Archived: Eastfield Hall

Eastfield Hall is situated in Askern, Doncaster. The home provides accommodation for people who require nursing or personal care. The home can accommodate a total of 59 people. One part of the home is known as Eastfield Hall and provides personal care. The other part is known as Eastfield Lodge and provides nursing care for people living with dementia.

The service did not have a registered manager in post at the time of our inspection. 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. A home manager had been appointed and had been in post since January 2016 and was in the process of applying to be registered with the CQC.

Since our last inspection the umbrella company, Larchwood Care Homes (North) Limited, had remained the provider, however, the company managing the service on a day to day basis on behalf of Larchwood Care Homes (North) Limited, had changed. This had an impact on policies and procedures and how the home completed audits to ensure they were being effectively followed.

People were at risk of not receiving the support they required in relation to risks associated with their care or treatment. We saw risk assessments were in place but care plans had not been updated to show the current risks.

We looked at staff files and found the recruitment policy had not always been followed. We could not evidence that staff had completed an induction.

We observed staff working with people and found there were enough staff around to meet the needs of the people who used the service. However, on the first day of our inspection staff appeared disorganised and did not work as a team. This led to people not receiving care in a timely manner.

Medicines were managed safely and stored securely. There were protocols in place for administering medicines on an ‘as and when’ required basis. However the result was not recorded therefore we could not see what effect the medicine had.

Staff were knowledgeable about safeguarding people from abuse and would report anything of this nature immediately.

Staff we spoke with told us that it was a while since they had received a one to one supervision session with their line manager. The provider was in the process of changing the training process and it was difficult to see what training was required.

Food was supplied in sufficient quantities to meet people’s needs and dietary requirements were catered for. However, the mealtime experience on the first day of the inspection was chaotic. Drinks and snacks were offered at regular intervals throughout the day.

The provider was meeting the requirements of the MCA and DoLS. However, staff were not always constantly providing choices and enabling people to make decisions.

People were supported to maintain good health, have access to healthcare services and received ongoing healthcare support.

We observed staff interacting with people who used the service in Eastfield Hall and on the first day of our inspection found staff to be task focused and spoke over people. However, on the second day we found a much calmer atmosphere where staff were interacting well with people and engaging in conversation.

Staff were knowledgeable about how to preserve people’s dignity and how to respect them and their home.

Care records contained a care plan summary which outlined the person’s preferred daily routine. However, these had not been updated since they were written and one was dated 2014. This no longer reflected the person’s current daily routine preferences.

The manager told us that they had been waiting for paperwork to arrive so they could start new care plans; therefore some plans were out of date and did not reflect the person’s current care needs.

We spoke with people who used the service and their relatives and found that social stimulation was limited. On the first day of our inspection we did not see any activities taking place. However, when we completed our second day of inspection we saw a coffee morning took place and a buffet tea was arranged to celebrate the Queens 90th birthday.

The provide had a complaints procedure and people we spoke with felt able to raise concerns. However one person told us there was never a resolution.

We observed a lack of leadership within the home. Staff sometimes appeared to lack guidance and direction. Staff were more focused when the deputy manager and team leader were in the home.

We saw an impact audit had been completed but actions had not been place on the home development plan. Other audits could not be located.

People who used the service had access to a meeting where they could share their views. However, it was not clear that their issues had been addressed. The service had not completed a quality assurance survey to seek out opinions.

We inspected the service on 10 March 2014 and found the provider to be compliant.

People were protected from the risk of infection because appropriate guidance had been followed.

At the time of our inspection the home was being managed by a project manager from Orchard Care.

We spoke with three people who used the service. They all told us they were happy with the care provided at the home. They said all of the care staff were kind. One person said, 'They are absolutely lovely.' Another person said, 'All are very kind. I am happy here.'

People were not cared for in a clean, hygienic environment. We completed a tour of the building and found that several areas of the home were not clean.

Appropriate arrangements were in place in relation to the management of medicines. We spoke with two registered nurses and a senior carer about the way medication was managed in the home. They each demonstrated a clear understanding of the medication policy and system.

There were enough qualified, skilled and experienced staff to meet people's needs.

Peoples' needs were assessed but care and treatment was planned and delivered in line with their individual care plan. People felt that staff offered the support required and gave them time to be independent. One person said, 'The staff are kind and pleasant.' Another person said, 'Nothings too much trouble.'

People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services.

People were protected from the risk of infection because appropriate guidance had been followed.

There were enough qualified, skilled and experienced staff to meet people's needs. We spoke with four staff and they all felt there was usually enough staff working with them. One relative we spoke with said, 'There always seems to be enough staff around when I visit.'

The provider had an effective system in place to regularly assess and monitor the quality of service that people received. We spoke with people who used the service and their relatives and they told us that they would feel confident to complain if they needed to.