Eastbourne House is a care home based in Whitley Bay which provides accommodation and personal care and support to older persons, some of whom are living with dementia. People living with dementia at the home were accommodated in an area named the ‘Grace Unit’. At the time of our inspection there were 51 people using the service. This was our first inspection of this service since it was registered with the Care Quality Commission (CQC).
This inspection took place on 10 and 11 September 2015 and was unannounced.
A registered manager had been in post until the week prior to our inspection and a new manager had already been appointed and was working at the home on the two days that we inspected. The newly appointed manager told us they were in the process of submitting an application to the Care Quality Commission to register themselves as the registered manager of this service. 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.
People spoke highly of the staff who supported them, saying they felt safe in their presence. Appropriate systems were in place to protect people from abuse and there were channels available through which staff could raise concerns. Records showed that matters of a safeguarding nature had been handled appropriately and referred on to the relevant local authority safeguarding team for further investigation, in line with set protocols.
Overall, people’s needs and the risks they were exposed to in their daily lives had been assessed and regularly reviewed. Environmental risks within the home had also been considered assessed and measures put in place to mitigate these risks. Medicines were managed and administered safely but some recording around medicines needed to be improved. Recruitment processes were robust and staffing levels were sufficient to meet the needs of the people who worked at the service.
Staff supervision and appraisal systems were in place, but supervisions did not always take place at regular intervals. The provider’s representative told us this would be addressed. Staff meetings took place regularly and staff told us they felt supported. Records related to staff training showed that this was up to date and staff received training relevant to their roles. Some of our observations highlighted that either staff training in dementia care was not detailed enough, or staff did not always apply the skills they had learned when supporting people with dementia care needs. In addition, the environment in the Grace unit where people living with dementia were accommodated did not reflect best practice guidelines. We have made a recommendation about this.
People were supported to meet their nutritional and general healthcare needs. A rotating varied menu was available with a wide variety of food choices. External healthcare professionals were contacted for help and support related to people’s care, as and when needed. Staff displayed caring attitudes and they promoted people’s privacy, dignity and independence. End of life care planning had been undertaken with those people who wished to plan in advance. Advocacy was arranged for those people who needed an independent person to act on their behalf and there was a policy for staff to refer to and follow.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA), including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. There was evidence to show the service understood their legal responsibility under this act and that they assessed people’s capacity when their care commenced and on an on-going basis where necessary. Decisions that needed to be made in people’s best interests’ had been appropriately taken.
Some records related to the care people needed and that which was delivered to them, were not always up to date or appropriately completed. However they were individualised. We have made a recommendation about this.
A varied activities programme was in place for those people who wished to partake in communal activities and for those who did not, the activities co-ordinator spent time with them on a one to one basis if they wished.
A complaints policy was in place for staff to follow and historic complaints that had been made had been handled in line with the provider’s policy. Surveys to gather people’s views and those of their relatives, staff and healthcare professionals involved with the home were carried out regularly and the results analysed to see where improvements to the service could be made. People were kept informed about the service and any changes via meetings or newsletters and promotional literature, which were distributed regularly.
Audits in key areas were carried out regularly alongside monitoring visits from the operations manager to review the service delivered. This was with a view to driving through improvements within the service. The provider had staff recognition and award schemes in place and worked in partnership with local community organisations to enhance the service provided to people within their care.