At our previous inspection to the service on 21 and 22 August 2017, there were two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This referred specifically to appropriate arrangements not being in place to recruit staff safely. Additionally, not all staff had attained up-to-date training or received an induction, supervision or appraisal of their overall performance. The overall assessment rated the service ‘Requires Improvement’. The registered manager submitted an action plan detailing the steps they had or were taking to address the concerns found in August 2017.

This inspection took place on 31 August 2018 and 4 September 2018. We checked to see that the registered provider had made the required improvements. We found that the required improvements had been made and the service was now compliant with regulatory requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Southend Blind Welfare Organisation 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.

Southend Blind Welfare Organisation is registered to provide accommodation with personal care for up to 25 older people, people living with a visual impairment and others who may live with dementia related needs. Southend Blind Welfare Organisation is a large detached property situated in a quiet residential area in Westcliff on Sea and close to all amenities. The premises are set out on two floors with each person using the service having their own individual bedroom and adequate communal facilities are available for people to make use of within the service. There were 15 people receiving a service at the time of our inspection.

The service had a registered manager in post. 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.

Our key findings across all the areas we inspected were as follows:

Suitable arrangements were in place to keep people safe. Policies and procedures were followed by staff to safeguard people and staff understood these measures and the actions to take if abuse was suspected. Risks to people were identified and managed to prevent people from receiving unsafe care and support. The service was appropriately staffed to meet the needs of the people using the service. People received their medication as prescribed and in a safe way. Recruitment procedures were now followed to ensure the right staff were employed and all records as required by regulation sought. People were protected by the registered provider’s arrangements for the prevention and control of infection. Arrangements were in place to learn from events when things go wrong.

Staff now received a thorough induction to carry out their role and responsibilities effectively. Staff had the right competencies and skills to meet people’s needs and received regular training opportunities. Suitable arrangements were also now in place for staff to receive regular formal supervision and staff employed longer than 12 months had had an appraisal of their overall performance. People’s nutritional and hydration needs were met and they were provided with drinks and snacks throughout the day. People received appropriate healthcare support as and when needed from a variety of professional services. The service worked together with other organisations to ensure people received coordinated care and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and

This inspection took place on 21 and 22 August 2017.

Southend Blind Welfare Organisation is registered to provide accommodation with personal care for up to 25 older people, people living with a visual impairment and others who may live with dementia related needs. There were 18 people receiving a service at the time of our inspection.

The service had a registered manager in post. 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.

Appropriate arrangements were not in place to recruit staff safely so as to ensure they were the right people and improvements were required. Not all staff had received training/refresher training to enable them to carry out their role and responsibilities to an appropriate standard. Although a rationale was provided by the registered manager as to why staff had not training, action was needed to address this. Additionally, although an induction programme was in place that prepared newly employed staff for their role, an induction had not been undertaken for the newest member of staff or for staff provided by an external agency. Improvements were also needed to ensure staff received formal supervision and an annual appraisal of their overall performance.

Whilst arrangements were in place to regularly assess and monitor the quality of the service provided, these measures were not as robust or effective as they should be. The registered manager was required to take proactive action to make the necessary improvements as detailed above.

People told us the service was a safe place to live and there were always sufficient staff available to meet their care and support needs. Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed to ensure their safety.

Medicines were safely stored, recorded and administered in line with current guidance to ensure people received their prescribed medicines to meet their needs. This meant that people received their prescribed medicines as they should and in a safe way.

Staff demonstrated a good understanding and awareness of how to treat people with respect and dignity. Staff were able to demonstrate a good understanding and knowledge of people’s specific support needs, so as to ensure theirs’ and others’ safety.

People who used the service and their relatives were involved in making decisions about their care and support. People’s capacity to make day-to-day decisions had been assessed.

The dining experience for people was positive and people were very complimentary about the quality of meals provided. Where people were at risk of poor nutrition or hydration, this was monitored and appropriate healthcare professionals sought for advice and interventions.

Care plans accurately reflected people’s care and support needs and people received appropriate support to have their social care needs met. People told us that their healthcare needs were well managed. Staff were friendly, kind and caring towards the people they supported and care provided met people’s individual care and support needs.

