Eastcroft Nursing 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

People received safe care and treatment from staff who understood their healthcare needs and followed healthcare guidance from professionals. Staff knew how to safely support people around their individual risks. At the last inspection in January 2023 the provider was in breach of regulations because they failed to ensure people received safe care and treatment, to review and learn from incidents and accidents and to safely manage medicines. At the time, staff had not received all the training required for them to be competent for their roles. The provider made significant improvements and was no longer in breach of regulations at this assessment. The provider introduced a system which gave them oversight of developing trends and themes in accidents and incidents. This enabled them to provide necessary additional training to staff or to seek external support to manage recurrent themes. Staff were competent and deployed to meet fluctuating needs of people and in such a way as to monitor those cared for in their rooms. Staff recruitment process was safe and there were enough staff to provide timely and safe care. The provider ensured people were safe and received care which met their individual needs, protected their rights and safeguarded them from abuse and neglect. The manager adjusted staffing levels to respond to people’s changing needs. The home environment was safe. Medicines were managed safely by competent nursing staff. People were protected from the spread of infections.

This service scored 75 (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 learnt from their review of accidents, incidents and other events in the service. There was a system in place by which accidents and incidents were monitored so that emerging trends and themes could be identified. As a result of that, the managers introduced a new training platform which staff found easier to negotiate and which resulted in improved overall staff competence levels. The manager introduced a new monitoring process, which they told us, “Gives me better oversight and understanding of all training staff have done and need to do.” There was also increased provision of face-to-face training, some of which was provided by the local authority and shared with a neighbouring home.

Staff were aware what to do to record and report any accidents and incidents so learning could be identified. Staff were aware what action to take to address any immediate risks to people. One staff member said, “We will report to nurse in charge so immediate first aid is given. We have to write it down in the notes and accident forms. It rarely happens that we have any serious accidents.”

People’s relatives told us staff supported their loved ones safely and ensured any changes in people’s needs resulted in learning, appropriate consultation with people’s representatives and action being taken to better support people.

Staff knew how to ensure they worked well with other system partners to provide seamless and safe care to people. One staff member said, “We have good access to other healthcare professionals. Frequent referrals are done to meet residents’ healthcare needs.”

The healthcare professionals working with the service were complimentary about changes made to how staff communicated with them and arranged any relevant care reviews in a timely way when people’s needs had changed.

People’s relatives told us their care was well-assessed and coordinated so they could access timely support from staff in the home and other services when needed.

The manager clearly described partnership working alongside other local authority professionals, for example to manage one person’s return to community living and to ensure care was provided in people’s best interests. People’s care and clinical records evidenced how staff worked well with other health and social care professionals to address people’s changing needs and to support safe and person-centred transitions in care.

Staff knew how to recognise and report any concerns and protected people from abuse and neglect. Staff received safeguarding training and felt assured the managers would act on the concerns raised. Staff were able to describe different types of abuse and give examples of things they would report. Staff said, “We are here to keep our residents safe. We would inform nurse, then the management. We have a telephone number for MASH (multi-agency safeguarding hub) in staff room”; and “We have whistleblowing training, and we have a phone number in the staff room we can ring if management aren’t doing anything.”

The provider had clear policies and procedures around safeguarding and whistleblowing. Safeguarding concerns were recognised, reported and investigated with actions taken to protect people. Staff received appropriate safeguarding training and information on how to raise concerns was readily available in the home.

People’s relatives told us they felt safe with staff and in their home. One relative told us, “I would say [relative] feels very safe – this is obvious in their demeanour, they think they are in their own home and are calm and settled. I trust all the staff implicitly.” Another relative commented, “I am informed of unexplained marks or any illness, and where necessary, the nurse will refer to the GP.”

Staff knew people’s individual needs and how to support them safely. For example, staff explained to us how they supported people who could become distressed. Staff commented, “It’s a very calm place. We will ask other staff to try (to support the person) or reassure them. We never need to use restraint”; “We stay calm and don’t challenge.”

People’s individual risk assessments included information and guidance for staff critical to people’s safe care. For example, risk of choking, falls, allergies, skin integrity, nutrition. People’s care plans reflected the level of risk and support required and were regularly reviewed.

People were supported safely as per their individual needs. For example, we saw staff encouraged people to mobilise independently and to use their walking aids safely to prevent risk of falls.

