Eagle House Residential Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this newly registered service. This key question has been rated outstanding. This meant people were protected by a strong and distinctive approach to safeguarding, including positive risk-taking to maximise their control over their lives. People were fully involved, and the provider was open and transparent when things went wrong.

This service scored 88 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had trained staff in various champion roles, which meant they had specific knowledge on topic areas such as safeguarding, equality and diversity and wellbeing. Staff shared this learning and used their knowledge to mentor other staff, conduct observations of practice and other audits. They identified best practice and any areas that could be improved and discussed this with the whole team to agree how to continually improve. Leaders and staff liaised regularly with external professionals for advice and joined up working arrangements to agree next steps following safety events. This practice helped to minimise the risk of a closed culture developing and empowered people and staff to ensure care was delivered in a way that best met people’s needs.

The provider always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

The provider had excellent working relationships with external professionals due to good communication and mutual respect. This supported positive joint working and flexible approaches. One professional told us, “Eagle House worked positively with the hospital [person] was in prior to their discharge to Eagle House and a robust transition plan was agreed and worked.”

The registered managers had comprehensive systems in place to ensure assessments and care planning was detailed and promoted a person-centred approach. People were fully involved in all aspects of planning and reviewing their care plans and were supported by relatives or advocates. This helped promote their rights and reduce the risk of them declining care. This was important to ensure continuity of care and treatment as some people’s mental health could relapse quickly if care was not consistent.

Staff focused on people’s strengths when planning how best to support them and identified people’s preferences and approaches that might create anxiety or distress. Where this was the case, they came up with solutions to reduce the risk of distress by agreeing the approaches to care people preferred. This promoted a high level of trust and confidence, which was key to a positive relationship. One person told us, “I was down and out and in a bad way, now I know I can get better and have a future all thanks to the guys here.” Another person said, “I feel very safe. Staff have your best interests at heart."

The provider worked well with people and healthcare partners to fully understand what being safe meant to them and the best way to achieve that. Staff had a clear focus on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider always shared concerns quickly and appropriately.

Staff had a very good understanding of safeguarding and incidents and accidents were monitored and analysed to identify triggers and what could be learnt from them. People, relatives and staff all knew how to report concerns and were confident to do so. There was a clear complaints procedure in place, which was used regularly by people and appropriate responses sent to them following a thorough investigation by the registered managers. Managers had an understanding of their duty of candour and wrote to people to apologise when things went wrong. A professional told us, “Safeguarding issues are raised in a timely manner and communicated to us.”

Where restrictions were in place for people who were not able to make decisions for themselves, the provider had conducted detailed and high-quality mental capacity assessments, which considered how best to approach the information shared and the decision being discussed. They ensured people were fully involved and where a person’s mental capacity varied for example, due to the time of the day or the temporary effects of illness, assessments took place at the best time to suit them. They liaised with others to ensure any decisions were in that person’s best interest and where required had applied for deprivation of liberty safeguard (DoLS) authorisation to ensure restrictions were lawful. The staff team followed up on restrictions by working with people to develop skills or understanding that might mean when next assessed restrictions could be further reduced.

People had access to information about staying safe to educate them and access external helplines if required. This was available in easy read formats to help people clearly understand. People told us they felt very safe at the service due to the staff’s skills and level of support. One person told us, “Here, I know that the staff ‘have my back’ and I can recover without people looking at me and making this illness worse.” Another person said, “When I first went into care (elsewhere), they would get you in arm locks and give injections. But here staff are very kind and accommodating. I feel very safe.”

Relatives echoed these sentiments and told us people were very safe. One relative told us, “They’re really nice people and I can’t fault the home. [My family member] is safe and secure there.” Another relative said, “[My family member] is safe and being well looked after physically; better than the places they’ve previously been in. It’s clean and well maintained. The staff treat them properly and I’ve no concerns."

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

The staff supported people to understand risks related to their care and wellbeing and worked with people to agree the best way to promote positive outcomes. Risks were assessed and recorded in detail. Care plans offered staff high quality, detailed guidance about the risk. This included information about the persons health, history, early warning signs of any deterioration, and situations that might cause distress. There was further guidance on how to de-escalate interactions that could lead to distress or harm and who to seek advice from.

People were in most cases, able to identify concerns and risks for themselves and knew they could approach whichever staff they felt most comfortable with for help. This gave them confidence and security and meant incidents of distress were reduced as people felt better able to manage their feelings. One person told us, “Living here is making me feel calmer and stronger and I trust all of them to give me good advice.” A professional said, “I have found the risk management with people has been excellent. They devised a safety plan which enabled people to access the community independently.”

The registered managers also took a proactive approach to other risks such as those related to drug and alcohol abuse or life skills. Staff had been trained in the use of a drug that quickly reverses the effects of a drug overdose should it be necessary. They have also had a defibrillator device installed onsite in the event of someone having a cardiac arrest, this is known to make the difference between life and death. People told us they had been supported to learn new skills and work safely in the kitchen. They said, “Staff are teaching me how to cook and about food safety and hygiene."

