Archived: Eastfield Hall

Updated 4 June 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 checked 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.

The inspection took place on the 19 and 21April 2016 and was unannounced on the first day. The inspection team consisted of one adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we reviewed all the information we held about the home. We spoke with the local authority and Healthwatch Doncaster to gain further information about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

As part of our inspection we spoke with other professionals who have contact with the home and offer support on a regular basis.

We spoke with six people who used the service and three relatives and spent time observing staff supporting people. We used the Short Observation Framework for inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with three care workers, a team leader, a member of the catering team, the administrator, and the manager. We looked at documentation relating to people who used the service, staff and the management of the service. We looked at five people’s care and support records, including the plans of their care. We saw the systems used to manage people’s medication, including the storage and records kept. We also looked at the quality assurance systems to check if they were robust and identified areas for improvement.

Updated 4 June 2016

The inspection took place on 19 and 21 April 2016 and was unannounced on the first day. Our last comprehensive inspection at this service took place in October 2014 when breeches of legal requirements were identified. The provider to send us an action plan outlining how they would meet these breeches. We inspected the service again in March 2015 to look at the progress and found they were meeting requirements. However, the rating of the service remained as requiring improvements as we needed to ensure that the actions taken were embedded into practice. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Eastfield Hall’ on our website at www.cqc.org.uk.

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.