place to effectively manage medicines. We sampled a number of medicine administration records (MAR) and found these to be well documented.

We found care was provided in an environment which was modern, clean and well organised. Visitors we spoke with told us: "It is always spotless; I have never seen anything out of place, even when staff are really busy".

Eden Mansions had systems in place to ensure staff were safely and effectively recruited and employed. We noted staff had the appropriate skills and training in order to carry out their roles and responsibilities.

We completed an unannounced inspection at Eden Mansions Care Home 20 August 2012. We visited each of the four units at Eden Mansions.

On the ground floor, Stanneylands unit provided care and support for people whose general nursing care needs outweighed that of their dementia care needs and Capesthorne unit provided care for people who had their needs assessed as requiring residential dementia care.

On the first floor, Ashleigh unit provided care and support for people with assessed dementia and mental health conditions and Chester unit provided care and support for people with challenging behaviour, dementia care needs and mental health conditions.

As part of this review, we asked relatives to comment on the management of the home and the standard of care provided. We also spoke with the Local Authority and a visiting GP for their views of the service.

We spoke to a number of people who used the service who were able to tell us their views but for some people who used the service the information obtained was limited due to communication difficulties. In light of this, we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. During the visit, we saw positive interactions and engagement between staff and the people using the service to ensure they received the care and support they needed.

Relatives comments about the maintenance of the privacy dignity and respect of their family members included: “Privacy and dignity is maintained, care is always given in private.” One relative told us: “They (the staff) always treat my family member as an individual." We were told they felt that their family members were appropriately cared for and supported. One relative told us: "The care is excellent my family member is really well cared for." One relative told us that they found: “the staff are very welcoming and friendly.”