Eccleshare Court

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 good. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (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 had systems in place to review incidents and promote learning to improve people's safety and care. Managers reviewed areas of risk and shared learning through meetings and supervision sessions. Leaders used examples from incidents and events across the wider health and social care sector to promote discussion and learning with staff.

However, learning from incidents was not always effective. We reviewed a significant number of incidents relating to people's distress and found incident records often lacked sufficient detail to fully understand what had happened or identify opportunities for learning. This limited the provider's ability to analyse incidents effectively and demonstrate what action had been taken to reduce the likelihood of recurrence. The number of incidents involving some people had not reduced over time, indicating that lessons identified were not always translated into effective preventative measures or improvements in practice.

The provider had processes in place to support safe admissions and continuity of care. Pre-admission assessments were completed before people moved into the service and relatives told us they had been involved in sharing information about their family member's needs. One relative said, "The paperwork when [my family members] arrived was fine. I've been involved all along."

People and relatives did not raise concerns about the admission process or the continuity of care provided following admission. Feedback indicated staff understood people's needs and responded appropriately when changes in health or wellbeing occurred. Relatives told us they were informed when concerns arose and when healthcare intervention was required.

The service worked with a range of external professionals including GPs and other healthcare services to support people's ongoing needs. One relative described staff identifying signs of deterioration and arranging hospital treatment promptly whilst keeping family members informed. Another described being notified when healthcare professionals reviewed and changed their relative's medicines. This feedback demonstrated there were safe systems in place to identify and respond to deterioration in people's health promptly, ensuring they received appropriate medical attention when needed.

People and relatives told us they felt safe living at the home and were positive about the way staff treated them. One relative said, "We visit three times a week and feel [my family member is] safe there. The staff are lovely." Staff understood their responsibility to report safeguarding concerns and told us they would escalate concerns to senior staff and felt confident doing so. Staff had completed safeguarding training and were able to describe how they supported people who became distressed through reassurance and person-centred approaches.

However, systems were not always effective in ensuring people's rights were protected. At the time of the inspection, leaders were unable to readily demonstrate the current status of Deprivation of Liberty Safeguards (DoLS) authorisations and associated conditions. Whilst the provider subsequently supplied an up-to-date overview of DoLS applications and authorisations, and relevant information was also available within individual electronic care records, this information was not readily accessible during the inspection. This reduced assurance that DoLS authorisations, conditions and associated safeguards were being consistently monitored and overseen. Whilst people were safeguarded from abuse and neglect, stronger oversight was needed to ensure legal safeguards were effectively managed.

The provider did not always effectively support people to manage risks associated with their care and wellbeing.

Staff demonstrated a positive understanding of non-restrictive approaches and described using reassurance and distraction techniques. However, these approaches were not consistently reflected in care plans or risk assessments. Records often lacked clear guidance regarding triggers or effective strategies to support people experiencing distress which increased the risk of inconsistent practice.

We reviewed several recurring incidents involving people experiencing distress. Whilst the provider monitored these incidents, records frequently lacked sufficient detail to understand what had happened or evaluate the effectiveness of interventions. As a result, recurring incidents were often viewed as known behaviours rather than opportunities to review and amend support strategies to reduce future risks. This resulted in a reactive approach to risk management, with limited evidence that learning from incidents was translated into improved care planning or preventative measures.

There was limited assurance that medicines used to manage people's distress were always administered appropriately. Records did not provide a clear rationale for administration which reduced assurance that medicines were being used appropriately and as part of a proactive strategy to support people and reduce the likelihood of further incidents.

Leaders were aware of these concerns and had identified the need to improve understanding of people's distress and the quality of incident recording. They had plans to work with a dementia lead to strengthen staff knowledge and support staff to record incidents in greater detail so information could be more effectively reviewed and used to reduce future risks.

The environment was suitable for the needs of people living at the home. People and relatives did not raise significant concerns regarding the safety of the premises and people told us they mostly felt safe living there. We observed equipment being used appropriately and people who required assistance with transfers told us staff used equipment safely. Environmental and equipment checks were completed and records demonstrated regular monitoring of the premises and safety systems.

However, environmental risks were not always effectively managed. Several people described ongoing incidents where other people using the service entered their bedrooms uninvited, including during the night. One person described this as frightening whilst another reported personal belongings being repeatedly taken. This demonstrated the environment was not always supporting people's privacy and safety.

People were supported by caring and competent staff, however staffing arrangements did not always ensure people's needs were met consistently and in a timely way.

People and relatives were positive about the staff who supported them and described them as kind and caring. However, people and relatives raised concerns about staffing levels, particularly at weekends and during busy periods. Several people described waiting longer for support than they would like and relatives commented that staff could be stretched at mealtimes which affected their ability to respond promptly to requests for assistance. Staff told us mealtimes could feel rushed when staffing levels were reduced.

The provider had completed the required recruitment checks for staff. However, they had identified gaps in some employment histories and sought further information to address these. Whilst this demonstrated oversight, the information obtained was limited and did not always provide sufficient detail to fully explain periods of employment or unemployment. This reduced assurance that recruitment processes had consistently been robust.

Training compliance was good, and staff told us they had access to the learning and support required to carry out their roles. One member of staff highlighted the need for additional dementia training to reflect the needs of people living at the home. The provider had recognised this and was planning further training focused on dementia and meaningful engagement to strengthen staff knowledge and skills.

People were protected from the risk of infection through effective infection prevention and control practices.

People and relatives consistently described the home as clean and well maintained. No concerns were raised regarding cleanliness and the home was fresh and clean throughout the inspection. One relative told us, "The whole home is kept clean." Another said, "The place is kept very clean really."

Laundry arrangements were effective, although some people reported occasional items being returned to the wrong person.

People and relatives told us staff wore Personal Protective Equipment (PPE), such as gloves and aprons, when providing personal care. Staff confirmed PPE was readily available and demonstrated an understanding of infection prevention and control practices. During our observations, staff followed appropriate hygiene practices when handling food and supporting people in communal areas.

Medicines were managed safely, and people received their medicines as prescribed.

We found effective systems for the storage, administration and monitoring of medicines. Records were completed appropriately; stock balances were accurate and staff had access to clear guidance to support the safe administration of medicines. Additional safeguards were in place where people required medicines to be administered covertly or where medicines required closer monitoring.

Staff received training and regular competency assessments to support safe practice. Audits and routine checks were completed to provide oversight of medicines management and identify any areas requiring action.