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Inspection carried out on 2 May 2019

During a routine inspection

About the service: Eastbank is located in Hereford, Herefordshire. The service provides accommodation and care for up to seven people with learning disabilities, physical disabilities and dementia. On the day of our inspection, there were seven people living at the home.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.' Registering the Right Support CQC policy

People’s experience of using this service:

• People enjoyed living at the home and were complimentary about staff and the way the home was managed.

• People, relatives and staff told us they saw the provider and registered manager regularly and found them approachable.

• Staff understood risks to people’s safety and supported them to stay as safe as possible.

• There were enough staff to care for people at times people wanted assistance.

• People were supported to have their medicines safely and checks were undertaken to ensure these were administered as prescribed.

• The risk of infections and accidental harm was reduced, as staff used the knowledge and equipment provided to do this.

• Staff spoke very affectionately about the people they cared for. People were confident to request support and reassurance from staff when they wanted this, and staff took time to provide this in the ways people preferred.

• People told us staff respected their rights to make their own decisions about their lives and care. Where people needed support to make some decisions staff assisted them, using people’s preferred ways of communicating.

• Staff had received training and developed the skills they needed to care for people, through induction and on-going training. People told us staff knew how to help them and knew what to do if they suspected anyone was at risk of harm.

• People had good access to other health and social care professionals and staff followed any advice given.

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

• Staff ensured people had opportunities to do things which they enjoyed, and people were supported to keep in touch with others and religious practices that were important to them.

• The views of people, relatives and other health and social care professionals were considered when people’s care was assessed, planned and reviewed, so people’s needs continued to be met, and based on people’s preferences.

• Procedures were in place to take any learning from complaints and to further improve people’s care.

• People’s wishes for their care at the end of their lives had been planned and the views of their relatives considered.

• The registered manager and provider checked the quality of the care provided and encouraged suggestions from people and staff to improve people’s care further.

• The registered manager kept up to date with best practice developments, so they could develop the care provided further.

Rating at last inspection

At our last inspection the overall rating of this provider was Good. The report was published on 19/10/2016.

Why we inspected: This was a planned inspection based on the ratings at the last comprehensive inspection. The rating has improved to Good overall.

Follow up: We will continue to monitor the service through the information we receive until we return, as part of the inspection programme. If any concerning information is received we may inspect sooner.

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

Inspection carried out on 26 September 2016

During a routine inspection

Eastbank is located in Hereford, Herefordshire. The service provides accommodation and care for up to seven people with learning disabilities, physical disabilities and dementia. On the day of our inspection, there were seven people living at the home.

The inspection took place on 26 September 2016 and was unannounced.

There was a registered provider in post, who was also the manager; there was not a legal requirement of this service to have a registered manager in post. Registered providers and registered managers 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 were involved in decisions about how to keep them safe. People's individual support needs were assessed and staff knew how to keep people safe. People were supported by staff about how to recognise abuse or harm and how to report this.

People enjoyed their freedom and were supported to maintain this, whilst keeping safe.

People received their medicines safely and as prescribed.

People were supported by staff who were trained to meet their needs. People had the right to make their own choices and these were respected.

People received specialist input from a range of health professionals, where required. People's health was maintained, which included supporting people with eating and drinking.

People felt accepted by staff. There was an inclusive culture in the home, which recognised and celebrated differences.

People were involved in decisions about their care. People's changing health and wellbeing needs were responded to.

Feedback, comments and complaints were captured and used to make improvements in the care people received.

The manager was respected by staff and had good relationships with people living in the home. The manager routinely monitored the quality of care provided to people. There were established links with the local community, which were used to benefit people.

Inspection carried out on 9 April 2014

During a routine inspection

We considered our inspection findings to answer the questions we always ask;

This is a summary of what we found.

Is the service safe?

We saw that people had been cared for in an environment that was safe, clean and hygienic.

There were sufficient staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies.

Staff personnel records contained all of the information required by the Health and Social Care Act. This meant the provider demonstrated that the staff employed to work at the home were suitable and had the skills and experience needed to support the people who lived in the home.

The manager and the staff we spoke to understood the importance of safeguarding vulnerable adults, could identify potential abuse and knew how to report any incidents of abuse.

Is the service effective?

People told us that they were happy with the care that had been delivered and their care records were up to date and signed by them. One person said : “I love it to bits here.”

People told us they met with their key workers regularly to discuss what was important to them. Records confirmed people’s preferences, interests and goals had been recorded and care and support had been provided in accordance with people’s wishes. People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.

We heard that information was shared very effectively between staff using a number of different tools including handovers and a communication book.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People told us they were able to do the things they wanted to do both alone and with staff where they required support. Our observations confirmed this. One person told us : “It was a nice little move here.”

Is the service responsive?

People’s needs had been assessed before they moved into the home which meant that their needs had been identified.

People told us that one person had developed memory problems as he got older and additional support had been put in place to meet their needs.

People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.

Is the service well-led?

Staff had a good understanding of the culture of the home and quality assurance processes were in place. Customer satisfaction surveys had been sent out but people preferred to contact the manager by telephone or face to face if they had any concerns.

Staff told us they were clear about their roles and responsibilities. They said the management had consulted with them before they implemented changes to the number of beds in the home and their views had been taken into consideration.

Inspection carried out on 29 August 2013

During a routine inspection

People told us they felt safe in the home and were well supported. We found that people were encouraged to be independent, get involved in activities of their choice and access local community facilities.

The staff team was stable and so staff knew people and their preferences well. People’s wellbeing and any concerns were taken seriously. Information was shared effectively between staff.

People felt able to raise any concerns with staff or the manager. The staff were suitably trained and felt supported. The team sought input from external professionals when needed.

There were effective leadership arrangements in place to manage the care service and monitor health and safety risks.

Inspection carried out on 20 September 2012

During a routine inspection

When we visited Eastbank we met the owner and one of the staff. We talked to three of the five people who lived there about their experiences and got feedback from two relatives. They were very satisfied with the support they received which helped them be as independent as possible. We looked at two people’s care records and staffing records. We spoke to another worker after the inspection.

We found that people were supported in promoting their independence and community involvement. Their diversity, values and human rights were respected. People told us they liked the staff and they provided good care and support. They felt safe and were able to raise any concern they had.

We looked at staff training records and spoke to two staff to get their views. They felt the staffing levels were suitable and they were well supported and trained.

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