Northern Counties Eventide Home Limited

Northern Counties Eventide Home Limited (Eventide Home) is a residential care home providing personal care to 21 people aged 65 and over at the time of the inspection. The service can support up to 29 people in one adapted building.

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

The leadership of the service promoted a positive culture that was person-centred and inclusive. We received positive feedback about the quality of care and support people received and the overall management of the service from people and their relatives.

The registered manager and the staff team showed a desire to improve on the service provided and in turn the quality of life experiences for the people living at Eventide. However, the systems in place to monitor the quality and safety of the service were not comprehensive to ensure a quality service was being provided. Documentation in some people’s care records was not accurately recorded or was incomplete and checks had not identified this. Medication audits were not always completed regularly.

Staff treated people with kindness and compassion. The atmosphere was homely and staff knew people well and spoke about them fondly. A programme of activities was provided and access to a minibus enabled day trips to take place. People were supported to follow their faith and attend local churches if they wished.

There was a stable staff team who were knowledgeable about the people living at the service and had built trusting and meaningful relationships with them. People received enough to eat and drink and a diet suitable for their needs. People told us the food and drink on offer was good and that they were given a choice at mealtimes.

Safe recruitment procedures were followed by the provider to ensure staff were safe and suitable to work with vulnerable people. Staff received the training and support they needed to do their job effectively. The number of staff on duty was sufficient to meet people's needs. People told us they felt safe living in the home. Staff were kind and caring and knew how to safeguard people from the risk of abuse.

People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at last inspection

The last rating for this service was requires improvement (published 14 February 2019). At their last inspection we identified breaches of regulations 12 (Safe care and treatment) and 17 (Good governance). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulation 12 (Safe care and treatment). Enough improvement had not been made and the provider was still in breach of regulation 17 (Good governance).

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

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.

Northern Counties Eventide Home is registered to provide accommodation and personal care for up to 29 people. At the time of the inspection there were 24 people living at the home.

Eventide is a Victorian property situated in a residential area of Southport. Accommodation is provided over three levels and a passenger lift provides access to all floors. Facilities at the home include three lounge areas, a spacious dining room and gardens to the front and rear. The home operates as a charitable trust with strong links to the Christian faith.

Eventide is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of our inspection a manager was in post who had made an application to CCQ to become registered. A registered manager is a person who has registered with CQC 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.

At the last inspection in June 2016 we rated the home as 'Good.' At this inspection, we rated it as 'Requires improvement'. This is the first time the home has been given this rating. This is because we found the service to be in breach of ‘Safe, care and treatment’ and ‘Good governance’ which are breaches of Regulation 12 and Regulation 17 of the Health and Social Care Act (Regulated Activities Regulations) 2014.

Systems in place to manage topical medication, thickening agent, PRN medications (as and when required medication) were not always being properly managed and systems to manage the quality and safety of the service were not always effective.

We found that topical medicines were not managed safely. This meant that people were at risk of not receiving their topical medication as prescribed and in a safe and appropriate manner.

We also found that the use of thickening agent in fluids was not recorded on fluid input charts. This placed people at risk as it was unclear as to whether thickening agent had been added to their fluids.

We looked at the management of PRN medication. We found that for some people who were on PRN medication (such as pain relief), staff had not recorded the time of administration and some people did not have PRN protocols in place.

We also found systems to manage the quality and safety of the home were not always effective. Although we saw evidence some audits were carried out in relation to the safety and cleanliness of the environment and for the management of medication, there were no audits in place in relation to written documentation such as care plans, daily records and risk assessments.

You can see what action we asked the provider to take at the back of the full version of this report.

All of the people we spoke with and their relatives told us they felt safe living at Eventide. Staff understood their responsibilities in relation to safeguarding people from abuse and mistreatment and were able to explain how they would report any concerns.

Arrangements were in place with external contractors to ensure the premises were kept safe.

We looked at how accidents and incidents were reported in the service and found they were managed appropriately.

We looked at recruitment processes which were in place. We reviewed personnel records for four members of staff. We saw that each staff member’s suitability to work at the service had been checked prior to employment to ensure that staff were suitable to work with vulnerable people.

We looked at care records belonging to four people. We saw that people’s care requirements were identified and people were appropriately referred to external health professionals when required. This helped to maintain people’s health and well-being.

People and their relatives were involved in the formulation of their care plans. We saw that people’s preferences were considered. Staff supported people in a person-centred and dignified way.

Staff sought consent from people before providing support. Staff we spoke with understood the principles of the Mental Capacity Act 2005 (MCA) to ensure people consented to the care they received.

We found there were enough staff on duty to meet people’s needs. Interactions we observed between staff and people living at the service were genuine and caring. Staff treated people with the utmost respect and took care to maintain people’s privacy, dignity and independence. People living at the service and their relatives told us that staff were extremely compassionate and professional.

There was an open visiting policy for friends and family. This helped both people and their visitors feel supported. Friends and family told us the service involved them in the care of their relative and made them feel welcome. For people who did not have anyone to represent them, the service supported them in finding an independent advocacy service to ensure that their views and wishes were considered.