People’s relatives told us staff knew people’s individual needs and risks and provided safe care. One relative said, “[Person] has no mobility and needs two staff, they always have two staff when moving. They are very well aware of [person’s] mobility and mental health.” Another relative told us, “I think staff really understand [person’s] needs; they are at significant risk of falls risk but has never had a fall since being, so from that I believe the staff understand [person’s] risk.” Where people needed specific support, for example their drinks to be thickened to mitigate risk of choking, relatives told us staff were “aware because all the time they mix drinks I see them adding it.”

The provider had clear systems to assess, monitor and address risks around environment, maintenance and any emergencies, for example, around fire safety or use of care equipment. The managers completed regular health and safety checks and ensured there were suitable business continuity plans in place to be used in emergencies.

People’s relatives told us the home environment was safe, accessible to people and well-maintained. Relatives commented, “There seems to be adequate signage and [people] can move their way around the home just fine”; “Judging by how [person] can easily find their room and the bathroom, without bumping themselves or falling, the layout is definitely perfect for them.”

Staff knew how safety of the environment and care equipment were maintained in the home and what responsibilities they had. One staff member said, “Fire alarms are checked every Tuesday. We attend the main fire alarm board, and the nurse will tell us what to do. When the fire training comes, we have the practical knowledge and they show us all the equipment and how to use it.” Staff we spoke with were knowledgeable around safety, for example what to do in the event of emergency evacuation. Senior staff knew their responsibilities around health and safety and maintenance of a safe environment. One senior staff told us, “We like to do a weekly audit, so we know we are on top of everything”.

We observed the home environment was safe and well-maintained, free of clutter and malodours.

Staff told us there were enough of them to provide good quality and timely care to people. One staff member said, “There are always enough staff. We are never short. When we are full, we have more staff. Nurses are always willing to help.” Another staff member told us, “Yes, there are enough on each shift.”

People’s relatives told us there were enough competent and skilled staff to assist people in a timely way and to provide safe care. Relatives said, “There seem to always be enough staff when we visit, more than enough staff around to assist.”; “On the basis of how well staff know [relative] and keep them safe, I would definitely say they are well trained and know how to go about their job.”

Staff did not appear rushed as they went about their duties. They responded to people’s requests and took time to engage with them. People did not have to wait long for staff to attend to them.

The provider monitored staffing levels and ensured these were adjusted, for example, in response to people’s changing needs. No new staff were recruited since the last inspection. The manager rectified omissions on staff files noted on the last inspection. The manager also implemented a new administrative system to enhance their safe recruitment process. The provider developed a robust monitoring system to monitor staff training compliance and competencies. They ensured that nursing and care staff were given time to complete required training, as well as to attend external training organised by healthcare professionals.

People’s relatives had no concerns around cleanliness of the home and how staff adhered to infection prevention and control best practice when supporting their loved ones.

Staff knew how to protect people from the risk of spread of infections. One staff member said, “We have training, and we have the sluice. We are using PPE (personal protective equipment). We always have stock and are never short of anything. We are covering for domestic currently, so all need to know about infection control.” Another staff member told us, “We do handwashing, using sanitiser, we always are using hand gloves and aprons. If one resident has [infection] they stay in their room, so others are safe. We have training about what to do and the nurse to guide us.”

The provider had appropriate policies and procedures around infection prevention and control. There were regular audits and checks of staff practice and the environment. When needed, action was taken to improve infection prevention and control in the home.

The home was clean, and we had no concerns about the hygiene levels. Staff were seen to wear appropriate personal protective equipment for the task they were completing. There were plentiful supplies of PPE available in the home.

People’s relatives did not raise any concerns around support people received with their medicines. They were complimentary around overall standard of care and treatment provided to their loved ones in the home.

Staff we spoke with knew how medicines were managed in the service and what was needed to do this safely. Staff were aware of people’s individual needs and risks around medicines and could explain to us what processes their followed to administer medicines safely and to maintain appropriate medicines records.

Monthly medicines audits were completed by the deputy manager and staff who administered medicines checked for omissions after each medicines round. Some areas of weakness were identified in these audits, including oversight of trend and themes. A healthcare professional agreed to support the provider to address this following this assessment.