Archived: Eachstep Blackburn

Eachstep Blackburn is a residential care home providing personal and nursing care to 52 people at the time of the inspection. The service specialises in providing care to people living with dementia and can accommodate up to 64 people. The home is divided into three households, each of which is decorated to a high standard and provides themed areas to promote social interaction. Accommodation is provided in single en-suite bedrooms. The home also provides a cinema, vintage tearoom and secure garden area.

People’s experience of using this service and what we found

People continued to receive exceptional quality care which was personalised to meet their individual needs and preferences. Staff spoke about people with respect and demonstrated a commitment to enabling them to live their lives as independently as possible.

People were supported by staff who were extremely kind and caring. Staff spoke about the home as being a family where people were cared for in a loving and happy environment. Our discussions with relatives supported this view. The home was described as a “Rolls Royce service” and staff as “caring, kind and respectful.”

People told us they felt safe in Eachstep Blackburn. Staff had received training in safeguarding adults and were confident about the action they needed to take to keep people safe. They told us policies and procedures were available on each household for them to refer to if necessary.

Staff had been safely recruited. Four out of the five people spoken with told us staff always responded promptly to their needs. One person told us they sometimes had to wait for staff; this was addressed immediately by the manager of the home.

The provider’s infection control policies had been updated to reflect the additional risks posed by the Covid 19 pandemic. Staff understood and followed the procedures. The home ensured extra vigilance when people were required to shield due to their health needs or were required to isolate following admission to the home or return from hospital.

Staff and relatives spoke positively about the way the home was led. They told us the new manager was approachable and willing to listen to any suggestions they had. People described the home as caring and like a family.

Rating at last inspection

The last rating for this service was outstanding (published 26 September 2018).

Why we inspected

The inspection was prompted in part due to concerns about the number of safeguarding alerts received by the local authority regarding people living in the home as well as standards of record keeping. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has remained outstanding. This is based on the findings at this inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At our last inspection in March 2017, we identified one breach of legal requirements; this was because the provider’s recruitment processes were not sufficiently robust. We asked the provider to complete an action plan to show what they would do and by when to improve the key question ‘Is the service safe?’ to at least good.

Eachstep Blackburn is a ‘care home’. People in care homes receive accommodation and nursing or 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.

Eachstep Blackburn is registered to provide accommodation for up to 64 people who require nursing or personal care. The service is purpose built and specialises in providing care to people who are living with a dementia. The home is divided into three households, each of which is decorated to a high standard and provides themed areas to promote social interaction. Accommodation is provided in single en-suite bedrooms. The home also provides a cinema, vintage tea room and secure garden area. At the time of our inspection there were a total of 61 people using the service.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection in March 2017, the service was rated as good. At this inspection, the rating has improved to outstanding.

The service has built on their previous success and sustained the outstanding level of person-centred care provided to people who lived in Eachstep Blackburn. The philosophy of the service to ‘care with passion’ was exemplified by all the staff who worked in the home. People received personalised care which was extremely responsive to their needs and wishes.

People were supported by staff who were extremely kind and caring. During the inspection. We observed all staff, including ancillary staff, took care to ensure all their interactions with people were meaningful and caring; this helped to ensure people felt they mattered to the staff who supported them. People told us that Eachstep Blackburn felt like a family. Throughout the inspection, we saw numerous examples of this family atmosphere with relatives, people who used the service and staff having conversations, laughing and showing they cared for each other

We heard of numerous examples where staff had gone above and beyond what might normally be expected of them in their role to help ensure people who lived in the home had an excellent experience. Typical feedback provided by people who lived in the home included, “Staff are very good, they’re lovely”, “I love them, they’re so kind”, “The staff are lovely”, “Staff are lovely; they’re always around for us” and “The staff are very kind, very friendly and chatty.”

Staff were extremely responsive to people’s needs. We saw examples of staff anticipating people’s needs which showed they had an excellent understanding of how individuals communicated, including people who had limited verbal communication. A strong emphasis was placed on engaging people in meaningful activity which met their individual interests; to support this the home had developed links with a wide range of community based organisations and used these to help improve the quality of life for people who lived in Eachstep Blackburn. In addition, all care staff understood that it was an important part of their responsibilities to engage people in activities on a day to day basis and we saw this was put into practice throughout the inspection.

Staff spoke consistently about Eachstep Blackburn being a good place to work. They told us the registered manager led by example and encouraged them to use their initiative to ensure people received high quality, personalised care. The registered provider had introduced a number of schemes to recognise and reward staff who had made an outstanding contribution to the care of people who lived in the home.

The culture of Eachstep Blackburn was one in which staff were encouraged to report any concerns and lessons were learned from any accidents, incidents or safeguarding matters. Quality assurance systems were robust and used make improvements in the home.

Staff had been safely recruited and there were sufficient numbers of staff on duty to meet people’s needs in a flexible way which met their preferences and promoted their independence. People told us they felt safe in Eachstep Blackburn. Staff had received training in the protection of adults and knew what action they should take if they suspected or witnessed abuse.

People’s medicines were safely managed. The ethos of the service was to deliver person centred care which included the administration of medicines. We observed that people received their medicines wherever they felt most comfortable.

