• Care Home
  • Care home

Archived: Eastbourne Villa

Overall: Requires improvement read more about inspection ratings

21 Eastbourne Road, Hornsea, Humberside, HU18 1QS (01964) 533253

Provided and run by:
Mr & Mrs G Hart

Important: The provider of this service changed. See new profile

All Inspections

6 May 2015

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection of this service on 6 November 2014. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach in respect of poor moving and handling techniques, recruitment procedures, the lack of quality monitoring systems and the care of people living with dementia not being based on published guidance.

We undertook this focused inspection to check that they had followed their plan and to check that they now met legal requirements. This report covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Eastbourne Villa on our website at www.cqc.org.uk

We found that the manager and deputy manager had made progress towards carrying out the improvements that were recorded in their action plan. We found that action had been taken to alleviate concerns about the moving and handling techniques of staff but the other areas that were previously breaches of regulation still required further improvement.

In addition to the above, we had received some information of concern since the inspection in November 2014 about people at the home becoming dehydrated and about communication between staff and relatives. We checked these concerns as part of this inspection.

On the day of the inspection the manager told us that they had being interviewed by an inspector with the Care Quality Commission for the post of registered manager, and during the inspection they received a telephone call to say that they had been successful. 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.

There were recruitment and selection procedures in place but these needed to be consistently adhered to. This was needed to ensure that only people considered suitable to work with vulnerable people had been employed.

Staff had completed training in moving and handling and this provided them with the knowledge they needed to assist people with transfers and moving around the home safely.

Improvements had been made to the environment; some signage had been provided and walls and flooring were not distracting for people with cognitive difficulties. However, further improvements needed to be made in the availability of signage and to promote the well-being of people living with dementia.

People had been consulted about the way in which the service was operated both by the distribution of surveys and in meetings with staff and people who lived at the home. However, surveys had not been collated or analysed to record any action that was needed as a result of feedback received in surveys.

The quality of the service was being measured through regular auditing of medication, infection control, complaints received and accidents / incidents. However, audits needed to be more robust to become effective tools for improvement.

Although we saw that action had been taken in the areas where we had previously recorded breaches of regulation, some of these were insufficient to evidence sustained improvement.

We have made recommendations about the recruitment and selection of staff, the need to follow good practice guidance in respect of supporting people who are living with dementia, the monitoring of nutrition and hydration, communication between staff, and quality assurance.

When we next inspect Eastbourne Villa we will look at these areas again to check that the improvements made have been further developed and have resulted in the home providing a good service.

6 November 2014

During a routine inspection

This inspection took place on 6 November 2014 and was unannounced. We previously visited the service on 23 July 2014. We found that the provider did not meet the regulations that we assessed in respect of staffing levels, staff training, monitoring the quality of the service and record keeping. We asked the provider to take action to achieve compliance. At this inspection we found that appropriate action had been taken to make the improvements identified at the previous inspection.

The service is registered to provide personal care and accommodation for 15 older people, some of whom may have a dementia related condition. People are accommodated in single rooms and some have en-suite facilities. The home is situated close to the sea front and to town centre amenities.

The provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission (CQC); they had been registered since 23 January 2014. 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 that they felt safe living at the home. However, we observed staff moving and transferring people inappropriately and this could have resulted in people sustaining an injury.  

Staff received appropriate training although a more robust system was needed to record people’s induction training when they were new in post and some staff still needed to complete training that was considered mandatory by the provider. However, training had been booked for November and December 2014. We did not see any evidence that care for people living with dementia was based on published research or guidance.

Staffing levels had increased and this meant that there were sufficient numbers of staff to meet the needs of people who lived at the home. However, staff had not always been recruited following the home’s policies and procedures to ensure that only people considered suitable to work with vulnerable people had been employed.  

People’s nutritional needs had been assessed and people told us that they were satisfied with the meals provided by the home. We found that medicines were safely managed.

We observed good interactions between people who lived at the home and staff on the day of the inspection. People told us that staff were caring and this was supported by the visitors and health care professional who we spoke with. One visitor said that some staff were very caring but others were ‘task orientated’ rather than providing individualised care. Activities had reduced at the home although this was not raised as an issue by people who lived at the home.  

People’s comments and complaints were responded to appropriately but there were insufficient systems in place to seek feedback from people and their relatives about the service provided.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the action we have asked the provider to take is recorded at the end of the report.

