The Care Quality Commission
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Archived: Eastfield Lodge Care Home

Overall: Requires improvement read more about inspection ratings

7 Stanley Road, Leicester, Leicestershire, LE2 1RF (0116) 270 3861

Provided and run by:
Eastfield Lodge Care Home LLP

All Inspections

8 March 2016

During a routine inspection

This inspection took place on the 8 and 9 March 2016 and was unannounced.

Eastfield Lodge Care Home provides residential and nursing care for up to 17 older people, who are living with dementia and may have a physical disability. At the time of our inspection there were 13 people in residence. Accommodation is provided over two floors with access via a stairwell with a stair lift. Communal living areas are located on the ground floor. The service provides single rooms. There is a walled garden which is in the main laid to lawn.

Eastfield Lodge Care Home 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.

Visitors we spoke with told us they believed their relatives to be safe at the service. We found the approach to people’s safety was not consistent. Whilst people could be confident that staff were knowledgeable about their role and responsibilities in reporting and acting upon potential abuse or avoidable harm their approach to maintaining people’s safety as a result of identifying risks was not always managed consistently.

In some instances we found that the emphasis on ensuring people’s safety meant people’s independence was compromised. Where risks had been identified and reviewed, potential risks were not supported by a care plan which detailed how risks were to be managed by staff to promote people’s welfare and safety.

There were sufficient staff to keep people safe, however we found staff knowledge and skills were not fully reflective of the needs of people who used the service. This meant staff were not always able to support people well.

People’s medicines were managed safely by nursing staff who reviewed people’s records to ensure their medicine had been administered as prescribed and were safely stored. We found that there were shortfalls in medicine administration guidance as people’s care plans did not sufficiently provide guidance as to how people who on occasions declined their medicine were to be supported.

The approach to staff induction, training and on-going supervision and appraisal was not consistent. There was no plan in place to structure staff development. Staff’s competency was not assessed and their opportunity to develop their skills and training was limited. This impacted on the ability of the service to determine and further develop the quality of the service it provides through staff development.

People enjoyed the meals provided and we found meals to be of a good quality, with people being offered choice. We found the dining experience for people could be improved to provide a more enjoyable time for people to socialise.

Staff were caring in their approach to people but the quality of care had the potential not to be consistent as the information contained within people’s care plans and other records was difficult to determine. We found there was a lack of cross referencing and consistency of information between different documents, which made it difficult to get an overview as to people’s needs.

People’s care plans contained information as to their nursing and personal care needs, but contained very little if any information about them as a person. We found this meant staff delivered care based on the completion of tasks, with little consideration as to how they could support the person in a way that met their individual needs.

People’s lifestyle and preferences were not factored into their daily lives as people’s opportunity to engage in and develop their care plans was limited. Information about people’s hobbies and interests had not been explored by staff, and therefore the opportunity for people to continue with their interests had not been planned for. People’s opportunity to take part in activities was further reduced as the activity organiser was limited as to the time they had to provide activities as they were required to providing personal care and support to people.

Concerns and complaints were recorded and we found examples of where these had been investigated and had brought about improvements to the service. However we found there was no clear audit trail identifying whether those raising the concerns had been made aware of the outcome and any action taken.

The leadership and management of the service and its governance systems were not robust, which impacted on the quality and consistency of care being provided and restricted the development of the service. The provider did not have a system to ensure themselves that the service they were providing was governed well and that they were meeting their obligations.

We found four breaches 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.

5 & 6 January 2015

During a routine inspection

This inspection took place on the 5 and 6 of January 2015 and was unannounced.

Eastfield Lodge Care Home provides residential and nursing care for 17 people, some of whom are living with dementia. At the time of our inspection there were 12 people in residence. The service is a converted Victorian building with accommodation on two floors.

Eastfield Lodge Care Home had a registered manager in post at the service 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.

Staff were able to tell us what action they would take should they believe somebody was being abused and were aware of the provider’s policies and procedures, which included whistleblowing.

People who used the service and visiting relatives told us they were satisfied with the care and support they received, and told us they were safe and well cared for. We saw staff supporting people and offering reassurance when they became anxious or distressed. People were supported by staff in a timely and sensitive manner, which meant people’s needs were met and that there were sufficient staff on duty.

Identified risks to people were managed by the use of maintained equipment that was used to support people safely and promoted their health and safety. The expertise of health care professionals was sought and followed where risks to a person’s care and welfare had been identified.

People received their medication as prescribed and their medication was stored safely. We found that the principles of the Mental Capacity Act (MCA) 2005 had not been correctly followed with regards to the administration of medication covertly (without the person’s knowledge).

People were supported by staff who had a good understanding of people’s needs and had received training. There were good communication systems within the service and staff told us they were supported by the registered manager, which meant all staff were kept up to date as to the needs of people.

People who used the service and visitors we spoke with were complimentary as to the service provided. Visitors of people using the service told us that the attitude and approach of staff was positive and that this had improved the lifestyle of their relatives.

People were protected under the Mental Capacity Act Deprivation of Liberty Safeguards (MCA DoLs). We found that appropriate referrals had been made to supervisory bodies where people were thought to not have capacity to make decisions themselves about receiving personal care and leaving the service without support.

People we spoke with were complimentary about the meals provided at the service. Meals were ‘home made’ by the chef; specialist diets and culturally appropriate diets were catered for. Where people were at risk of poor nutrition, advice from health care professionals was sought and their recommendations followed. This meant people were supported to eat and drink enough and maintain a balanced diet.

People we spoke with and their visitors told us they had good access to healthcare. Relatives of people using the service told us they were kept informed about any changing health care needs. Records showed people were referred to the appropriate health care professionals when necessary and that their advice was acted upon. Staff we spoke with were aware of the health care needs of people who used the service. This meant people were supported to maintain good health.

People who used the service and visitors told us they were supported by staff who were caring and attentive. People’s individual needs, including religious and cultural beliefs were met by the wider community and by staff.

We were told by those using the service and by their visiting relatives that their privacy and dignity was respected and promoted by the staff. And that people were consulted as to what was important to them and made decisions about their day to day lives. We saw throughout our inspection people being asked by staff for their opinions and on day to day decisions, such as what they would like to eat or drink. Staff told us how they promoted people’s privacy and dignity and offered choice when delivering personal care and support.

Our observations showed that people were supported by staff who knew about their individual needs. Staff responded to people when they needed assistance and encouraged people’s independence. Throughout our inspection we saw people being supported to take part in a range of group and individual activities, which they enjoyed. People using the service received visits from community groups who supported their cultural beliefs and some staff within the service were able to speak to those whose first language was not English.

People told us they had no reason to complain and visitors to people using the service confirmed this. However visitors were not aware of the complaints procedure, the registered manager took action to address this.

People who used the service, and their relatives and staff working at the service were complimentary about the registered manager saying they were confident to speak with them and found them to be approachable.

There were effective systems in place for the maintenance of the building and equipment which ensured people lived in an environment, which was well maintained and safe. Audits and checks were effectively used to ensure people’s safety and their needs were being met.

The records of the provider’s involvement in the service was limited and there was no evidence that they sought the views of people who used the service, their relatives or the staff working at the service.