All meals were home cooked on the premises using locally sourced fresh ingredients. Staff were knowledgeable about people’s preferences and dietary requirements.

The service had a complaints procedure in place. People and their relatives told us they would feel comfortable in raising any concerns they had with the manager. Complaints were recorded and acted upon appropriately.

We found the environment to be clean and well maintained. People could decorate their own room so that each room was completely unique to them. We found that the environment required some improvement to adapt to the needs of people living with dementia.

Feedback about the management of the service was positive. People and staff told us the manager was supportive and approachable.

Situated in a residential area of Southport, Northern Counties Eventide Home provides accommodation and personal care for up to 29 people. The home is a charitable trust with strong links to the Christian faith. Facilities at the home include three lounge areas, a dining room, a patio area, car parking and gardens. A passenger lift is available for access to the bedrooms located over three floors.

A registered manager was 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.

The people that we spoke with and their relatives told us that care was delivered safely and we saw that the home had systems and checks in place to monitor safety. Staff knew how to recognise abuse and discrimination and understood what action to take if they had concerns.

A personal emergency evacuation plan (PEEP) had been produced for each person living at the home. The home had conducted regular fire drills and fire alarm testing. Fire safety equipment was tested by external contractors annually and by the home on a regular basis. Other essential safety checks, for example, gas safety and electrical safety were completed annually.

Staff were recruited safely following a robust process. Staffing numbers were more than sufficient to safely meet the needs of people living at the home and provide additional one-to-one time.

People’s medication was stored and administered in accordance with good practice.

Staff were suitably trained and skilled to meet the needs of people living at the home. The staff we spoke with confirmed that they felt equipped for their role. Training was provided by an external organisation and refreshed annually.

The records that we saw showed that the home was operating in accordance with the principles of the MCA.

Meals were prepared from fresh ingredients and served in a well presented dining room. Tables were laid out with table-cloths, napkins, matching crockery and cutlery. People were given choice about their preferred meals and offered drinks regularly.

People were supported to maintain good health and to access healthcare services by staff. We saw records of visits by a range of healthcare professionals in care files.

People told us and we observed that staff were very caring in their approach. People were treated with respect and their dignity was promoted throughout the inspection.

Friends and relatives were free to visit people at any time and spoke positively about their experience of the home.

Records relating to care used personalised language and offered a detailed, positive view of each person and their care needs. People and their relatives were actively involved in the planning and review of care. We saw evidence that care had changed following such reviews.

The home described itself as having strong links to the Christian faith and we saw that people were encouraged and supported to follow their faith by the home. People’s rooms were filled with personal items and family photographs.

The home had a programme of activities including quizzes, crafts, chair exercises and a history club. Activities were also organised away from the home. For example, a trip on a canal boat.

People’s views about the quality of the home and the care provided were sought during reviews of care and informally through conversation. People told us that staff and managers regularly asked if they were satisfied with their care and if they would like to change anything. They also told us that they would feel confident in making a complaint if they had to.

The registered manager was supported by a management team with responsibility for specific aspects of the service such as; care management, personal care, dementia and dignity. We spoke extensively with the registered manager throughout the inspection. It was clear that they knew each person living at the home and their care needs well. People spoke positively about the registered manager, their approachability and leadership of the home.

Staff understood what was expected of them and were motivated to provide good quality care. We saw that staff were relaxed, positive and encouraging in their approach to people throughout the inspection.

The provider had systems in place to monitor safety and quality. They completed a monthly audit which included information that was fed-back to the staff team. The records that we saw indicated that all audits had been completed in accordance with the home’s schedule.

The registered manager maintained records of notifications to the Care Quality Commission and safeguarding referrals to the local authority. Each record was detailed and recorded outcomes where appropriate.

The care records we looked at showed the home had made the improvements required. Risk assessments were up-to-date and care plans had been updated to reflect people's needs.

'It's a lovely place. They treat me well.'

'It's good here. I get the support I need. The staff are generally nice.'

'It's absolutely wonderful. I couldn't fault it. Staff are always around when I need them.'

We found that people had their nutritional needs supported.

We found that there were sufficient staff available to meet the needs of the people who used the service.

We found there were systems in place to find out the views of the people who used the service and their relatives about how the home operated.

Care plans and risk assessments were in place with information about people's needs and risks identified. We found that some improvements were needed to these records to ensure that staff had access to all the information required to support the people who used the service.

People living at the home were positive and complimentary about the care and support they received. One person told us the staff were 'kind and thoughtful.' Another person said, 'The home has a good ethos and atmosphere'.

Care record files were clear and concise. Care plans were in place which reflected people's needs and they were reviewed on a regular basis. Arrangements were in place for cleaning the building and minimising the risk of infections spreading.

Effective structures were established for the recruitment of new staff. Arrangements were in place for monitoring the quality of the service, including the opportunity for people living at the home and their relatives to provide feedback on the service.