Eagle View Care Home

Eagle View Care Home is a residential care home providing personal care to up to 42 people. The service provides support to older people and people living with dementia. The service can also support younger adults and adults with a physical disability. At the time of our inspection there were 26 people using the service.

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

People were not protected from the risk of abuse and improper treatment. Risks to people were not always appropriately assessed, managed, and mitigated. There were medicine stock discrepancies which could not be accounted for. Some areas of the service required cleaning and maintenance. There were some gaps in required recruitment checks.

People’s needs were not always fully assessed. Where people’s needs had been assessed, these needs were not always met. There were sufficient numbers of staff, but they were not always appropriately trained or deployed. Mealtimes were not always person-centred.

People were not always treated with dignity and respect. People were not always fully supported to be independent. We received mixed feedback from family members as to whether they were involved in their relatives’ care.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the systems in place did not support this practice.

People were not supported to take part in a range of meaningful activities. On the first day of our inspection there was limited interaction between staff and people using the service. Care was not person-centred, and people’s needs and preferences were not always met. People’s communication needs were not always robustly considered or met.

The culture of the service was not person-centred. Systems and processes had not identified or resolved in a timely manner concerns around person-centred care, safeguarding and dignity and respect. The provider’s systems and processes were not established or operated effectively to assess and monitor the service, and to ensure continuous learning and the improvement of the quality of care. The quality of the service had deteriorated since our previous inspection.

The manager had arranged safeguarding training and had raised awareness of safeguarding and whistleblowing procedures. People we spoke with were happy with the care provided. Medicines were stored safely and securely. A home improvement plan was in place.

Staff confirmed they had regular supervisions, and these were useful. People’s weight was monitored, and referrals made to the dietician where appropriate. People had access to a regular GP who carried out a weekly visit. During the second day of our inspection, we observed kind, caring and attentive interactions between staff and people. A new activities co-ordinator had been recruited.

Information about making a complaint was accessible for people and their relatives. People’s end of life wishes were recorded in their care plans. Staff generally told us they felt supported by management and staff told us they felt more able to raise a concern now, than previously. The manager had introduced ‘resident of the day’ to involve people more and gather feedback about their experience of the service. Most relatives told us they were kept up to date and were involved in discussions.

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

Rating at last inspection

The last rating for this service was good (published 28 September 2022).

Why we inspected

We received concerns in relation to staff practice and the culture of the service. As a result, a decision was made to undertake a focused inspection to review the key questions of safe, effective, and well-led. Due to concerns identified during the inspection, the scope of the inspection was widened to include all five key questions.

We have found that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last inspection, by selecting the ‘All inspection reports and timeline’ link for Eagle View Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to person-centred care, dignity and respect, safe care and treatment, safeguarding, staffing, recruitment, and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Eagle View Care Home is a care home providing personal care to up to 42 younger adults and older people some of whom may be living with dementia or physical disability. At the time of this inspection, 35 people were living at the service. The home is purpose built, set over three floors and is located in the centre of Scarborough.

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

Improvements had been made since the last inspection. Governance systems were now in place and effective in monitoring the quality and safety of the service.

Medicine were managed safely. Guidance for staff was now in place for medicines that were prescribed as and when required. Staff had completed medicine training and had their competencies in medicine management assessed.

People told us they felt safe living at the service and spoke highly of the staff team.

Staff had been recruited safely. An appropriate tool was used to calculate safe staffing levels. Agency staff had been utilised to ensure the required staffing numbers were met. Thorough checks and an induction were in place for all agency workers to ensure they were familiar with the homes policies and procedures.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported to be involved in making decisions about their care and support.

Risks to people had been assessed, recorded and reviewed on a regular basis. Risk relating to the environment had also been assessed and appropriate maintenance checks were completed on a regular basis.

Staff told us the recent changes in the management team had affected staff morale, but the manager and provider were addressing this. People, relatives and staff were encouraged to provide feedback on the service provided. Action had been taken to address any issues raised.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 10 July 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 10 July 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve their governance processes.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Eagle View Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Eagle View care home is a residential care home providing accommodation and personal care to 37 older people at the time of our inspection. The service can support up to 42 people in one adapted building.

