About the service

Emscote House provides care and accommodation for up to eight people with learning

Disabilities and / or physical health needs, on a short stay basis. On the day of our visit there were eight people staying at the service and each had their own room.

People’s experience of using the service

People using the service benefitted from caring, dedicated staff. Not all people living at Emscote House were able to verbally express their views to us but we observed they looked comfortable and at ease with staff. Their nonverbal language, facial expressions and laughter indicated they were happy.

People and their families were placed at the heart of the service and involved in decisions as far as possible. In relation to Registering the Right Support we found this service was doing all the right things, ensuring choice where possible and maximum control. Registering the Right Support (RRS) sets out CQC’s policy registration, variations to registration and inspecting services supporting people with a learning disability and/or autism. These values include choice, promotion of independence and inclusion. The goal is to enable people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People’s care was provided safely. The staff team were consistent, staff knew people well and supported them to move safely around the service if needed, and when they were out of the home.

People’s medicines were well managed.

People’s risks were known and managed well, promoting independence as far as possible. Positive behavioural support plans were in place where required for staff to follow to support people’s care.

People were protected from discrimination because staff knew how to safeguard people. Staff knowledge of people meant they were alert to signs of change which may indicate someone was not happy.

People lived in a service which had a positive culture and was led by a committed registered manager and staff team.

Emscote House had worked hard to develop good relationships with local professionals supporting people’s care for example the local authority, commissioners and learning disability service.

Rating at last inspection:

At the last inspection the service was rated as Good (The last report was published 3 October 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained Good.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned based on the rating. If we receive any concerns we may bring our inspection forward.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 20 July 2016. This was an unannounced inspection.

At the time of our last inspection in November 2013, Emscote House was found to be meeting all of the essential standards relating to the quality and safety of care that we looked at.

Emscote House provides accommodation and personal care for up to eight people with learning difficulties and/or physical health care needs, on a short-stay basis. At the time of our inspection, there were eight people staying at Esmcote House.

There was 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.

The service was safe because people were supported by enough members of staff who had been safely recruited. Staff had the knowledge and skills they required to protect people from the risk of abuse and avoidable harm and they knew what the reporting procedures were. People were supported to have their medication when they required it from staff that had the relevant knowledge and skills required to promote safe medication management.

The service was not always effective because key processes had not been fully followed to ensure people’s rights were protected and they were not unlawfully restricted. However, people received care and support with their consent where possible, and the staff ensured that people were supported in the least restrictive ways in order to keep them safe.

People’s dietary needs were assessed and monitored to identify any risks associated with their food and fluid and they were encouraged to be as independent as possible with preparing food they enjoyed.

People were supported to maintain good health because staff worked closely with other health and social care professionals when necessary.

The service was caring because people were supported by staff that were kind, caring and who took the time to get to know them, including their personal histories, likes and dislikes. People were also cared for by staff that protected their privacy and dignity and respected them as individuals.

People were encouraged to be as independent as possible and were supported to express their views in all aspects of their lives, including the care and support that was provided to them, where possible. People felt involved in the planning and review of their care because the provider promoted a person-centred approach and staff communicated with people in ways they could understand.

People had an enhanced sense of well-being and quality of life because staff actively encouraged and supported them to engage in activities that were meaningful to them.

Staff felt supported and appreciated in their work and reported Emscote House to have an open and honest leadership culture. The management team endeavoured to improve and develop the service and had systems in place to assess and constantly monitor the quality of the service. People were encouraged to offer feedback on the quality of the service and knew how to complain if they needed to. They felt that the registered manager was responsive to feedback and staff reported the registered manager to be a positive role model who was dedicated to providing a high quality service.

There were eight people staying at the service for a short break at the time of our visit. Due to the complex needs of the people staying at the service they were not all able to give their views about the service provided. We were able to speak with two people in some depth and briefly to another three. We also spoke with the manager, deputy manager, the staff development officer and three staff.

People we spoke with told us they liked staying at the service and looked forward to going there. One person told us ‘‘I get really excited about coming here (to the service).’’

People's privacy and dignity was respected. Staff spoke with people in a respectful way using their preferred names. People were relaxed in the presence of staff.

People were supported to take part in a variety of activities in the home and the local community which meant that they led fulfilled lives.

Staff were aware of people's needs and plans were in place to deliver care in a personalised way. There were systems in place to identify and manage risks to keep people safe.

Staff were supported through training, staff meetings and supervision with senior staff to ensure that they could meet people's identified needs.

There were systems in place to monitor the quality of the service provided and for improvements to be made when needed.

There were eight people staying at the service for a short break at the time of our visit. No one knew we would be visiting. We spoke with six people, two relatives, five staff and the manager.

We saw good interactions between people and the staff team. The atmosphere was friendly and relaxed. We saw people making choices about what they wanted to do.

People we spoke with told us positive things about the home and the care and support they received. One person said “I love it here”.

Staff knew how to support people and how to meet their needs.

The home was clean and was free from offensive odours. There were systems in place for staff to follow to prevent the spread of infections and keep people safe.

Recruitment procedures in place ensured the risk of unsuitable staff working at the home was reduced.

There were systems in place to make sure the home was well run and people’s views about the home were listened to.

When we visited the service on 1 February 2012 the registered manager told us that eight people were staying for a short break at that time. Seven people were out for the day as was their usual routine when they were at their family home.

We followed the care of one young person who was at the service that day including during the day. The manager told us that the person stayed regularly at the service. We saw they had the support of a care worker. We spoke to the person and had lunch with them. We saw that before lunch they had been out to local shopping centre with their support worker. They were actively engaged in computer and craft activities after lunch. We saw and heard that support workers helped them to make choices about food, drink and activity. They were helped to prepare their own lunch.

We saw that they had well organised and up to date care records. These included care plans that were individual to them. Risks posed to the person by their condition were identified and there were agreed plans for managing them. Plans and guidance for support workers balanced the person's safety with their right to take risks and enjoy independence.

We spoke to a worker who was on duty that day supporting the person whose care we followed. They knew the person well and were able to talk to us about the plan for their care and how risks were managed.

We looked at the training records of the keyworker to the person whose care we followed. We saw that they held the NVQ in health and social care at level three. They had also undertaken regular short training courses while in the employment of the provider organisation. These included training in safeguarding adults from abuse and the risk of abuse.

We saw that the person whose care we followed had their own bedroom. It was clean and held sufficient furniture for comfort for a short stay at the service. The bathroom that they shared with other people was being refurbished while we were there.

We looked around the communal rooms at the service including the open plan kitchen used by people. These facilities were not sufficiently clean to protect people from the risk of infection. We have asked the provider organisation to improve hygiene practice at the service.

The manager told us that the basic staffing level at the service was one worker to two people. If a person required two workers support for their safety and care this level was provided when they stayed at the service. The manager said that there was a duty manager designated to run each shift. There were at least two workers awake on duty each night.

This level of staffing was confirmed by a support worker that we spoke to on the day of our visit. We saw that day that the person whose care we followed had one to one support from workers. We asked the person if they enjoyed staying at the service. They told us " it's alright- a bit noisy sometimes." We asked if the support workers were alright and they told us "yeah."