Eachstep Blackburn

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe - this means we looked for evidence that people were protected from abuse and avoidable harm. The service had made improvements and is no longer in breach of regulation. However, we found further improvements were needed to care plans and the provider was working on this. Processes around the safe administration of medicines and safe storage of medicines needed to be consistently robust. One person had been exposed to risk when offered a meal with an ingredient their care plan stated they were allergic to. The person came to no harm and the provider reviewed their processes to lessen the risk of this happening again. The management team reviewed incident and took action to prevent their reoccurrence. Care plans now guided safe practice. The provider had enough staff to ensure people’s safety and meet their needs. People were supported to have choice and control and were involved in planning their care. Improvements had been made to the processes to manage risk and people were supported by staff who knew the help people needed to promote their safety. People lived in a clean environment and staff followed processes to minimise the risk and spread of infection. Systems were in place to protect people from abuse and harm. Staff were recruited safely, undertook training and were deployed so people received support when this was needed or requested. People lived in an environment that was well maintained and equipment was also checked to ensure its safety. The provider had a food hygiene rating of 5. This meant the hygiene standards were very good. The registered manager assessed risks to ensure people were safe. The registered manager and staff promoted positive risk taking to help people gain skills and live an independent life as possible. There were effective safeguarding processes in place, which staff had received training on, to support people’s safety.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

When required people received one to one support to ensure their safety was maintained. People told us they had built positive relationships with staff and management and felt confident they would be treated positively if they raised any concerns.

The provider had acted in response to feedback from our last inspection and made improvements to the quality of care. Information on best practice had been shared with staff.

Systems and processes were in place to support continued learning. These included supervisions, training, investigations of concerns and the completion of logs for incidents, accidents, potential safeguarding events and complaints. The provider had a process to learn and make improvements when something went wrong. Staff recorded accidents and incidents, which management reviewed on a regular basis to identify any trends, themes and areas for improvement. The registered manager acted on feedback from people, relatives staff and adopted best practices from colleagues based in other homes.

People’s views were considered, and this led to positive risk taking by the provider to enhance people’s quality of life. One person told us, “I am safe here, the staff always check on me, so I tell them if I’m not feeling well.”

The provider worked with the local authority to meet people’s physical and emotional needs. This included providing one to one support to keep people safe and reviewing documentation to ensure if reflected people preferences and support needs. Staff told us that their views were listened to and acted upon. One staff member told us, “We have assessments to follow and they're always up to date. We get time to read care plans and we get updated at handovers every shift, or during shift if it's needed.”

The provider had worked with the local authority to drive improvement on the quality of care being delivered. Health and social care representatives told us the management team had engaged in the improvement planning process and improvements had taken place.

Pre-admission assessments were carried out to ensure the service could meet people’s needs. Whenever possible, health professionals and those important to the person were included. The registered manager told us they consulted with contracted nurses on people’s clinical needs. This helped ensure people’s care was planned to meet their needs and wishes. Risks related to people were reviewed and referrals were made to healthcare and specialist support services when required.

People told us they were appropriately supported so they felt safe. They said they understood what it meant to feel safe and could say how they would raise any concerns. People told us they felt confident the provider would act on any concerns raised. One person told us, “I feel safe and there’s always enough staff.” A second person commented, “On the whole I do feel safe.”

Staff had received training and had a strong understanding of safeguarding and how to take appropriate action. Staff told us they would report concerns to the provider, and they were confident any concerns would be actioned. One staff member told us, “Yes people are safe, we are going beyond to try our best to keep them safe.” A second staff member said, “ I do think people are safe living here. I wouldn’t work here if they weren’t.”

People told us they felt safe and knew who to speak with if they had concerns. People were visibly comfortable and settled in the presence of staff. Staff responded to people’s requests and provided them with the support they asked for or needed. We observed staff deliver care safely. People were appropriately supported, were comfortable in the company of staff and told us they did not feel unsafe or neglected. The provider had a good understanding of the Deprivation of Liberty Safeguards (DoLS), and this was only used when it was in the best interest of the person.

The provider had a system for the management of safeguarding concerns. This meant people were protected from the risk of harm or abuse. Staff had received training to recognise abuse and knew what action to take to keep people safe, including reporting any allegations to the appropriate person or authority.

One person was offered a meal with an ingredient they were recorded as having an allergy to. The provider stated they would investigate how this had occurred and take action to reduce the risk of this happening again. People told us the choices they made about their own care were respected and supported. One relative told us, “My mum has a sensor mat, in case she gets up in the night.” Sensor mats are one of the most effective ways to prevent falls. It works by detecting when someone steps on it and then alerting staff members.

The provider told us staff were knowledgeable on people’s physical and emotional needs and knew what to do to meet their needs and keep them safe. Staff explained how to keep people safe and said they had been trained on what actions to take to meet people’s physical and emotional needs and to lessen risk when people were distressed.

There was a balanced and proportionate approach to risk that supported people’s independence and respected the choices they made about their care. During this assessment we observed the registered manager review lifestyle choices with 1 person and action was taken to promote positive risk taking while mitigating hazards. Staff supported people in accordance with risk assessments, care plans and health professional’s instructions.

The registered manager and staff had a clear understanding of people’s needs and the risk associated with this, however, this was not always supported by robust documentation. All care plans and risk assessments needed to include strategies to guide people on how to support people safely and effectively. Management were responsive to this feedback and were already working with the local authority to deliver improvements.

