Eastbourne Care 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

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 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.

The provider was in continuing breach of legal regulation in relation to good governance.

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.

Lessons were learnt to identify and embed good practice. Accidents and incidents were monitored to see if lessons could be learnt to reduce risk, and these were discussed at staff meetings to share knowledge. People told us they felt safe at the service.

No admissions into or transitions out of the service had taken place since our last assessment. Leaders outlined how these would take place, emphasising how they would work closely with healthcare partners to provide continuity of care.

Improvements had been made in safeguarding people from abuse. Staff said they would not hesitate to report any concerns they had, and were able to describe the steps they would take to keep people safe. Records showed the provider shared concerns quickly and appropriately.

The provider did not always work well with people to understand and manage risks. Staff provided care to meet people’s needs that was safe and supportive, but this was not always effectively and consistently planned or recorded. For example, people with epilepsy did not always have risk assessments or care plans in place. In other cases, the support people received with safe eating and drinking was not always recorded.

The provider did not always detect and control potential risks in the care environment. They did not make sure that facilities supported the delivery of safe care. For example, during our visit we found that windows in the building were loose in their frames, presenting a risk to people living there. This had not been identified or addressed by the provider. We were also able to access areas of the garden that were not safe as they were being used to store sharp tools or discarded furniture. Following our visit action was taken to address these risks, but prior to this they had not been identified or addressed by the provider’s own governance processes.

The provider did not always make sure staff received effective support, supervision and development. Some staff told us they did not always feel supported to develop in their roles, whilst others said they were. The provider was reviewing how supervisions were carried out and implementing a new system to support staff participation. This included monitoring how the clinical skills of staff were overseen. Records confirmed that staff training was taking place, and most staff said this was useful. Some staff said they had been unable to access relevant training. The provider was aware of this issue and was working to ensure all staff had access to required training. There were sufficient staff deployed at the time of the assessment to meet people’s needs. Staff were safely recruited into the service, and required checks were carried out before they started work.

Action had been taken to improve infection prevention and control practice. The provider assessed and managed the risk of infection, and had worked with healthcare partners to improve this. The premises were clean and tidy, with regular cleaning taking place.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

Sufficient improvements had been made in medicine management that the service was no longer in breach of regulation, however further and sustained improvements were needed in medicine records.

Systems were in place to make sure people’s medicines were administered safely. Stock mainly balanced with records; however, we saw some confusion when recording non-administration codes in the electronic medicine record system and thickeners were not clearly recorded. Medicines that needed to be given at specific times were given correctly. People’s medicines allergies were recorded accurately.

We observed medicine administration to two people; staff were respectful, and people were given the time they needed.

Guidance was available for creams applied by care staff as part of personal care; however, records were not fully completed. Patch application records did not always demonstrate rotation in line with manufacturers guidance to prevent side effects.

Some people were prescribed medicines to be taken on a ‘when required’ basis or with a variable dose. Information for how these medicines should be administered needed further person-centred detail. Information on why medicines were given and if they were effective should also be recorded in line with the providers policy.

Information on how people took their medicines if given covertly was not sufficiently clear. The manager said they would review this after our inspection. Medicine information in some care plans was not updated when changes happened.

Medicines were stored securely. Temperatures were recorded for the medicine rooms and fridges; however, the fridge maximum temperature had been out of range and had not been investigated to ensure medicines were safe to use.

Comprehensive policies and procedures were in place to support the administration of medicines. Audits had picked up some of the issues we found.

After our inspection the provider showed us, improvements made in records and training that had been done with staff. These needed to be embedded in practice.