Archived: Eastfield Lodge Care Home

Updated 28 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 8 and 9 March 2016 and was unannounced.

The inspection was carried out by one inspector and specialist professional advisor. The specialist professional advisor who supported us on this inspection was a qualified nurse with experience of palliative and end of life care within care homes. And has worked as an education facilitator in end of life care with regards care planning.

We contacted commissioners for social care, responsible for funding some of the people as well as health and social care professionals who support people using the service and sought their views about the service people receive.

We also reviewed the information that the provider had sent to us which included notifications of significant events that affect the health and safety of people who used the service.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with three people who used the service and spent time with people and staff in the communal areas of the service. We spoke with six visitors who were visiting their relatives and friends.

We spoke with the manager, the deputy managers, four members of staff and the chef. We looked at the records of five people, which included their care plans, risk assessments, medicine records, daily records and supporting documentation.

We also looked at the recruitment files of four members of staff, a range of policies and procedures, maintenance records of equipment and the building and minutes of meetings.

We asked the manager to forward to us audits carried out and actions planned as a result of these and the matrix detailing staff training. These were provided as requested.

Updated 28 April 2016

This inspection took place on the 8 and 9 March 2016 and was unannounced.

Eastfield Lodge Care Home provides residential and nursing care for up to 17 older people, who are living with dementia and may have a physical disability. At the time of our inspection there were 13 people in residence. Accommodation is provided over two floors with access via a stairwell with a stair lift. Communal living areas are located on the ground floor. The service provides single rooms. There is a walled garden which is in the main laid to lawn.

Eastfield Lodge Care Home 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.

Visitors we spoke with told us they believed their relatives to be safe at the service. We found the approach to people’s safety was not consistent. Whilst people could be confident that staff were knowledgeable about their role and responsibilities in reporting and acting upon potential abuse or avoidable harm their approach to maintaining people’s safety as a result of identifying risks was not always managed consistently.

In some instances we found that the emphasis on ensuring people’s safety meant people’s independence was compromised. Where risks had been identified and reviewed, potential risks were not supported by a care plan which detailed how risks were to be managed by staff to promote people’s welfare and safety.

There were sufficient staff to keep people safe, however we found staff knowledge and skills were not fully reflective of the needs of people who used the service. This meant staff were not always able to support people well.

People’s medicines were managed safely by nursing staff who reviewed people’s records to ensure their medicine had been administered as prescribed and were safely stored. We found that there were shortfalls in medicine administration guidance as people’s care plans did not sufficiently provide guidance as to how people who on occasions declined their medicine were to be supported.

The approach to staff induction, training and on-going supervision and appraisal was not consistent. There was no plan in place to structure staff development. Staff’s competency was not assessed and their opportunity to develop their skills and training was limited. This impacted on the ability of the service to determine and further develop the quality of the service it provides through staff development.

People enjoyed the meals provided and we found meals to be of a good quality, with people being offered choice. We found the dining experience for people could be improved to provide a more enjoyable time for people to socialise.

Staff were caring in their approach to people but the quality of care had the potential not to be consistent as the information contained within people’s care plans and other records was difficult to determine. We found there was a lack of cross referencing and consistency of information between different documents, which made it difficult to get an overview as to people’s needs.

People’s care plans contained information as to their nursing and personal care needs, but contained very little if any information about them as a person. We found this meant staff delivered care based on the completion of tasks, with little consideration as to how they could support the person in a way that met their individual needs.

People’s lifestyle and preferences were not factored into their daily lives as people’s opportunity to engage in and develop their care plans was limited. Information about people’s hobbies and interests had not been explored by staff, and therefore the opportunity for people to continue with their interests had not been planned for. People’s opportunity to take part in activities was further reduced as the activity organiser was limited as to the time they had to provide activities as they were required to providing personal care and support to people.

Concerns and complaints were recorded and we found examples of where these had been investigated and had brought about improvements to the service. However we found there was no clear audit trail identifying whether those raising the concerns had been made aware of the outcome and any action taken.

The leadership and management of the service and its governance systems were not robust, which impacted on the quality and consistency of care being provided and restricted the development of the service. The provider did not have a system to ensure themselves that the service they were providing was governed well and that they were meeting their obligations.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.