People told us they thought the home was clean and that they liked their rooms. Relatives said they had no concerns. People chose which communal areas to sit in throughout the day, and the corridors were free from obstacles to promote their safety and independence. People’s rooms were clean, well maintained and had safeguards in place such as window restrictors to keep them safe. Window restrictors are safety devices fitted within a window frame that prevent the window from being opened past a certain point when individuals are at risk of falling. By adding window restrictors to the window this minimises the risk of injury. One relative told us they had placed an alarm in their relative’s bedroom to alert staff if they got up in the night so they could minimise the risk of falls. The provider had introduced smart lamps into several bedrooms to support falls prevention. The lamps had automatic lighting when someone gets out of bed, and alerted staff if someone fell, reducing the risk of people being left on the floor.

The provider had systems and processes to detect and control potential risks in the home. Staff had received fire evacuation training. This ensured staff knew what to do in the event of an emergency to lessen the risks and keep people safe.

We had a walk around the home to make sure it was homely, suitable and safe. Feedback from people, and staff was positive on the support delivered. We observed the lift, hoists and falls mats were suitably maintained and operated correctly. Hazardous materials were securely stored. The building was accessible for people with mobility needs. People’s names were on people’s doors, which helped people with finding their way around the home.

Staff were clear on what their responsibilities were in relation to the upkeep of the home. There were cleaning schedules in place to guide staff. Maintenance of the home was well managed. Robust systems and processes were in place to ensure maintenance and services were up to date and there was clear information to demonstrate services and system checks were completed. The provider had ensured Personal Emergency Evacuation Plans (PEEPs) had been completed to show staff how to safely support people in the event of a fire or the need for a building evacuation. All the PEEPs reviewed were sufficiently detailed and easy to follow in the event of an emergency. The management team used a variety of method to assess, monitor and improve the quality of the service provided. Smoke alarms, fire extinguishers and fire doors complied with British standards and were regularly checked and serviced. The registered manager sought legal authorisation where people were subject to any restrictions for their safety. Where DoLS authorisations were granted, we saw the service ensured any conditions were met.

We received mixed feedback on staffing levels from people. However, most people we spoke with told us staff were responsive and attended to their needs. One person told us, “Everybody [staff], even the cleaner comes in everyday and chats with me.”

We received mixed feedback on staffing levels from staff. Care staff told us there were enough staff to meet people’s needs, however there were times when more staff were needed. Staff told us they felt supported by the management and were provided with the correct training to give them the skills they needed to work with people. One person told us, “Every day you learn more, and we do refresher training, I've learned so much here. I'm proud of the care we give.”

We saw staff worked well as a team to make sure tasks were completed, and they interacted with people in an appropriate way. Staff were visible and available in communal areas and people did not wait long for their support. Staff did not appear rushed, and treated people kindly and with respect.

The provider operated safe recruitment processes. Staff told us when they had been recruited and a range of checks including references, disclosure and barring checks (DBS) had been requested and obtained prior to starting work in the service. The information helps employers make safer recruitment decisions. Staffing levels were monitored by the registered manager and people’s needs were reviewed to establish if staffing levels were sufficient. This meant people's changing needs were considered when deciding the appropriate ratio of staff and ensured safe staffing in the event of emergencies. One staff member told us, “Staffing's got a lot better; we're using less agency, and our staff know residents.” Care plans did not indicate what level of supervision people required from their one to one staff member. This was discussed with the provider who stated they would review the care plans. Consultation had taken place with health and social care professionals to ensure people who required intensive oversight received one to one support from staff. There were processes in place to make sure staff received the support they needed to deliver safe care. When people tired of their one to one support, staff members were changed to promote positive outcomes for people. Staff received a handover meeting daily. They received a briefing on any issues that occurred, any outstanding tasks and any other relevant information to keep people safe. Care staff worked on all floors of the home if necessary, allowing them to get to know everyone living at Eachstep Blackburn.

Relatives confirmed that the home is always clean and tidy when they visit. One relative told us, “Everywhere is always clean."

We spoke with a member of the housekeeping team who told us they followed cleaning schedules to ensure the service remained clean and hygienic. They told us they had access to suitable cleaning equipment, personal protective equipment and had received appropriate training for their role.

We took a tour of the home, carried out observations and spoke with staff and relatives. We were assured there were effective processes related to the cleanliness of the environment, equipment and waste management.

The location had recently received a food hygiene rating of 5 from the food standards agency. The rating system, which is run in partnership with local authorities, gives clear information about businesses hygiene standards. The rating of 5 meant hygiene standards in the kitchen were very good.

People were offered patient support when taking their medicines and should the covert administration of medicines be needed, care was taken to ensure this was done safely. A GP led ‘ward round’ was carried out at the home most weeks, and where new medicines were prescribed these were started promptly. Checks were carried out to confirm people’s medicines on admission to the home, but on one occasion staff had not promptly followed-up missing information. One medicine was unavailable for 4 days however, when required medicines were used during this time to help reduce the impact of this. The electronic system prompted staff to help ensure that enough time was left between repeated doses of the same medicine. Charts were used to help ensure that medicine patches were placed on different body areas each time, but on occasion the application sites were not rotated as frequently as advised.

Staff spoke positively about the medicines training and managers completed staff competency assessments to help ensure policies were followed in practice. Managers completed medicines audits and incident reviews. Outcomes were shared both within and between sister homes to raise awareness and support learning. However, only a small sample of medicine records were checked at each audit, and we found some examples where medicines could not be accounted for because the electronic stock records did not tally with the actual quantities in stock.

Individual written information supported the administration of medicines and application of creams. However, we saw one record that had not been updated with new advice from a dietician and another where cream records had not been updated when the type of barrier cream used had changed. Allergy information was not correctly captured on one person’s record. Medicines were stored and disposed of safely. The required warning signage was in place where oxygen was stored or in use, however unused cylinders were not chained or clamped to reduce the risk of them falling over. Thickeners were stored safely, and staff we spoke with knew how to prepare drinks to the right consistency.