23 July 2014

During a routine inspection

Our inspection team was made up of one inspector. We gathered evidence against the outcomes we inspected to help answer the five key questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

We looked at a range of records, spoke with the manager, five members of staff and five people who used the service. We also observed the interactions between staff and people living at Eastbourne Villa.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they were listened to and that they felt safe. Staff understood their role in safeguarding the people they supported.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. At the time of our inspection they had no DoLs in place. The home had policies and procedures in relation to the Deprivation of Liberty Safeguards but not for the Mental Capacity Act and only five out of 16 staff had received Mental Capacity Act training, three of which were in 2012.

There was no system in place to make sure that manager and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This increased the risk of harm to people and failed to ensure that lessons were learned from mistakes. The home did not have a complaints policy.

Safe recruitment procedures ensured that people were protected from unsuitable staff.

Is the service effective?

People's health and care needs were assessed and however it was not recorded that these were reviewed. Some monthly reviews were dated December 2013. Body maps were in place but these were not fully dated, for example one person's said 20/7 but no year was added.

Daily records such as fluid charts, turning charts and daily events charts were completed but the column that said date and time, only the date was added.

People's care plans provided information on the care they needed but they were not person centred. There was very little information about a person's life history, their likes or dislikes.

Records of activity and social recordings were not completed, therefore it looked like the last time someone had quality time spent with them was August 2013.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff engaged with people in a positive way and showed respect, kindness and gave people gentle encouragement.

Staff we spoke with demonstrated a good understand of the people they cared for and were able to tell us how they tried to recognise and meet people's individual needs. Staff told us they were looking forward to starting the distance learning dementia training.

Is the service responsive?

People who used the service said they knew how to make a complaint if needed. We asked to see the complaints file, there was one complaint registered. The manager told us that any verbal complaints or little complaints such as clothes going missing were not recorded. There was information on the walls to say how someone could make a complaint, although this needed updating. This meant people were at risk of not having their concerns and needs properly taken into account.

Staff we spoke to had a good understanding of how to raise concerns and felt able to raise these with the manager.

Two people who used the service had seen the dietician and been diagnosed as clinically malnourished. One person was in May 2014 and had not been weighed since and one person was diagnosed on the 11th June 2014 but was not weighed again until the 8th July 2014. We spoke with the manager regarding this and the first person was not weighed due to mobility reasons and needing special scales, the manager had been in contact with the dietician about this, although this was not recorded. The second person was due to the decision to weigh them monthly rather than weekly. We have asked the manager to put something in place immediately regarding this.

In one person's care file it stated they liked to see the chiropodist regularly, there were no records of any visits to see the chiropodist. Whilst we looked at the finance records we saw evidence of payment to a chiropodist. We asked a member of staff to find this record in the professional visits log, this was not recorded.

One person had not received a diabetic eye screening test since January 2013. We spoke to the manager about this and there was a legitimate reason, this had not been recorded.

Is the service well-led?

We looked at the finance records for seven people and found that there were discrepancies with one of them, there was '1.10 less money than recorded. We spoke with the manager about this and she was going to investigate.

The service did not have any records of quality assurance systems in place. Therefore the registered manager was not protecting the people who used the service and others against the risks of inappropriate or unsafe care and treatment.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to quality assurance and record keeping.

People who used the service had the opportunity to attend meetings. Topics discussed were mainly food and the choice, likes and dislikes.

Staff also attended regular meetings where they discussed holidays, a recent local authority inspection, and completion of records along with handwriting. At the latest meeting they discussed staff cut backs, fees and rotas. The manager also said she puts a monthly newsletter in with their pay, this covered any updates, changes, relevant news and inspections that had taken place.

The manager said she was planning on setting up relative's meetings.

Survey/questionnaires had been sent out to all relatives with a few responses. Staff had also completed one and the majority of the comments were they enjoyed working at Eastbourne Villa but the d'cor needed updating, they would like more activities and there were not enough staff. We discussed with the manager about how they were going to address these concerns.

One member of staff explained that they were key worker for a person that used the service. This person loves gardening and had totally transformed the back garden. They said they often took this person to garden centres, at least once a week. We questioned how this left the staff in the home, as there was only two staff on duty at any one time. The person said she could only do this on her day off.

Eastbourne Villa was badly in need of redecorating, paper was coming off the walls, walls were half painted and then left, paint was coming off window seals leaving bare wood and carpets needed cleaning. Many areas looked like they could do with a thorough clean; the manager said it was difficult as they had one cleaner who worked for two hours a day. It was then left for the two members of staff to clean, do laundry, provide all meals after the cook went home at 1pm and care for the people who used the service. There were also a clear lack of any activities taking place; we have asked the manager to look into this.