People and their relatives told us that if they had any concern they would discuss these with the management team or staff on duty. People were confident that their complaints or concerns were listened to, taken seriously and acted upon.

People were protected against the risks associated with medicines because the provider had improved arrangements in place to manage medicines

People who use the service told us that they were very happy with the care and support provided at Elkington House. People told us that they were treated with respect and dignity. Relatives spoken with were very complimentary regarding the service. They told us that communication was good and they were always kept informed about their relative's care, support and treatment and told of the outcome of any healthcare appointments. Over the preceding 12 months there had been no safeguarding alerts or complaints.

Further improvements are required to ensure that medication practices and procedures are developed so as to ensure positive outcomes for people. In addition improvements are required to ensure that all staff receive regular supervision. Effective quality assurance may assist the provider in recognising where there are gaps and areas for development.

People living at Elkington House had a wide range of needs. Some people had varying levels of dementia and different communication needs. We were therefore unable to fully understand everybody’s specific issues.

Those people with whom we spoke all told us that they were happy living at Elkington House, one person told us that they had made their own choice to live at Elkington House and another said that they had experienced life at Elkington House prior to their admission when they stayed for respite care and liked it.

Visitors told us that Elkington House has open visiting and they were always given a warm welcome and were always updated about their relatives’ condition and care.

Everybody we spoke with said that the meals provided were good and everybody spoke highly of the staff and considered staff to be helpful and supportive.

One person told us “The care is fantastic, the girls really earn their money, you are waited on hand and foot, they are really lovely – all of them."

Another person said “It is very homely here and everyone is happy. The staff are very good and helpful. We have fun and a laugh and the food is fantastic.” Another person said that they had “never been as spoilt as they have here.”

We were told that the staffing levels were “Ok, as long as there is no sickness, there was only two the other day; we have not had any agency staff for a while.”

They told us that their wishes to be independent were respected and they were supported to make decisions about their care. People said that they could choose their own routines, for example, what time they wanted to go to bed or to get up. One person said “I have retained my autonomy and I voice any concerns I may have about my care.”

People told us that they enjoyed the social activities that were arranged for them. One person told us how they enjoyed playing dominoes; another told us that the friendly competitiveness between the teams provided plenty of friendly banter between them.

We were told that activities such as dominoes, quiz games and bingo were provided three mornings a week by the activity co-ordinator. One person told us that apart from these activities they get very tired doing nothing, they listen to the radio but they don’t go out. Another person told us that they like to play dominoes and they listen to the radio but it does get a bit boring. They said that they only go out with friends and they had not been inside a shop since moving in to the home and this would be something that they would like to do.

The inspection was completed on 14 July 2015, 17 July 2015 and 24 July 2015 2015 and there were 20 people living at the service when we inspected.

Southend Blind Welfare Organisation provides accommodation and personal care for up to 25 older people, people who are visually impaired and people living with dementia.

A registered manager was in post. 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 and their relatives told us the service was a safe place to live. There were sufficient staff available to meet their needs and appropriate arrangements were in place to recruit staff safely.

Medicines were safely stored, recorded and administered in line with current guidance to ensure people received their prescribed medicines to meet their needs. This meant that people received their prescribed medicines as they should and in a safe way.

Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed.

Staff received opportunities for training and this ensured that staff employed at the service had the right skills to meet people’s needs. Staff demonstrated a good understanding and awareness of how to treat people with respect and dignity.

The dining experience for people was positive and people were complimentary about the quality of meals provided. People who used the service and their relatives were involved in making decisions about their care and support and told us that their healthcare needs were well managed.

Staff were able to demonstrate a good understanding and knowledge of people’s specific support needs, so as to ensure their and others’ safety. Care plans accurately reflected people’s care and support needs. People received proper support to have their social care needs met.

The manager was up-to-date with recent changes to the law regarding the Deprivation of Liberty Safeguards (DoLS) and at the time of the inspection they were making sure that people’s legal rights were being protected.

People and their relatives told us that if they had any concern they would discuss these with the manager or staff on duty. People were confident that their complaints or concerns were listened to, taken seriously and acted upon.

There was an effective system in place to regularly assess and monitor the quality of the service provided. The manager was able to demonstrate how they examined the care provided to people, and how this ensured that the service was operating safely and was continually improving to meet people’s needs.