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Eastfield Residential Home Requires improvement

Reports


Inspection carried out on 29 April 2021

During an inspection looking at part of the service

About the service

Eastfield Residential Home is a care home providing accommodation and personal care for up to 25 people with a mental health condition. At the time of our inspection 23 people lived at the service.

People’s experience of using this service and what we found

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this.

Medicines were not always managed safely, in particular medicines which were prescribed on an ‘as and when required basis’ (PRN.) Improvements were needed to improve standards of record keeping in relation to PRN medicines. We have made a recommendation about this.

Since the last inspection the provider has sought support and guidance from a consultant to implement a new quality monitoring system within the service. However, this did not identify shortfalls we found during inspection. We have made a recommendation about this.

Staff rotas were not always up to date and needed improving to ensure they clearly identified staffing arrangements. We have made a recommendation about this.

Staff were recruited safely and received an induction to ensure they had the skills and knowledge to undertake their role. Further improvements were required in relation to updating areas of staff training. The registered manager has put a plan in place to ensure all training is refreshed by the end of June 2021.

Since the last inspection, the provider had improved the quality of people’s care plans which now included guidance for staff to respond to risk and considered people’s medical conditions.

Improvements had been made to ensure high standards of cleanliness of the environment were maintained. Bedrooms had been recently redecorated with new carpets fitted.

People and their relatives said they felt the service was safe and that people were well supported and received good quality care. Safeguarding systems were in place to protect people from abuse.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 22 September 2020) and there were six breaches of regulation. At this inspection we found whilst some improvements had been made, the provider was in breach of one regulation.

Why we inspected

This was a planned inspection to follow up on action we told the provider to take following the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection for those key questions not looked at this visit were used in calculating the overall rating at this inspection. The overall rating for the service has remained the same as at the last inspection, requires improvement. This report only covers our findings in relation to the key questions Safe, Effective and Well-led.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 4 August 2020

During an inspection looking at part of the service

About the service

Eastfield Residential Home is a care home providing accommodation and personal care for up to 25 people with a mental health condition. At the time of our inspection 23 people lived at the service.

People’s experience of using this service

Records were not up to date and checks in place to monitor the quality of care being provided had not identified or addressed the concerns found. Improvements had not been made since the last inspection in relation to governance and oversight.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Risks to people were not always identified and managed. One area of the recruitment process required improvement to ensure safe and robust recruitment of new staff. Medicines practices were still not robust.

Staffing levels were low, and the service struggled to maintain a stable staff team. Staff did not feel valued or that their opinion mattered. Staff had not been supported in their roles and there were no records to demonstrate discussions regarding changes in institutionalised practices or culture since our last inspection. We found institutionalised practices were still in place.

There was a notifiable incident that happened at the service that should have been notified to Care Quality Commission (CQC) but this had not been done.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 2 April 2020). There were six breaches in regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We undertook this focused inspection to check whether the Warning Notice we previously served in relation to regulation 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been complied with and whether the provider had fulfilled their action plan to achieve compliance with legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led.

The ratings from the previous comprehensive inspection for those key questions not looked at this visit were used in calculating the overall rating at this inspection. The overall rating for the service has remained the same as the last inspection, requires improvement.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link Eastfield Residential Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to record keeping, consent to care, the management of risks, staffing, safeguarding, person-centred care and monitoring of improvements.

We have written to the provider and they have submitted an improvement plan. We will work closely with the provider to monitor their improvements.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special measures

The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of

Inspection carried out on 25 February 2020

During a routine inspection

About the service

Eastfield Residential Home is a care home providing accommodation and personal care for up to 25 people with a mental health condition. At the time of our inspection 25 people lived at the service.

People’s experience of using this service

People received support which was not person-centred and was institutionalised in approach. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible. The policies and systems in the service did not support this practice.

Risks to people were not always identified and managed. Processes in place for fire safety were not robust. We referred this to the local fire officer. Medicines processes were unsafe and did not follow best practice. Only one staff member had been checked for their competency to administer medicines safely.

Records were not up to date and checks in place to monitor the quality of care being provided had not identified or addressed the concerns found. The registered manager and supporting management team lacked knowledge of best practice and guidance and failed to deliver a service in line with regulations and the law.

Recruitment processes were in place and robust. Staffing numbers had reduced due to a large number of care staff leaving at the same time. Supervision and appraisals had not taken place in line with the home’s policy. Staff lacked training and skills to meet people’s needs.

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

Rating at last inspection

The last rating for this service was good (published 15 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to record keeping, the management of risks, medicines and infection prevention and control, staffing and their training and support, consent to care and restrictions placed on people and monitoring and improvements at the service at this inspection.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 21 June 2017

During a routine inspection

Eastfield lies to the North of the City of Hull, near to the village of Wawne. It is a family-run service. The service is registered with the Care Quality Commission (CQC) to provide accommodation and personal care for up to 23 adults who are living with mental health issues.

There are sufficient communal areas, bathrooms and toilets and an accessible garden with ample car parking. The home is situated close to public transport facilities and local shops are within walking distance.

The registered manager is also the provider. A registered manager is a person who has registered with the CQC to manage the service. Like providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were 23 people residing at the service at the time of the inspection.

This inspection was unannounced and took place on the 21 June 2017. The inspection was undertaken by one adult social care inspector. The service was last inspected in June 2015, found to be compliant with the regulations looked at and we rated it as good. At this inspection, we found the service remains good.

Staff knew they had a duty to report any abuse to the proper authorities. Training in how to recognise abuse was provided to staff and regularly updated.