The layout and decoration of the home were designed to provide people with a safe, calm environment and encourage them to participate in activities of their choice. We observed people were able to move freely throughout all areas of the home and were welcomed by staff wherever they chose to spend their time.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff members we spoke with fully understood the importance of acknowledging people’s diversity, treating people equally and ensure that they promoted people’s rights. We saw people’s ethnicity, spiritual needs and sexual orientation were discussed and recorded in their care plans.

People had a wide range of opportunities to provide feedback on the care provided in Eachstep Blackburn. The registered manager had been proactive in developing a leaflet to encourage people to provide immediate feedback should they have any concerns or if they wished to compliment staff; this demonstrated their commitment to a process of continuous improvement in the service.

Further information is in the detailed findings below.

Eachstep Blackburn is registered to provide accommodation for up to 64 people who require nursing or personal care. The service is purpose built and specialises in providing care to people who are living with a dementia. Six beds are also commissioned by the local Clinical Commissioning Group (CCG) to provide rehabilitation and nursing care to people who have been discharged from hospital. The home is divided into three households, each of which is decorated to a high standard and provides themed areas to promote social interaction. Accommodation is provided in single en-suite bedrooms. The home also provides a cinema, vintage team room and secure garden area. At the time of our inspection there were a total of 57 people using the service.

The home had won the award for best dementia care home at the National Dementia Care Awards 2016.

The service had a registered manager in place as required under the conditions of their registration with CQC. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager had won the award for the best dementia care manager at the National Dementia Care Awards 2016.

During this inspection we identified one breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because recruitment processes were not sufficiently robust to protect people from the risk of unsuitable staff. Required additional checks had not been carried out by the provider’s central human resources team when applicants had worked previously with vulnerable adults or children. These checks are important in order for the provider to ascertain why an applicant’s employment in any relevant services had ended.

The care people received was outstanding. People told us staff were exceptionally kind and caring and that nothing was too much trouble for them. We saw the service placed great emphasis on the importance of treating people as individuals and providing care in flexible, responsive and personalised manner. During the inspection we observed there were no set routines for people to follow and they were encouraged to decide for themselves what they wanted to do each day. Staff were observed to be patient, encouraging and reassuring throughout the inspection. We noted staff were extremely skilled in the use of distraction techniques when people became anxious or upset. This helped to reassure people and create a sense of well-being.

Creative ways were found to enable people to live full lives which impacted positively on their health and well-being. The use of ‘Community Circles’ supported by volunteers identified opportunities for people to participate in meaningful activities based on their interests or skills. People were also supported to re-engage with social and family networks which were important to them and helped to maintain their sense of identity. The registered manager had been proactive in developing partnerships with local community groups to help ensure the service provided was accessible and culturally appropriate for the local population.

Staff had received training in safeguarding adults from abuse. They were able to demonstrate their understanding of the correct action to take if an allegation of abuse was made to them or if they suspected that abuse had occurred. Staff told us they would be confident to use the whistleblowing policy that was in place should they witness poor practice in the service.

We found people were cared for by sufficient numbers of suitably skilled and experienced staff. We saw that staff received the essential induction, training and support necessary to enable them to carry out their role effectively and care for people safely. Staff understood their responsibility to protect people’s rights under the Mental Capacity Act (MCA) 2005. Appropriate action was taken to ensure any restrictions were legally authorised when people were unable to consent to their care in Eachstep Blackburn.

We found the system for managing medicines was safe. Records we reviewed showed staff worked in cooperation with health professionals to help ensure that people received appropriate care and treatment.

People were cared for in a safe and clean environment. Great care had been taken to ensure the environment helped to promote the independence, freedom and well-being of people who lived in the home. Photographs of the local area as well as items of interest located around the home were used to stimulate meaningful conversations with people who used the service.

Procedures were in place to prevent and control the spread of infection. Systems were in place to deal with any emergency that could affect the provision of care.

People’s care records contained enough information to guide staff on the care and support required. Care records had been regularly reviewed, with people who used the service and, where appropriate their families, being involved in the review process. People were asked to comment on what was working or not working for them in the care they received. We saw that action had been taken to change the care arrangements for individuals following comments they had made.

Systems were in place to help ensure people’s health and nutritional needs were met. People who used the service told us the quality of the food was very good. We observed that, where necessary, staff offered people gentle support and encouragement to eat.

Staff told us they enjoyed working in Eachstep Blackburn. They told us the managers set high standards for the care people should receive in the home. We noted there was a focus on ensuring people’s health and well-being was promoted through the provision of meaningful activities, and engagement with the local community to meet people’s particular interests. The registered manager had been proactive in developing partnerships with local community groups to help ensure the service provided was accessible and culturally appropriate for the local population.

Staff told us the managers in the service were approachable and supportive. Regular staff meetings meant that staff were able to make suggestions about how the service could be improved. Staff told us their views were always listened to.

Systems were in place to monitor the quality of the service provided. Regular checks were undertaken on all aspects of the running of the home. All the people we spoke with told us they would feel confident to make a complaint although they had not had a reason to do so.

The registered manager was focused on ensuring people received high quality care and support which met their individual needs; this was evidenced in the outstanding practice we recognised in some areas during the inspection. Their commitment to ensuring best practice in dementia care had been recognised through the award of ‘Best Manager’ in the 2016 National Dementia Care awards.