Edgehill 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. Edgehill provides accommodation with personal care for up to 60 people. At the time of our inspection 56 people were living in the home.

At the last inspection in November 2015, the service was rated Good. We carried out a comprehensive inspection on 31 January and 1 February 2018. At this inspection we found the service had deteriorated to Requires Improvement.

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.

People’s medicines were not safely managed. Staff did not always administer medicines safely, in accordance with the provider’s policy or national best practice guidance.

Sufficient numbers of staff were deployed at the time of our visit. Staff performance was monitored. Staff received supervision and training to ensure they could meet people’s needs.

Staff demonstrated a good understanding of safeguarding and whistleblowing and knew how to report concerns.

Risk assessments and risk management plans were in place. We found improvements were needed to ensure all appropriate actions were taken to keep people safe.

Incidents and accidents were recorded and the records showed that actions were taken to minimise the risk of recurrences.

People were supported with food and fluids and provided with choices at mealtimes. Where people were assessed as at risk of malnutrition, they were monitored and actions taken in consultation with external health professionals.

Staff were kind and caring. We found people were being treated with dignity and respect and people’s privacy was maintained.

Activities were provided. Recruitment was taking place for dedicated activity staff posts.

Systems were in place for monitoring quality and safety and actions were taken where areas for improvement and shortfalls had been identified. The audits had not identified the shortfalls we found.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we told the provider to take at the back of the full version of this report.

We spoke with fifteen people who used the service to find out what they thought of Edgehill Care Home, we spoke with two relatives, a visiting community nurse and six staff who worked there.

People had positive views of Edgehill. Examples of comments from people who used the service included, the staff “are brilliant” and that they “do their best” and their care was “really good”, a relative said that Edgehill “looked after Mum really well”.

People were effectively assisted by the staff so that their range of care needs were met.

The majority of people spoken with felt satisfied with the meals that were provided at the home.

People were assisted by staff who were suitably trained and supervised, to ensure good care practice. People received appropriate care and support, to meet their needs. Staff were able to obtain further qualifications and were trained in subjects relevant to peoples’ needs.

The quality of care and overall service people received was checked and monitored to make sure it was safe and suitable.

You can see our judgements on the front page of this report.

People told us they liked the staff and felt supported by them. They also told us that they could make choices and their rights to privacy and dignity were respected.

We observed care practices and saw that people were receiving effective, safe and appropriate care.

People felt safe within the home and staff were aware of their responsibilities to recognise and report a suspicion or allegation of abuse.

Staff we spoke with told us that there were enough staff to ensure people were given an excellent standard of care. One member of staff told us that “I love my job and feel I can make a real difference to people’s lives.”

The manager took account of comments from people to help improve the service.

People who lived in the home told us they were well treated by the staff and that their needs were met. We were told the staff were friendly and treated people with respect.

We were told that continence care was managed professionally and sensitively by the staff team.

The home had increased the number of people it accommodated and had made changes to the way staffing was organised. It was also changing the sytems and recording used for assessing, planning and reviewing care and support. Staff told us these changes were positive improvements.

We were told that sometimes during the ealry hours of the morning the night shift could become very busy and that the staffing occiasionally needed to be reviewed for this time period.

A person we spoke with said that “staff treated them with respect” and they were “very kind”. Another person said “it’s very good here”. We were told by one person that they felt "the home, staff and food were great” and that they “felt safe”.

One person said the staff were “second to none” and they had no problems. They added that staff showed them concern and the personal assistance was “wonderful”. They reiterated that they were “exceptional staff”.

People confirmed with us that they had signed agreements to the care they received.

We spoke with the relative of a person admitted into one of the ‘crisis’ spaces. They said that they and the person living in the home, felt that the care was very good, the food was good. Another relative was happy with what they had seen.

We found that the home was clean and tidy. People were engaged in doing various things like watching television and reading. We saw staff were going about their work in a calm and professional way.

Edgehill Care Home provides accommodation which includes personal care for up to 59 older people. At the time of our visit 58 people were using the service. The home is situated on one level with bedrooms being located in three corridors. There are communal lounges in each corridor with a central communal area, kitchen and laundry. The home is part of Agincare, which is a family run business.

A registered manager was employed by the service to manage the day to day operations of the home. 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 the home. Staff understood their responsibilities and the actions they needed to keep people safe from harm and abuse. Risks to people’s health and safety were identified and plans were in place to minimise these risks.

Staff knew people well and supported them to with maintaining their independence. People and their relatives told us staff treated them or their relative with kindness and respected their privacy and dignity.

People were supported to have sufficient to eat and drink to maintain good health. People told us they enjoyed the food and that there was always plenty available.

People’s medicines were managed safely and they had access to health care services when required.

The registered manager investigated complaints and concerns. People, their relatives and staff were supported and encouraged to share their views on the running of the home. Their views were taken into account in the planning of the service.

Health and social care professionals spoke positively about the care and support people received and praised the management team. They said they found the staff and management team approachable and told us they sought advice and guidance where appropriate regarding people’s changes in care and support.

The provider’s had quality monitoring systems in place. Accidents and incidents were investigated and discussed with staff and at team meetings to minimise the risks of reoccurrence.

Arrangements were in place for keeping the home clean and hygienic and to ensure people were protected from the risk of infections. During our visit we observed that bedrooms, bathrooms and communal areas were clean and tidy and free from odours.

Staff acted in accordance with the requirements of the Mental Capacity Act 2005. Where people did not have the capacity to make the decisions themselves, mental capacity assessments were in place and records showed that decisions had been made in line with best interests. Where required Deprivation of Liberty Safeguarding applications had been submitted by the registered manager.