Staff had been recruited safely and were provided in enough numbers to meet the needs of the people who used the service. This ensured, as far as practicable, people’s needs were met and they were not exposed to staff who had been barred from working with adults at risk of abuse.

People who used the service were provided with a wholesome and nutritious diet which was of their choosing. People’s weight and food consumption was monitored and staff involved health care professionals when needed. Staff had received training which enabled them to meet the needs of the people who used the service; they also received support to gain further qualifications and experience. This meant people were cared for by staff who had the correct skills. Staff received supervision and support. People’s human rights were respected and upheld by staff who had received training in the principles of the Mental Capacity Act 2005. People were supported to access their GP and district nurses supported the staff to ensure people’s health needs were met.

Staff understood people’s needs and were kind and caring. People had good relationships with the staff and they had been involved with the formulation of their care plans and reviews. Where people needed support to agree their care, this had been arranged and family members or advocates had been involved.

People received care which was person-centred and staff understood and respected their choice and wishes. We observed staff respected people’s privacy and dignity. The service provided a range of activities for people to participate in, which included activities within the service and in the local community. People were supported to pursue individual hobbies and interests.

There was a complaint procedure in place for people who used the service or others to use. The provider investigated any concerns to the satisfaction of the complainant. All complaints were recorded and the outcome shared with the complainant; any action taken as result of a complaint was recorded and any lessons learnt were shared with the staff and changes made. Complainants were sign-posted to other agencies if they were dissatisfied with the way their complaint had been investigated.

People were involved with the running of the service. The provider sought people’s views and opinions; they also sought the views of others who had an interest in the people’s wellbeing. The provider had a range of audits and checks which ensured, as far as practicable, people lived in a safe, well-run service. However, these could be expanded to include more areas of the service,

Inspection carried out on 4 June 2015

During a routine inspection

Eastfield lies to the North of the City of Hull, near to the village of Wawne. It is a family run home and the registered provider is also the registered manager. The service is registered to provide accommodation and personal care for up to 23 adults who are living with mental health difficulties.

There are sufficient communal areas, an accessible garden with car parking available. The home is situated near to public transport facilities and there are local shops within walking distance.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were 23 people residing at the service at the time of the inspection.

This inspection was unannounced and took place on the 4 June 2015. The inspection was undertaken by one adult social care inspector. The service was last inspected July 2013 and found to be compliant with the regulation looked at.

Staff were provided with training about how to recognise abuse and how to report this so people were protected from harm. People were cared for by staff who had been recruited safely and were provided in enough numbers to meet their needs. The environment was clean, tidy and free from unpleasant odours. People’s medicines were handled safely and staff received regular training in this topic.

People were provided with a wholesome and nutritional diet and their preferences were catered for. Staff received training which was relevant to their role, training was updated on a regular basis and staff were encouraged to undertake further training and qualifications in care. People were supported by the staff to access health care professionals when they needed, this included attending appointments at their GPs and the hospital.

Staff received training in how to ensure people’s human right were protected so they could make informed decisions about their chosen lifestyle. People were supported to make informed choices and decisions which were in their best interest. Systems were in place to make sure people were protected and did not take any unnecessary risks. Staff had a good understanding of the principles of the Mental Capacity Act 2005 and the use of Deprivation of Liberty Safeguards.

People were involved with their care plans and could have a say about how their care was delivered. People who used the service had good, relaxed and friendly relationships with the staff. Staff understood people’s needs and how they should be supported to lead a lifestyle of their own choosing. People were supported to maintain friendships outside of the service and visitors were made welcome.

People were supported by staff to undertake activities both inside and outside of the service and were enabled to lead an independent life. People could make complaints and they were confident these would be listened to and acted on.

The registered provider undertook audits which ensured the service was safe and well run. People who used the service were asked for their opinion about how the service was run. Other stakeholders who had an interest in the welfare and wellbeing of the people who used the service were also asked for their opinions; this included relatives and health care professionals.

Inspection carried out on 12 July 2013

During a routine inspection

We undertook this compliance review following concerns raised with us regarding unsafe recruitment procedures and the lack of training for staff. We discussed this with the local authority safeguarding and external contracts and compliance teams.

We were told by people who used the service that staff supported them in maintaining their living skills. People also told us they were able to make choices about everyday life and commented, "I couldn't have chosen a better place", "I like it here, it's quite nice" and "The staff are very respectful, polite and lovely."

We did see some restrictions in place, in particular for smoking. However, people told us they had agreed to the restriction and this had been discussed openly with them.

People who used the service told us they felt safe in the home and confirmed that any incidents were dealt with by the management.

We saw that staff had been recruited safely and appropriate checks were in place prior to them commencing work in the home. We saw that the majority of staff had undertaken a thorough induction programme and that essential training had been undertaken or planned for.

Inspection carried out on 26 November 2012

During a routine inspection

People who used the service told us they were supported in promoting their independence. They also told us they were able to make choices about everyday life and this included meals, when to go out or what time they got up in the morning or went to bed at night. We noticed there were restrictions for some people who used the service, but when we spoke to them they told us they had agreed to this. One person commented, "The staff have my cigs and I have one every hour, if I didn't I would smoke them all in one go."

People told us, �I like to get up early around 6am�, �Sometimes I cannot sleep and I get up in the middle of the night, but the staff are good and make me a cup of tea" and "This is home."

People who used the service told us they were happy with the level of care and support they received. They also said, "The staff are all very nice", "There is always someone around if you need them", "I love my room and it's very clean here" and "This is the best home I have been in and I don't want to leave."

People who used the service told us they felt safe in the home and that their views and concerns were listened to.

Reports under our old system of regulation (including those from before CQC was created)