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Inspection carried out on 13 August 2018

During a routine inspection

This comprehensive inspection took place on 13 and 14 August 2018; the first day of the inspection was unannounced.

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

Inspection carried out on 21 March 2017

During a routine inspection

This was an unannounced inspection which took place on 21 and 22 March 2017. This was the first inspection since the service registered with the Care Quality Commission (CQC) in May 2016.

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 experi