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East Dean Grange Care Home

Overall: Requires improvement read more about inspection ratings

Lower Street, East Dean, Eastbourne, BN20 0DE (01323) 422411

Provided and run by:
ASA Care Home Limited

Report from 7 March 2024 assessment

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Responsive

Good

Updated 15 July 2024

People received person-centred care and felt able to speak with staff should they have any concerns. People and their relatives were given the opportunity to give feedback and the provider had a robust complaint policy in place. Staff supported people to access external healthcare support should this be required. The deployment of staff sometimes meant people went some time without any interaction from staff. However, staff were mindful of people’s individual needs and provided information in a format which was accessible. Staff had undertaken equality and diversity training. We saw people’s care plans contained information about their wishes in relation to their social, cultural and spiritual needs. However, improvements were needed to ensure this information was in place for everyone. The registered manager and providers were receptive to the assessment feedback.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Person-centred Care

Score: 3

People received person-centred care and spoke positively about this. People told us that their wishes and preferences were obtained to shape their personalised care plan. One person said, “I have a daily wash down, I don’t like showers, I prefer a bath, it is very good as it goes up and down, so I feel safe.”

Staff were familiar with people's individual routines and likes and dislikes. They knew people well and understood the importance of providing person centred care and offering people a choice in relation to how they chose to live.

Staff deployment and having multiple roles was at times a hinderance in regard to interaction between staff and people. We saw periods of time when people were left with limited interactions with staff. People were able to move freely around the home. However, it did appear that some people were moving without direction and looking for support. These people were not always able to express their needs and were reliant on available staff knowing them and their needs.

Care provision, Integration and continuity

Score: 3

People and their relatives told us that people were referred to the GP when required. One relative told us staff were in regular contact with the GP and district nurses to ensure their loved one received the appropriate treatment and support.

Staff demonstrated good knowledge of what to do should someone need additional support or care. They were confident to contact the GP surgery at any time if they had any concerns or questions. If other health professionals were required, such as speech and language therapists (SALT), the initial referral was made through the GP. Staff told us there was a good relationship with professionals.

Staff worked well with external agencies to ensure good care provision and continuity. A healthcare professional told us, “Staff try hard to be transparent, overall they are really engaged, they really understand people's needs. They’re switched on with services that can support them.”

There were processes in place to enable provision and continuity of care. The registered manager had oversight of the referral system for health and social care provision. We did identify some missing information regarding wounds which led to concerns for people and risked care provisioning needs being missed. Apart from this, records showed that health care professionals were contacted promptly when a person’s health needs changed.

Providing Information

Score: 3

People and their relatives spoke positively about communication and told us they were kept up to date with information about their care and support needs.

Staff and the registered manager demonstrated knowledge of how people would like information to be provided and amendments were made where necessary. For example, large print documents could be used if needed.

Some processes were in place to aid people in understanding information, however, there were areas where this could be improved. For example, at the time of the site visit there were no picture menus available for people to aid them when making choices about food. Some people would have found this beneficial. At our feedback visit, these had been developed. The registered manager confirmed staff were able to use them when needed.

Listening to and involving people

Score: 3

People and their relatives were able to raise any concerns or complaints with staff. They told us they were confident that these would be addressed. One person said, “I would talk to the staff if I was worried about anything.”

Staff were approachable for people to raise concerns should they have any. Staff told us if people or their relatives raised any concerns or provided feedback, these would be listened to, shared with management and addressed.

Processes were in place to gather feedback from people and their relatives. People were asked for their feedback through surveys and resident / relative meetings. This included discussions about activities, meals and general day to day changes. Care plan reviews indicated that some people were involved in the review, but this was not clearly documented to demonstrate people’s comments. There was a complaint process and complaints were responded to appropriately.

Equity in access

Score: 3

People and their relatives were supported to have access to additional care and treatment if required. They told us that if there were any concerns with their health or well-being then professionals who could support them would be contacted.

Staff understood people’s needs and could pick up when additional support may be required. The registered manager told us that some people who required dental care were not able to visit a dentist. They told us, “If people can get out then we will take them, but for these people who were unable to we were able to contact a dentist who visited people at the home”.

The home had a good working relationship with a number of external professionals. This promoted people’s equity in access of these services when needed. One healthcare professional said, “Staff are switched on with services that can support them.”

Systems were in place to help ensure people were not prevented from receiving the care and support they needed due to their health or disability. The systems supported referrals to be made without delay. The management team had oversight of referrals which were required and ensured these were made promptly when extra support was needed.

Equity in experiences and outcomes

Score: 3

People were able to choose whether to join in with activities and if it was something they didn’t like, they were not pressured to join in. One person said, “People don’t always want to do activities, there is exercise and painting, no trips out.” Another told us, “I am a very expressive person, I like conversing with people but not always the activity that is on.” A further person said, “I can ask to go out for a walk and my family visit and always made welcome, my relative was recently given a small lunch which she appreciated.” A relative added, “[Person] does join in some of the activities if they appeal to him, he enjoys going for local walks.”

Staff understood people had a right to receive the care and support that met their individual needs. They told us how they supported people with their individual choices for example, in relation to their routines and what they wore. They told us some people liked to attend church and how they were supported to do this. Staff and relatives told us about a visitor who was developing an area of the garden into a sensory garden. They told us people enjoyed watching the progress and were hopeful that people would be able to join in with the work once the weather improved.

Some people’s care plans contained information about their wishes in relation to their social, cultural and spiritual needs. However, improvements were needed to ensure this information was in place for everyone. Records showed staff had received training in Equality & Diversity.

Planning for the future

Score: 3

People’s views regarding future plans, including end of life care, had been sought. Relatives told us how staff were aware of changes in people’s health and well-being over time and the support they provided around this. No one directly discussed end of life care with us as part of this assessment.

Staff worked with healthcare professionals to develop end of life care plans. No one was receiving end of life care at the time of our visit. Staff worked with healthcare professionals to support their development. We spoke with a healthcare professional who told us staff provided good care for people at the end of their lives. They said, “I am confident talking to families about end of life care because I know that staff will be able to provide the care.”

Processes were in place to support people plan for the future. People had ReSPECT forms in place (Recommended Summary Plan for Emergency Care and Treatment). These included whether or not the person wished to be resuscitated in the event of a cardiac arrest. There was information in the care plans to show if people had these in place.