Archived: Eastwood Lodge

We found the following examples of good practice.

• People who lived at Eastwood Lodge and staff underwent regular COVID-19 testing in line with government guidance. This ensured anyone who had contracted COVID-19 could be identified in a timely way.

• A recent outbreak of COVID-19 was well managed. The provider responded in line with their infection prevention and control (IPC) policy and current good practice guidance.

• Safety arrangements were in place for professional visitors to the home which included the completion of a COVID-19 risk questionnaire and temperature checks.

• People were supported to maintain contact with family and friends through video calls, telephone calls and emails. Plans were in place to support visits to the home by relatives and friends when it was safe to do so.

• Staff had received training about current good practice for IPC and how to use personal protective equipment (PPE) in the right way. We saw staff implemented their training throughout the visit.

• There were sufficient stocks of appropriate PPE and cleaning materials. We saw staff followed enhanced cleaning schedules during the visit.

Further information is in the detailed findings below.

About the service

Eastwood Lodge is a care home situated in the village of Woodall Spa in Lincolnshire. The service offers accommodation and provides personal care for up to 19 people aged 65 and over. There were 17 people living at the service at the time of inspection. Eastwood Lodge is laid out over two floors.

People’s experience of using this service and what we found

Staff received safeguarding training and understood how to protect people from abuse. Risks associated with peoples care had been assessed and measures were in place to reduce the risk of harm. People received their medicines safely. There were shortfalls identified in the recruitment process which had been picked up during an internal audit in October 2019. Actions were being taken to rectify this. Lessons learned had been implement following accidents and incidents, which were clearly monitored.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Peoples needs had been assessed prior to admission. Staff received training in relation to their roles and were knowledgeable about the support they were providing to people. Peoples nutritional needs were met. Peoples capacity had been assessed and best interest meetings were carried out.

Staff interacted with people in a positive way. People felt well treated and respectfully supported by staff. People were offered choice. They were encouraged to have ‘wishes’ and asked what they would like to do.

People had care plans in place. The management team were in the process of re-writing these to ensure they were person-centred and fully reflective of people’s needs. People were encouraged to join in activities. Information was accessible to people in different ways. Concerns and complaints were managed appropriately. People had end of life care plans in place.

The registered manager had a clear vision for the service and was working to fully embed this in the staff team. People and staff spoke about the management of the service in a positive way. Staff were clear of their roles. There were quality monitoring systems in place to ensure over sight of the service and care delivered, where shortfalls were identified, action plans were in place. The registered provider was open and honest when things went wrong.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 20th October 2018) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The home offers accommodation for up to 19 older people. There were 16 people living at the home at the time of the inspection, some of whom had needs associated with memory loss and dementia.

At the last inspection, in 27 January 2016, we rated the service as ‘Good’. During this inspection we found concerns about the safety of home. We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report. This is the first time the service has been rated as Requires Improvement.

At the time of our inspection there was a registered manager in place. A registered manager is a person who has been registered with the Care Quality Commission (CQC) to manage the service. Like registered providers they are “registered persons”. Registered persons have the legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated regulations about how the service is run.

During this inspection we found this service was not consistently safe. There were several concerns about how medicines were managed. This placed people at risk of not receiving their medicine as prescribed. Overall risks associated with people’s care and support were managed safely. Further work was needed to ensure behaviour support plans contain all the required information to guide staff support.

Staff had good knowledge of safeguarding processes. There were enough staff to keep people safe; however, people reported some short delays to their care. Safe recruitment practices were followed. The home was kept clean and infection control procedures were followed.

Mental capacity assessments were in place for people who were unable to consent to their care; however, further work was required to ensure people’s rights were fully protected. Some staff training was out of date and staff did not always receive regular supervision. There was a risk people may not receive the support they required with their health as some care plans lacked information and staff did not always have a good knowledge of people’s health needs. People told us that they were given choice of meals and said the food was good quality.

We found the service was caring. People were treated with respect and encouraged to make decisions. They were supported to live as independently as possible. People were given privacy and treated with dignity.

Most of care plans we reviewed clearly reflected people’s needs and staff had a good understanding of the support people required. There were detailed end of life care plans in place. People’s feedback about the activities available inside the home was positive. People told us that they liked visiting the local community with staff and that these trips were individual to them. Some people told us that they would like more opportunities to go into the community.

We found the service was not consistently well led. Audits were not consistently effective in identifying or addressing areas for improvements. The registered manager was responsive to feedback and took swift action to act upon our concerns. We received positive feedback on the leadership of the home. There was a positive atmosphere with in the service and evidence of cross-agency working. People, their representatives and staff had opportunities to feedback on the running of the service.

As part of our inspection visit we spoke with five people who lived at the home and a relative who visited the home. We also spoke with the manager, three staff members and a professional training assessor who visited the home.

People told us staff were caring and responsive to their needs. One person said, “Good staff equals good care.” A visiting relative said, “It’s like coming into someone’s home. Staff are casual but always caring.”

People told us they enjoyed all the meals at the home. One person we spoke with said, “I don’t like too much food so for each meal they balance it out so I get exactly what I want. I don’t like waste and they (staff) respect my wishes.”

We saw the environment was maintained appropriately and the manager responded to changes that were identified as needed to ensure the safety of people who lived there.

The home owners and manager demonstrated they had effective systems in place in order to respond to any or concerns complaints raised with them.

Overall we observed that people were supported by skilled and experienced staff who understood their roles and responsibilities.

We saw staff had received the appropriate checks before commencing employment and subsequently received training and support to enable them to provide the appropriate support to people.

We saw people were treated with dignity and supported to make decisions about their care. Care records were up to date and we saw care reflected what was written in the care plans.

The quality assurance systems in place enabled people to express their views about the services and care they received. People were encouraged to comment on how the home was run at meetings and on a day to day basis.

People told us they liked living at the home and they were well cared for. One person said, “Very nice,” and ”It’s lovely

People said the food was good and were given a choice at mealtimes. A relative told us, ”Food is ok” and “Staff are great.” They told us if they had any issues they would be able to discuss them with the staff.

When we spoke with a nurse visiting the home they told us the home provided good care and they had a good relationship with the home. They told us care was carried out as they recommended for people. They also said communication was good.