Eccleston Court 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 people were protected from abuse and avoidable harm.

At our last assessment we rated this key question as requires improvement. At this assessment the rating has remained requires improvement. This meant some aspects of the service were not always safe. There was an increased risk people could be harmed.

The provider was in breach of Regulation 12, Safe care and treatment, of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The provider was also in breach of Regulation 18 Staffing of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We have asked the provider for an action plan in response to the concerns found at this assessment.

This service scored 50 (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. We received feedback from partners who shared their positive experience working with the provider regarding safety incidents.

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

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated 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 shared concerns quickly and appropriately. Feedback from people told us, ‘’I feel safe here, the staff are good.’’ And ‘’I feel safe here, the staff are like mates.’’ Feedback from partners was positive on how the provider managed quality concerns. Six people's finances were spot checked and the processes in place were safe.

The provider did not always work well with people to understand and manage risks. It was not evident how people were involved where possible to manage their risks. Staff did not always provide care to meet people’s needs that was safe, supportive and following information in care plans such as support and observations for people with eating and drinking. Repositioning of people was not always undertaken in line with peoples assessed needs and mattress settings were not always correct for people. Staff told us they don’t always have time to read peoples care plans; they read the highlights. One staff member stated, “We have good handovers.”

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, and facilities supported the delivery of safe care. Wardrobes were found to be unsafely secured to the walls. Towel rails and toilet roll holders were broken in people’s en-suites leaving exposed and loose screws. Rooms, equipment and furniture were found to be requiring a deep clean and, in some instances, lap tables to be replaced. However, the laundry and kitchen equipment was in good working order.

The provider did not always make sure there were enough staff on Park Suite, this was corroborated by staff stating there was not enough staff presence on duty. We observed a disorganised and poorly led dining experience on Park Suite due to lack of staffing. People who were allocated one-to-one care were not in receipt of this at lunch time on day two. Staff did not always work together well to provide safe care that met people’s individual needs. Staff recruitment files were requiring to be audited and updated information required. However, families and people we spoke to have said that they see the same familiar faces of staff in the service.

The provider did not always assess or manage the risk of infection prevention and control practices. We observed Park Suite kitchen and dining area to need a deep clean. There was ineffective oversight due to the absence of a cleaning schedule for the Park Suite kitchen. We found equipment being used by people such as wheelchairs, slings and hoists were observed to be unclean and beds required to be changed upon observation and a sluice room in Eccleston Court found with contaminated waste bags on the floor which had not been disposed of appropriately. However, on inspection the laundry was clean, tidy and organised and the main kitchen in Eccleston Court was clean and organised. Staff training was compliant and in infection prevention and control. Families' comments were positive about the environment, stating it appeared clean and tidy when they visit.

We found care plans were not always person centred and did not contain sufficient information to support staff to safely administer medicines. When people were prescribed ‘when required’ medicines, information to support staff to know when to give the medicines was not always person centred, there was a risk people might not get their medicines when they needed them. In addition, when there was an option to give a variable dose, for example 1 or 2 tablets, there was not always information to support staff to know which dose to give, there was a risk people might not receive the appropriate dose. Medicines which needed to be given before or after food were not given following the manufacturer’s instructions so there was a risk they might not work. When people had their medicines covertly, hidden in food or drink, records were not always in place to show this was in the person’s best interest. The route of administration of medicines was not always recorded correctly, there was a risk people might be given their medicines unsafely via an incorrect route. When medicines were being crushed or given via a different route to the manufacturers licence, there was not always information from a suitably qualified health care professional to support staff to give them safely. When people had their drinks thickened to prevent choking, the records showed drinks were not always thickened correctly, which placed people at increased risk of choking. The care home completed audits regularly, however, they had not always been effective in identifying issues and the concerns found on this assessment.