Eastfield

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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question Inadequate. At this assessment the rating has changed to Good. This meant people were safe and protected from avoidable harm.

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 registered manager had established a robust safety culture within the service. Staff actively listened to safety concerns, thoroughly investigated incidents, and reported them appropriately. Lessons were continuously learned to identify and embed best practices.

Staff completed accident and incident forms, which were then reviewed by the registered manager to ensure that immediate and follow-up actions were taken as needed.

The registered manager regularly analysed accidents and incidents to identify patterns and trends. When recurring issues were identified, preventative measures were put in place. For example, one analysis showed that several falls occurred during early mornings and weekends. In response, the registered manager conducted checks during those times and reviewed staff deployment, assessed staffing levels, and observed practices.

Group staff supervision sessions were held and these focused on incidents, prevention strategies and reflected on lessons learned.

The registered manager worked with people and healthcare partners to make sure there was continuity of care, including when people moved between different services.

Since our last inspection, the service had not admitted anyone new to the service. However, the registered manager was able to describe to us the process they used when assessing whether Eastfield would be a suitable place for someone to live.

We talked to senior management about new people being admitted to the service.. They told us, “We will not be moving in 5 people a week. We will take it slowly; 1 or 2 people every couple of weeks. We will also not move people in unless we have sufficient staff in place first.”

The registered manager worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

The registered manager shared concerns quickly and appropriately. They told us, “I raised a safeguarding on Monday following an unwitnessed fall of one person. I’ve worked with staff on safeguarding and how to recognise it. For example, staff didn’t realise it could include incidents between people.”

Staff undertook safeguarding training and were able to describe to us what may constitute a safeguarding concern and how they would report this. One staff member said, “If someone hit someone else that is definitely a safeguarding concern. I would not leave it. I would always take action.”

The registered manager worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. One relative told us, “He was upstairs. I asked if he could come downstairs. He had falls out of bed. It was easier to monitor him down here. They (staff) lower his bed when he is in it. They do everything they can to avoid it (a fall).” A second said, “She was moved to the ground floor. It was safer.”

One person was at risk of self-neglect as they disliked being supported with their personal care. Information was clear in care plans that staff should choose the most appropriate time to offer personal care to the person as well as trying to ensure that staff who the person liked were in attendance. This person was also at risk of constipation due to a health condition and as such, staff had introduced daily monitoring so they could react promptly if the person was showing signs of being uncomfortable. Where people had epilepsy, there was guidance for staff on the symptoms to look out for and details on when emergency medicines may need to be used.

Staff told us, “We have to keep an eye on people and support them when they are walking. If someone is losing weight, we offer them nice food, fortified foods and calorific food. Some people need you to be with them when they are eating.”

The registered manager detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. A relative said, “The redecoration means it’s a better environment for residents and for working in.”

Since our last inspection, the service had undergone a complete refurbishment and old furnishings and fittings had been replaced. We found the service was well-maintained and maintenance staff were available to make repairs, etc. when needed. This included fixing a wobbly dining table and securing some radiator covers that were not firmly fixed to the wall which we had identified.

The registered manager said fire drills were done quarterly both day and night and a whole new fire system had been installed since our last inspection. They said, “The new system tells you the exact location of the fire. Either myself or the deputy will update people’s personal emergency evacuation plans to ensure they are accurate.”

The registered manager made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

We observed sufficient staff on duty throughout the day and we did not see anyone needing to wait to receive attention. Staff told us they felt there were enough of them to provide care to people in a calm, unrushed way and people’s feedback was that they did not have to wait for care to be provided. One staff member said, “There is enough staff and we have time to do everything as well as talk to people.” Relatives had no concerns about staffing levels and said they saw consistent staff. One told us, “I’ve not seen many agency (staff).”

The registered manager carried out spot checks during the night and walkarounds during the day to check on staff deployment. They told us, “At night, I will check Zimmer frames are in place, sensor mats are in place and beds are at the right setting. Part of the daily walkaround is checking on how long call bells take to answer. The majority of people can’t use their call bells, so we have sensor mats in place.”

Staff underwent induction, shadowing and training prior to working on their own. All staff said the induction/training programme was robust and that it provided them with the knowledge and skills they needed to be a competent member of staff. They confirmed where specialist training was required, this was provided to them. For example, acquired brain injury or epilepsy. A staff member said, “The induction was really, really good. I carried out shadowing shifts and only worked alone when I felt comfortable.”

Staff received support through face to face meetings with their line manager. This gave them the opportunity to discuss their role, concerns or training needs.

Prospective staff went through a robust recruitment process which included providing evidence of performance from their current role, their right to work in the UK and their fitness for the role. All staff underwent a Disclosure and Barring Service (DBS) checklist to help ensure they were suitable to work in this type of service.

The registered manager and staff assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

We found the service was clean and hygienic and observed housekeeping staff working throughout the day to maintain a good standard of cleanliness.

Staff had access to appropriate personal protective equipment (PPE) when they needed it, such as gloves and aprons and we saw them wearing PPE at times throughout the day, such as when they were serving lunch or giving people drinks. One relative said, “He is always clean and his clothes are clean.” A second told us, “There are no smells in the home.” Another said, “We always find [person’s name] room clean, tidy and well presented.”

The registered manager carried out regular infection control audits and their daily walkaround included some checks of cleanliness.

The registered manager made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. One person said, “I’ve not had any problems with my medicines.”

People received their medicines as prescribed. We reviewed medicines administration records (MARs) and were able to reconcile peoples’ medicines supply. MARs had accurate information for staff to administer people’s medicines safely including details of allergies and how they liked to take their medicines.

Medicines were stored safely and securely. Risk assessments and care plans for high-risk medicines were in place; these were person centred and had the right information for staff to follow to ensure that risks were managed safely.

Medicines audits were completed regularly, and appropriate actions implemented.

We observed a medicines administration round and saw that staff had good rapport with people and gave their medicines safely as prescribed.