Background to this inspection
Updated
14 February 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was carried out by one inspector and an assistant inspector on the first and second day of inspection. On the third day one inspector attended.
Service and service type
Eagle View is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced on day one and announced on the second and third dates.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from partner agencies and health professionals. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service, three relatives and two visitors about their experience of the care provided. Four health professionals provided feedback about the service during the inspection. We spoke with twelve members of staff including two area managers, the registered manager, two senior care workers, 3 care workers, 1 ancillary worker, 1 maintenance person, an activities co-ordinator and the cook. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four staff files in relation to recruitment, training and supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
14 February 2020
About the service
Eagle View is a residential care home providing personal care to 38 people at the time of the inspection. The service can support up to 42 people, some of whom may be living with dementia or a physical disability. The premises are in one adapted building over three floors.
People’s experience of using this service and what we found
Risks to people had not always been identified, assessed and measures put in place to mitigate them. Staffing levels and deployment were being monitored to ensure peoples safety and well-being was managed. We have made a recommendation about risk management. Accidents and incidents were recorded and managed appropriately. Overall medicines were managed safely, recording issues have been addressed in well-led section of this report.
Systems in place to support good nutritional intake were not effective. People did not always receive support from staff to eat and drink. Monitoring records to highlight concerns were incomplete which did not support health professionals to determine treatment plans. We have made a recommendation about this. Recruitment systems were robust. Staff supervisions and appraisals were being scheduled. We identified some gaps in training, which the registered manager took measures to address.
People had not always received regular activities. Records in this area did not demonstrate meaningful interactions with people that were living with a dementia related condition. The registered manager appointed a new activities co-ordinator and staff were due to support improvements in this area. We have made a recommendation about this. End of life care plans required further work to ensure peoples wishes were respected.
Governance systems were in place including quality audits. The registered manager acted promptly to rectify areas identified as needing improvement during the inspection and had already made improvements which were beginning to impact positively within the service. However, some areas were a work in progress and required time to demonstrate they could be sustained and embedded in practice.
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. Some improvements were needed to ensure that documentation was accurately completed and contained the information about how least restrictive options had been considered when making decisions.
People were treated with kindness and respect. The majority of staff knew peoples needs and how they preferred to be supported. Staff knew how to support people in a dignified way. Care plans needed further work to promote people’s independence.
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 good (published 1 February 2017). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to staffing and governance. These included gaps in training to support staff undertake their role; staffing levels and deployment of staff to meet people’s needs; various issues with records and audits highlighting areas that required improvements to be made.
You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.