Archived: Eastrise Residential Home

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service and the staff who supported them, and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

' Is the service caring?

Staff were aware of people's preferences and diverse needs; care and support had been provided in accordance with people's wishes.

' Is the service responsive?

At our last inspection on 6 May 2014 we issued a compliance action for this outcome area. We were concerned that people were not protected against the risks associated with not having an effective system in place to reduce the risk and spread of infection. During this inspection on 14 August 2014 we found improvements had been made and that people were cared for in a clean, hygienic environment.

' Is the service safe?

Staff had completed relevant training and people were protected from the risk of infection because appropriate guidance had been followed.

' Is the service effective?

There were effective systems in place to reduce the risk and spread of infection.

' Is the service well led?

The registered manager checked the cleanliness of the home on a daily basis and challenged any poor practices as required.

What people who used the service and those that matter to them said about the care and support they received.

One person who used the service told us, 'There is a cleaner who is always working, she does a good job because its lovely in here (the home).'

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service and the staff supporting them, and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

' Is the service caring?

People were supported by attentive staff who understood their needs. We saw that care workers showed patience and gave encouragement when supporting people who used the service.

People who used the service, their relatives, friends and other professionals involved with the service, completed an annual satisfaction survey. Where suggestions or concerns had been raised the provider had listened and made changes to the service.

People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

' Is the service responsive?

Staff knew the people they cared for and understood their preferences and personal histories.

We saw that people's care needs were kept under review and care plans, risk assessments and support plans were updated when required.

Accidents and incidents were reviewed regularly by the provider. Where improvements to the service could be made they were implemented effectively.

' Is the service safe?

Systems were in place to make sure that the registered manager and staff learnt from events such as accidents and incidents, complaints, concerns and investigations. This reduced the risks to people and helped to ensure that the service continually improved.

The people who used the service told us they were happy and that they felt safe. We saw that people were treated with respect and dignity by staff.

Equipment was well maintained and serviced regularly so people who used the service were not put at unnecessary risk.

The provider did not follow best practice guidance in relation to infection, prevention and control. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to infection control.

' Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

The premises had specialised equipment to meet the needs of the people who used the service.

' Is the service well led?

The service had quality assurance systems in place and records we looked at showed that identified shortfalls were addressed promptly.

The provider consulted with people about how the service was run and took account of their views.

Staff told us they were clear about their roles and responsibilities. This helped to ensure that people received a good quality service at all times.

Records were kept securely and could be located promptly when needed. Staff records and other records relevant to the management of the services were accurate and fit for purpose.

What people who used the service and those that matter to them said about the care and support they received.

People who used the service made comments including, 'The mood has changed a lot, it's a much calmer place than it used to be, everyone gets on now', 'I think the girls are fantastic, they are always there for me', 'The staff are very attentive' and 'It's clean enough for me, my room is kept clean and my clothes are too.'

We found that improvements had been made with the quality of the care records. People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We found that improvements had been made in relation to the management and reporting of incidents. The records we saw confirmed that accidents and incidents within the home had decreased since our last inspection.

We saw evidence that the home had completed a needs assessment for each person who used the service. The assessments were used to establish the level of staffing required within the home. The provider told us, 'During the initial assessment or as people's needs change we look at the dependency levels in the home and use that as the basis for our staffing levels.'

We found that the provider had developed an effective system to regularly assess and monitor the quality of service that people received. People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

A member of staff said, 'Incidents get recorded onto our system but I don't know why we bother, nothing ever gets done' and, 'We have people here that are very difficult to manage but we learn how best to deal with it.'

A member of staff we spoke with said, 'We just don't seem to have enough staff' and went on to say, 'We find people on the floor instead of being there to see them falling and being able stop it.' Another member of staff told us, 'I wish we could have more staff on shift. I feel like that would have stopped some of the incidents occurring.'

During discussions with a member of staff we were told, 'I have never had a formal supervision but I've discussed things with the manager when I've needed to.'

The home used a computerised system to capture all aspects of people's needs and daily activities, including accidents and incidents. However, there was no evidence to confirm that the recorded information was analysed or used in any way to improve the service.

Personal records were not fit for purpose and did not contain accurate or up to date information.

We were shown a number of risk assessments that had been completed and were told by the assistant manager, 'Reviews of people's care needs are completed monthly or whenever anything significant happens.'

There were effective systems in place to reduce the risk and spread of infection. When we arrived at the home we were taken on a tour of the building and found it to be clean, tidy and free from any unpleasant odours.

One member of staff we spoke with told us, 'I feel really supported in my job, this is the best place that I have worked' and 'We have one to one's every couple of months but I can speak to the manager at anytime if I need something.' Another staff member told us, 'The managers are really supportive.'

We spoke to a staff member who said, 'Family members will come to us with little issues and problems but we can usually sort them out there and then.' A relative we spoke with said, 'Overall I'm really happy with the service, I've got no complaints.'

A staff member told us they 'Treated people how you would want to be treated.'

The provider ensured that reasonably practical steps were taken to safeguard the people that used the service from abuse. The majority of staff had undertaken safeguarding adults and challenging behaviour training. One person that used the service told us 'I like it here, I feel safe, it's my home.'

There was a policy in place in relation to the safe handling of medicines. We were told about the specific training staff had received to manage medicines and corroborated this with the staff training records. There was a process to ensure the safe disposal of medication.

There was enough qualified, skilled and experienced staff to meet people's needs. Staff were able, from time to time, to obtain further relevant qualifications in relation to their roles. We found that staff received supervision. However this was not done regularly enough to ensure that staff could plan for their future professional and personal development or give them the opportunity to discuss areas of concern.