Eastham

Eastham is a residential care home providing personal care and support for up to 25 older people some of whom may be living with dementia and people with a physical disability and sensory impairment. At the time of our inspection 18 people were using the service. The service is set in an adapted building over 3 floors.

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

People and staff were not always protected from the risk of infection as policy and procedures were not being followed to keep people properly protected. Improvements had been made quickly to ensure people were not at risk of harm but these needed to be sustainable.

There was enough staff to support people with their personal care. However, staffing levels needed review to ensure people got good quality care in all aspects of their life at the service.

We have made a recommendation about staffing levels.

Safeguarding systems were in place to protect people from harm. People were given their medicines in the right way and at the right time. They were well managed by staff who were competent in their role.

Staff were safely recruited in line with legal requirements and the provider had completed the appropriate checks.

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

The provider worked alongside other healthcare professionals in order to support people's health needs, making referrals and seeking additional support where appropriate.

Lessons had been learnt from incidents and accidents and shared with staff to prevent them from happening again.

Staff and people who used the service were positive about the management of the service.

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 good (published 20 March 2021).

Why we inspected

We carried out this unannounced inspection on 12 December 2022 to review the key questions of safe and well led only. This focussed inspection was prompted by a review of the information we held about this service.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this 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.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

About the service

Eastham is registered to provide accommodation and personal care for up to 30 people. The service does not provide nursing care. At the time of our inspection there were 19 people using the service.

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

People living at Eastham care home and their relatives were kept up to date about the impact of COVID-19 on the service by the management team, and relevant policies and procedures were in place to prevent the spread of infection.

Rating at last inspection

The last rating for this service was good (published 17 April 2020)

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. A decision was made for us to inspect and examine those risks. The overall rating for the service has not changed following this targeted inspection and remains good.

CQC have introduced targeted inspections to follow up on a Warning Notice or other specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

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.

Easthams is a care home providing personal care and accommodation for up to 25 people. On the day of inspection, 23 people were using the service. The service does not provide nursing care.

People’s experience of using this service:

People's experience of the service was very positive. There were a range of innovative activities provided, which developed people’s interests. Diversity was actively celebrated. People’s care plans were detailed and accurate, ensuring staff consistently knew how to support people. People and their relatives told us they knew how to complain, and any complaints received were used to improve the service. We saw positive feedback from people’s relatives regarding end of life care, and the registered manager told us they supported people to remain at the service if that was their wish.

People said they felt safe at the service. Risks to people were assessed and staff knew what to do to keep people safe. People got their medicines correctly and at the right time. Good infection control practices were in place. There were sufficient staff who had been safely recruited. Staff had been trained in safeguarding and knew the signs to look for that people might be being abused and how to report any concerns.

Staff enjoyed working at the service and told us they were well supported. People were supported to have enough to eat and drink which met their needs and preferences. People’s healthcare needs were met in a timely way. 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 practice.

Staff were kind and caring and knew people well. People were included in decisions around their care and support. People's privacy and dignity was respected, and staff encouraged people’s independence. The service helped people maintain important relationships and visitors were made welcome at the service.

The service was well-led by a visible and approachable registered manager who was well thought of by the staff team. The service engaged with people and staff to include them in how the service was run. Feedback was invited and acted upon. Quality assurance audits were in place to monitor the safety and quality of the service and drive improvement. The provider had good oversight of the service.

Rating at last inspection: Good. (Last report published 26 July 2017).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor the service.

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

The inspection took place on 26 and 27 July 2017 and the inspection team consisted of one inspector.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manager 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 on 3 and 4 June 2015, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’ and was meeting the fundamental standards. Although we found in one domain the service had reached the ‘Outstanding’ mark.

At the time of the inspection there were 24 people living at the service. The registered manager told us that this was now full capacity as a room that had previously been a ‘double’ occupancy room had been changed to a ‘single’ occupancy room.

The service was exceptionally responsive. People consistently experienced care that met their individual needs. People's lives had been enhanced as a result, often with outstanding outcomes which changed their lives.

The service was safe. Staff were deployed appropriately to meet people’s needs. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People’s needs were met by staff who had been recruited and employed after appropriate checks had been completed. Medication was dispensed by staff who had received training to do so.

The service was effective. People were cared for and supported by staff who had received training to support people to meet their needs. People were safeguarded from the potential of harm and their freedoms protected. Staff were provided with training in Safeguarding Adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported with their nutritional needs and had access to healthcare when required.

The service was caring. Staff were attentive to people's needs. Staff were able to demonstrate that they knew people well. Staff treated people with dignity and respect.

The service was well-led. The registered manager had been in post for a number of years and was knowledgeable about the people who lived at the service. The registered manager had quality monitoring processes in place to monitor and drive improvements at the service. The registered manager had a number of ways of gathering people’s views including talking with people, staff, and relatives.

Further information is in the detailed findings below.

People told us that the service was well led. One person remarked, 'This place is excellently run.' Another person commented that under the registered manager's watchful eye that, 'Nothing goes a miss.'

People told us that they felt safe, and well looked after. They told us that staff supported them with their personal care, and when they become unwell, staff ensured that they were seen by a health professional within a timely manner. One person told us, 'Staff are good to me'I don't know all their names, but they are all good to me.'

We saw that people were given the opportunity to take part in group and one to one activities and build links with the local community. We saw that people were provided with a clean and homely environment.

People told us that they were given a choice of nutritious, home cooked meals and staff supported them to maintain a clean and homely environment. One person remarked, 'Food is nice, I like my food.' Another person told us, 'I have no complaints (about the food) what so ever.'

A number of people were not able to tell us directly about their experiences. However, we observed that they were relaxed and they interacted positively in different ways with the staff. For example, people had one-to-one time with the staff who talked to them whilst painting their nails and people enjoyed the gentle way staff were assisting them to eat.

Eastham had all the necessary policy and procedures, records, quality assurance and monitoring systems in place for the protection of people who used the service. Staff were well trained and supported by the manager so that they could carry out their caring responsibilities effectively. People who used the service and their families were involved in their care arrangements and in helping to improve the service.