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

We received positive feedback from people and their relatives who told us they were happy living at Eagle View. People received personalised care and the staff team knew people very well.

Medicines were administered safely however, they were not always managed well or recorded accurately. Some records regarding people’s medicines were not always in place. The providers medicine administration policy was not always followed.

The care plans were greatly improved, person centred and covered all aspects of people’s care and included histories, wellbeing and people’s personal preferences.

Improvements to infection prevention control practices were in place. All essential visitors had to wear appropriate personal protective equipment (PPE), and complete NHS Track and Trace information. Additional cleaning of all areas and frequent touch surfaces was in place and recorded regularly by staff. Training included putting on and taking off PPE, hand hygiene and other COVID-19 related training.

Additional competency and spot checks were carried out by the registered manager registered manager with all staff regarding safe use of PPE.

There were systems in place for communicating with people, their relatives and staff regarding peoples care and support. This included one to one meetings, handovers and team meetings. The environment was clean, safe and maintained to a good standard. It was also adapted to meet people’s needs.

Individualised risk assessments were in place to ensure people could take risks safely. Staff were confident about how to raise concerns to safeguard people. Robust recruitment and selection procedures ensured suitable staff were employed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Rating at last inspection and update

The last rating for this service was Requires Improvement (published on 19 February 2021) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found enough improvement had not been sustained and the provider was still in breach of one regulation.

At this inspection we found improvements had been made to meet Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also found not enough improvement had been made to meet the breach of Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This remained a continued breach.

The overall rating for the service has not changed based on the findings at this inspection and it remains requires improvement. We have found evidence that the provider needs to make improvement. Please see the Well-led section of this full report. The provider had taken some action during the inspection to mitigate risks and continued to liaise with the inspector after the inspection to advise of further improvements scheduled and/or carried out.

Why we inspected

This was a planned inspection based on the previous rating. 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 COVID-19 and other infection outbreaks effectively.

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.

Eagle View Care Home is a residential care home providing personal care to older and younger people who may have a physical disability and/or a dementia related condition. At the time of our inspection 41 people were living at the service. Eagle View Care Home is in one building over three floors and can support up to 42 people.

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

Feedback from people’s relatives/representatives and health professionals was mixed in relation to the effectiveness of risk assessments, updating records, communication and infection prevention and control (IPC). We discussed several issues with the registered manager during the inspection and asked them to update some records relating to risk and infection prevention and control (IPC). Other areas requiring improvement are ongoing and we will ask the provider to inform us when these have been completed.

Records relating to some risks to people had not always been regularly reviewed and updated. Staff were not always aware of the level of risks posed to people and monitoring of risks was not robust.

Staff did not always follow safe infection, prevention and control practices. The required Personal Protective Equipment (PPE) was available, but not always used in line with government guidance. We found IPC practices overall required further improvement. The provider took measures to improve these areas during and following our inspection.

Within the context of the Covid-19 infection risk, people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported best practice. We identified some gaps in records relating to best interest decisions.

People were safeguarded from the risk of abuse. Overall medicines were managed safely. We did identify some medicines records that required improvement.

The provider had made some improvements in relation to the management of accidents and incidents. However, further work was required to improve in areas such as, records management for assessing and monitoring risks, communications, medicines management and governance. Quality assurance systems were not always effective in highlighting and monitoring improvements. Lessons learnt had been shared with staff, but we found repeat issues that had not been effectively addressed.

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

Rating at last inspection

The last rating for this service under the previous provider was requires improvement (published 14 February 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made to meet Regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We identified a new breach of Regulation 12 (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also found not enough improvement had been made to meet the breach of Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This remained a continued breach.

Why we inspected

We received concerns in relation to the management of infection prevention and control at the service. As a result, we undertook a focused inspection to review the key questions of safe, effective 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 not changed based on the findings at this inspection and it remains requires improvement.

We have found evidence that the provider needs to make improvement. Please see the Safe, Effective and Well-led sections of this full report. The provider had taken some action during the inspection to mitigate risks and continued to liaise with the inspector after the inspection to advise of further improvements scheduled and/or carried out.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Eagle View Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.