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The environment, while large for a residential care home of this nature, still promoted the principles of The Right support, right care, right culture policy (RSRCRC). The registered managers ensured person centred approaches were used to meet people's individual preferences for their environment. Space was used to enable people to access areas of quiet and privacy as well as areas of group chat and socialising. People were supported to remain a strong part of their community with access to and from the building while still remaining secure and keeping people safe.

The staff team ensured regular servicing and checks of all equipment and buildings such as fire, gas, emergency doors, lighting and electrics. There was a box dedicated to the safe storage for vapes and a designated smoking area. The home was well maintained by a full-time on-site maintenance staff member. This enabled repairs to be made quickly and safely. The registered managers had devised an environmental sustainability plan and involved people in the recycling projects.

People were supported to choose how to decorate their bedrooms and could bring their own furniture. One person told us, “The décor is really lovely and they have made the lounge so homely. I can decorate my bedroom; I am going to decorate mine with staff help.” A relative said, “The home is always clean and immaculate when I’ve visited and the garden is well maintained."

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs. Staffing levels, skills and knowledge were exceptional.

Staff had completed numerous training courses focused on supporting people living with mental health conditions, people with learning disabilities and autistic people. Their competency was checked through audits, observations of practice and discussion in supervision and staff meetings. As a result, they knew how to support people when they felt distressed. For example, we observed occasions where people began to feel upset, and staff responded in a kind way to help them feel better. The level of staffing and how people’s funded hours were used, meant there was flexible working for people to change their mind about the level of support at that time or how they wanted to spend their time.

Due to staff’s training and approach, people did not need to be supported with physical restrictions when they felt unhappy nor did they have to wait for support. This had a hugely positive impact on people’s quality of life. One person told us, “The knowledge and expertise of staff here is amazing.” Another person said, “The staff are always within shouting distance, so I knew if I had become worse, they were checking on me all the time.” Relatives agreed with this view. One relative told us, “The staff seem to be really nice people and they’ve definitely got the skills to look after [my family member].”

The provider had a safe recruitment process in place that included checking staff work history and suitability for the role. The registered managers had created easy read job descriptions and trained some people to be able to participate as equal members of the interview panel for new staff. People were also able to choose their preferred key worker. A key worker is a person who works closely with a person to continuously support and review their care needs. This meant staff were matched to people’s needs and personalities, which promoted a positive, trusting relationship that better supported people to achieve their potential.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The provider ensured all staff had received training in infection prevention and control (IPC). However, some staff went on to gain further training qualifications as IPC champions. The champions conducted IPC audits every 3 months and an annual IPC report. They attended quarterly meetings with the IPC lead from Lincolnshire local authority to ensure their knowledge remained up to date with best practice. They shared this knowledge with the staff team and ensured standards remained high.

We found the environment to be very clean and fresh, additional cleaning occurred throughout the day. Staff told us they were supported with sufficient cleaning products and equipment such as disposable aprons and gloves. People told us they were supported to keep their home clean and sometimes helped to do this where they were able. A relative said, “The staff keep the place nice and clean and looks presentable."

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People were given their medicines safely and in a timely manner. This was recorded on their medicines administration record (MAR) and medicines were stored safely and securely. There were processes in place to ensure the safe and effective use of medicines. However, instructions for medicines which should be given at specific times were not always available.

Staff understood the principles of ‘Stopping over medication of people with a learning disability, autism, or both’ (STOMP) with psychotropic medicines and were working with people and health professionals to help people stop or reduce medicines they may not need anymore. Each person had a STOMP reduction plan in place where applicable.

Detailed guidance specific to each person on how to administer as required (PRN) medicines were available to staff. Some people were prescribed medicines with a variable dose i.e. one or two tablets to be given when required at regular intervals. Quantities were recorded, meaning that records accurately reflected the treatment people had received. One person self-administered medicines and risk assessments had been completed to ensure this could be done safely. Body maps were in place for medicines administered via a patch and for topical creams and ointments, to show staff the site of application.

We checked the quantities and stock balances for ten people and found them to be correct. This meant that we could be assured the correct doses of medicines had been administered as signed for by staff. There were records of people’s preferences to indicate how they wanted their medicines to be administered. Temperature records to ensure the safe storage of medicines were completed following national guidance. Appropriate arrangements were in place for the management of controlled drugs (medicines that require extra checks and special storage arrangements because of the potential for abuse). Records showed that staff completed regular balance checks in accordance with national guidance. Records showed that management or staff carried out regular medicine’s audits. Staff had received medicines handling training, and their competencies were assessed regularly to make sure they had the necessary skills. There was a process in place to record any medicines related errors. Some people had a different routine, such as preferring their medicines at different times to other people, and this was accommodated to ensure they were kept safe. Records were completed to indicate the name and quantity of medicines taken offsite.