Eastside Gardens

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. This is the first assessment for this service under the new provider. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 81 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We found a proactive, systematic approach to managing safety. Management’s strong focus was on a culture of openness and collaboration across the service, and safety was everyone’s top priority.

Staff, people using the service and visitors were actively encouraged and rewarded for raising concerns about safety and providing ideas to improve.

The nominated individual, who oversaw a group of local care services, was actively involved in our site visits. She clearly recognised the positives at Eastside Gardens and used her role to promote the sharing of best and innovative practises. For example, the positive outcomes of the ongoing ‘caffeine free’ trial at the home where a significant reduction in falls had resulted.

Levels of untoward incidents, safeguarding concerns and complaints about the service had been exceptionally low over the past year.

The registered manager took the lead on ensuring a proportionate and resourced approach to responding to safety events that had occurred, including incidents and complaints. We saw from a written response to a relative how this included recognition of where things could have been better and a willingness to apologise.

We met with staff leads from all departments. Without exception their commitment to maintain and improve safety was apparent. Each person had clear roles and responsibilities and took great pride in meeting safety goals.

Staff were actively encouraged and appreciated for raising concerns about safety and ideas to improve. People felt part of a team where they could contribute towards safety and improvement.

A main reason for successful outcomes was the provider’s commitment to ensuring there were enough skilled staff to oversee, manage and deliver safe care. Staff had the time to do their jobs properly and were comfortable and confident when responding to the ever-changing demands of this large and busy care home.

Training included safety expertise, human factors and communication to support a positive safety culture within all levels of the workforce.

The management team always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was continuity of care, including when people moved between different services.

Care records described how people had access to a range of health and social care professionals, including GPs, district nurses, dieticians, social workers and occupational therapists. One relative told us, “They arranged for an optician to come out. She has new glasses now and she never wore glasses for years. They did tell me, so I knew about it.”

Policies and robust procedures were in place to ensure a consistency of approach, in the management of risk. There was an overall understanding and management of risk within the staff team.

The provider had a strong, professional working relationship with their local GP surgery, community matron and advanced nurse practitioner. They had collaboratively implemented an approach to appropriately reduce hospital admissions and instead, consider alternative action or treatment plans. This approach supported the delivery of safe personalised care and supported people to have control over their needs, wishes and preferences.

Staff told us communication was very effective when people moved into the service, and documentation confirmed referral records were detailed and complete. Preadmission assessments were undertaken. Information gathered transferred seamlessly into the care plan which was created with the person and their representative and was based on the initial information received. Care plans contained specific details on how to support people accordingly and reflected both their physical and mental health needs.

One relative told us, “They sat down and explained the process, I filled out the required form, the care plan, they then put it in Mam’s file.”

Leaders worked well with people and healthcare partners to fully understand what being safe meant to them and the best way to achieve that. Staff had a clear focus on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider always shared concerns quickly and appropriately.

We observed genuine and empathic interactions between people and staff during our visit. It was noticeably clear that staff knew the people they supported well and had developed trusting and effective relationships.

Everyone we spoke with told us that people were safe. One person said, “I’m safe, they regularly check-up at night and they also regularly check on me during the day.” A relative told us, “[Relative’s name] is very safe here. Staff are able to deal with any situations and very well from what I have seen when here.”

Following a recent concern that had been dealt with swiftly and professionally; a healthcare professional told us, “It is a pleasure to work with care home staff who show such professionalism and the ability to collaborate effectively in situations requiring immediate attention. The deputy manager’s actions were an excellent example of how timely communication and proactive partnership working can lead to positive outcomes” and “Their approach demonstrated strong leadership, accountability, and a genuine commitment to safeguarding.”

The management team 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.

Risk assessments were in place and contained person-centred information. Staff knew people very well and how to best and safely support individuals. Risk assessments were clear, detailed and had been improved since the previous inspection. One person told us, “I am safe, they wouldn’t let me go far without a carer as it’s better for me. I have confidence in them.”

People told us they felt safe with the care being provided, staff knew them and understood their needs. Daily records evidenced people were being supported safely. For example, one person required a special diet and their care plan documented exactly why and how their meals should be served. Further detail advised staff to liaise with the kitchen to ensure all meals with served correctly and for ongoing monitoring due to weight loss or gain.

The service had previously operated as 2 care homes. This provider had successfully amalgamated them into one which operated as 4 individual units all serviced by central catering and laundry services. The facilities, premises and equipment had been adapted, decorated, and fitted to an extremely high standard where they could be used to meet the various needs of people who used the service. We established that previous fire safety issues relating to a fire safety risk assessment had been fully addressed.

We examined the comprehensive system which supported initiative-taking and proactive management of the safety, maintenance and repair of the facilities, premises and equipment. We met with the full time, ‘two man’ maintenance team who took enormous pride in providing a safe and extremely comfortable environment for people to live in. This in turn promoted and protected staff welfare and supported their delivery of effective and innovative care and hygiene standards that kept people safe.

Up to date personal emergency evacuation plans were in place and quickly accessible, as was relevant information for the fire service, should an emergency arise.

Equipment checks were extensive, very well organised, and efficiently recorded. This reduced the levels of untoward events and equipment failures. Care staff communications and requests to the maintenance team were promptly responded to.

The maintenance staff oversaw fire safety and coordinated the provision of fire safety awareness and drills to a large and diverse staff team. Staff were confident and knowledgeable about safety and how to deal with possible emergencies.

A recent environmental health visit earlier this year achieved a 5-star (top of the scale) food hygiene rating. The report noted staff were very aware of food safety and allergy controls and that all paperwork had been completed and filed accordingly.

There was an ongoing environmental plan in place to ensure the home’s décor was consistently fresh and updated. The furniture in each unit was clean and looked new. All dining chairs were fitted with sliders to allow for ease of movement.