What people told us.

People who used the service said, 'Staff are nice, all helpful and pleasant,' and 'Staff are brilliant and will do anything for me,' and 'I feel safe, I have no worries.'

Staff we spoke with said, 'Staff interacts well on a personal level, they know the residents really well,' and 'I feel supported and my manager is very supportive,' and 'There is never a single day I do not want to come to work.' One member of staff said 'I love the residents; the manager is great I just wish the owners would support more.'

2 October 2013

During an inspection looking at part of the service

Although we chatted to people who lived at the home during this inspection, we did not ask them specific questions about the outcomes we assessed. We spoke with the manager and checked records to reach a decision about compliance.

At the last inspection in June 2013 we had concerns about the systems in place to control the risk of infection, staffing levels and quality monitoring. At this inspection we found that improvements had been made.

The manager had produced a file of information that included policies and procedures on the control of infection and good practice guidance. All staff were undertaking a distance learning course on the prevention and control of infection. The laundry arrangements were seen to be satisfactory and good hygiene practices were promoted by the provision of protective clothing for staff and the use of hand wash gel and paper towels.

Staffing levels had been increased and there were plans in place to increase them further. This ensured that care staff were spending their time with people who lived at the home rather than on domestic and laundry tasks.

The manager had produced a file of information to evidence that quality monitoring systems had been introduced and were being used. This included evidence of care plan reviews, resident and staff meetings, satisfaction surveys, a newsletter and quality audits. This gave people the opportunity to comment on the care they received.

5 June 2013

During a routine inspection

People who lived at the home told us they were happy with the care they received and on the day of the inspection we observed good interaction between people who lived at the home and staff. Staff were attentive to people's needs and listened to their requests and comments.

We saw that improvements had been made to medications systems at the home and that staff had completed appropriate training. Staff had also completed other training that assisted them in carrying out their role effectively.

Some improvements needed to be made to infection control policies and practices to ensure that the home met current guidelines, although we found the home to be clean on the day of our visit. People who lived at the home said, "Yes, the home is always clean and there are no unpleasant smells". The design of the home was suitable for purpose and had been appropriately maintained.

We saw that there were times of the day when staff had to take on dual roles, for example, assisting people to get up as well as preparing their breakfast and administering medication. We felt that people's dependency levels may not have been taken into consideration when staffing levels had been determined.

Quality monitoring systems had lapsed and therefore people did not have the opportunity to comment on their care or express their views. This had resulted in a lack of opportunity for learning to take place from analysis of audits and consultations.

15 October 2012

During an inspection looking at part of the service

The people we spoke with were happy with the way they were supported to take their medication by staff at the home.

We spoke with staff and observed the administration of medication on the day of this inspection. We found that staff administered medication in a safe way.

Improvements had been made to the home's medication policy, to the storage of medication and in returning medication to the pharmacy.

21 August 2012

During an inspection looking at part of the service

We carried out this inspection to check on the improvements made since our inspection in June 2012. On that occasion we made a compliance action for outcome 9 'Management of medicines'.

We did not speak to people living at the home on this occasion.

20 June 2012

During an inspection in response to concerns

We spoke with two people who lived at the home. Both told us that they were able to make decisions about their day to day lives, for example, where and how to spend their day. They said that staff encouraged them to be as independent as possible.

People told us that staff respected their dignity, for example, they called them by their chosen name and knocked on doors before entering. They said that the staff were lovely and that they provided the level of support that they needed. One person told us that staff assisted them when they needed it but also supported them to be independent and live their chosen lifestyle.

The people who we spoke with told us that staff assisted them to take their medication and that they received their medication at the times they needed it.They told us that they felt safe living at the home.

People said that they would not hesitate to raise concerns. They said that they rarely needed to mention anything of concern to staff, but when they had done, action had been taken. One person said, 'If I speak to any of the staff they listen, but I really haven't had anything to complain about'.

26 April 2011

During a routine inspection

People told us that staff were pleasant, caring and respectful and that they involved them in making decisions about their day to day life. They said that they were aware of the content of their plan of care and that they had agreed to it.

People told us that staff at the home were sensitive to their needs and that they felt safe when being assisted by them.

They said that the home was always clean and free from unpleasant odours.