Background to this inspection
Updated
7 April 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the registered provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was carried out by three inspectors.
Service and service type
Eastry House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the registered provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The registered provider was not asked to complete a registered provider information return prior to this inspection. This is information we require registered providers to send us to give some key information about the service, what the service does well and improvements they plan to make. This was because this was a focused inspection.
We reviewed information we had received about the service since the last inspection.
We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service about their experience of the care provided. We spoke with seven members of staff including the registered manager and care staff.
We reviewed a range of records. This included five people’s care records and medication records. We looked at four staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the registered provider to validate evidence found. We looked at training data and quality assurance records.
Updated
7 April 2021
About the service
Eastry House is a 'care home' for up to 22 people with learning disabilities. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection, there were 17 people living at the service.
People’s experience of using this service and what we found
People were very happy living at Eastry House and spoke highly of the registered manager and staff. Despite this, we found the registered provider had failed to ensure management oversight of the service since our last inspection. This meant some areas identified at our last visit had not been addressed. It also meant the service had failed to improve or learn from past feedback.
There was a lack of quality auditing of the service which included provider audits. The premises could not be cleaned properly due to the poor condition of some areas. Staff were not always following good infection control practices or government guidance in relation to COVID-19. Accidents and incidents were not always included in the registered manager’s analysis meaning they could not robustly review for themes or trends.
People told us there were sufficient staff on duty each day and they were kind to them which made them feel happy and safe. People received the medicines they required and any risks specific to them were identified and guidance in place for staff to help keep them safe.
People and staff felt involved in the service and felt listened to and we observed an obvious close relationship between staff and people.
The registered manager had started to improve Eastry House and the quality of the service people received. Staff told us they had already had a positive impact despite only being registered since December 2020. The registered provider had good links with external agencies to help ensure people received appropriate care in line with their needs.
We expect health and social care registered providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• The model of care and setting maximises people's choice, control and Independence.
Right care:
• Care is person-centred and promotes people's dignity, privacy and human rights.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.
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 10 September 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
The inspection was prompted in part due to concerns received in relation to incidents and allegations of abuse at other locations registered with the provider. A decision was made for us to undertake a focused inspection to inspect and examine those risks. This report only covers our findings in relation to the Key Questions of Safe and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained as Requires Improvement. This is based on the findings at this inspection.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Eastry House on our website at www.cqc.org.uk.