One person told us, “‘The fire alarm gets tested every Tuesday and the fire doors close. We do fire drills, everyone’s doors are shut, you are safe - even the lounge doors close.”

A visiting relative told us, “It has a lovely, homely atmosphere here and the cleanliness is immaculate.” Feedback from healthcare professionals included, “I noticed that the whole place felt clean, organised and welcoming.”

Leaders made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. The staff team worked together well to provide safe care that met people’s individual needs.

Staffing numbers across all delegations were impressive and no one raised any concerns over staffing levels or their abilities. There were waiting lists for people who wanted to live at the service and staff who wanted to work there.

The provider’s provision of more than adequate staffing in all departments enhanced and promoted the exceptional standards of care and safety.

The registered manager and her deputy proactively supported and encouraged the staff team to acquire new skills, use their transferable skills, and share best practice. Their combined commitment was a major contribution to the provision of high-quality care.

They described and shared examples of a values-based approach to recruitment. These covered dignity, compassion, caring, accountability, and inclusion. All aspects of staff appointments were led by the management team with nothing taken off site for corporate input.

Checks on a random selection of recruitment files for various staff designations, including agency workers, demonstrated robust and safe recruitment practices. Checks on the nurses’ registration with their professional body were all up to date.

A ‘refer a friend’ recruitment initiative had been very popular. The registered manager described the value of a buddy scheme for new starters. She had been proactive in introducing and maintaining a big focus on staff wellbeing and empowerment as part of staff support and supervisions. We saw person-centred examples of how this was delivered. HR surgeries were held for staff to utilise. The sponsorship of overseas staff was running smoothly.

The implementation of 2 clinical leads played a key role in developing and overseeing staff capabilities and competencies across the 4 specialist areas. In conjunction, the role of Clinical Practice Development Manager had also been implemented. This was a varied role which included support with clinical oversight, delivery of clinical training, assessment of competency, and coaching for all levels of staff.

Feedback from external healthcare professionals who worked alongside the home included, “The staff have been consistently excellent at keeping me fully updated and informed”, … “I appreciate how promptly they respond to any queries” and “I would like to compliment the entire staff team for their professionalism, responsiveness, and commitment to good communication.” Another healthcare professional stated, “Staff are hardworking and caring. They are friendly, professional and work well as a team. They have been open to improving teamwork and have achieved this. They are open to learning and reflecting on errors creating a psychologically safe working environment”.

This feedback demonstrated the staff team’s commitment and openness to person-centred care and empowerment.

The management team thoroughly assessed and managed the risk of infection. They quickly detected and controlled the risk of it spreading and always shared concerns with appropriate agencies promptly.

Housekeeping staff followed robust cleaning schedules and maintained cleanliness to an excellent standard showing compliance with the home’s infection prevention and control policy (IPC). Personal protective equipment was made readily available to staff who wore it correctly and at the appropriate times. Clean and clutter free handwashing facilities were available throughout the home.

The housekeeping manager monitored and undertook regular audits to ensure the cleanliness and IPC processes were continually effective. They knew what to do in the event of an outbreak and demonstrated excellent knowledge of the national guidance. Staff took part in regular infection control training.

People and relatives spoke extremely positively about the cleanliness of the home. One person told us, “It’s always clean and tidy, they clean the room every day, about now. I love my room, it’s cosy.” A relative told us, “There are no smells, that’s one of the pleasant things, if there’s been a recent accident it’s sorted out quickly.” Another family member fed back, “You couldn’t find more professional people, including the cleaning staff, it’s immaculate.”

Feedback from a healthcare professional, following a recent training event included, ”I would like to commend the immaculate condition of the environment. The cleanliness and attention to detail throughout the premises were clearly evident, creating a comfortable and inviting atmosphere for all attendees. It is clear that a high standard of care and professionalism is at the heart of everything that you do.”

This excellent feedback reflected the positive impact on people’s comfort, dignity, and overall experience of care, reinforcing their sense of being well cared for in a clean and safe environment.

The provider had not fully ensured that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff had not fully ensured that some medicines processes and protocols were recorded appropriately.

Medicine administration records (MARs) were used to record the administration of medicines and overall, showed people received their medicines as prescribed. We identified some’ time specific’ medicines had not been given at the correct intervals, which could have reduced their effectiveness. Information about medicines prescribed on a ‘when required’ basis was provided in ‘when required’ protocols. Some of the information included in these protocols was not sufficient to inform staff of how and when it was appropriate to give these medicines.

To maintain people’s health and wellbeing, staff were administering some medicines by disguising them in either food or drink. This is known as covert administration. We identified that the necessary measures to ensure these medicines were administered safely were not all in place. For example, one person prescribed covert medicines, was to be given the medicine crushed into a specific food type. The care plan did not state, how much of the food the tablet was to be crushed into, how did staff ensure all the tablet was then taken and what staff would do if the food was not accepted.

The records of medicines given by patch application detailed where on the body to apply the patches. However, evidence of how these patches were rotated around the different sites, in line with the manufacturer's guidance, was not always clear.

The minor shortfalls we identified with medicines recording were shared with the registered manager and nominated individual. The manager took immediate action to address the issues and provided evidence to show that improvements had been made. This responsive approach supported safe medicines management and demonstrated a commitment to continuous improvement.

Processes were in place for the timely ordering and supply of medicines. People’s allergies were accurately recorded. Staff were assessed as competent to administer medicines safely.

There was ongoing monitoring of the temperature of the treatment rooms where medication was being stored, including fridges. Storage of medication and controlled drugs was safe and checks and audits were regularly undertaken.

A person told us, “I get my medicine on time at the same time daily.” A relative told us,” They are excellent with the medication.”