This inspection took place on 30 October 2018 and was unannounced.

Eagle House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Eagle House is registered to provide accommodation for people who require nursing or personal care. The service can accommodate 46 people and predominantly provides care and accommodation for people who have enduring mental health needs or require nursing care. Accommodation and nursing care is provided over two floors in the main building. There are also four bungalows for people who are more independent. Each bungalow can accommodate up to four people. At the time of our inspection there were 38 people living at Eagle House.

Our last inspection of Eagle House took place on 13 November 2017. We rated the service requires improvement and we found there were two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There was a breach of Regulation 9; person-centred care because people’s care records did not always accurately reflect their needs and staff did not adequately document the support they provided to meet people’s needs. There was a breach of Regulation 17; good governance because the provider had not acted upon feedback provided by stakeholders to drive improvements to the service and the provider’s own audits were not always effective in identifying issues which needed to be acted upon.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the service to at least good. Although the service had started to make some improvements since the last inspection, at this inspection we found the service continued to be in breach of Regulations 9 and 17. We also identified a breach of Regulation 18; staffing.

There was a registered manager employed at Eagle House. A registered manager is a person who has registered with the CQC 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 and their relatives told us staff were kind and caring. Staff knew people living at Eagle House very well. People told us staff responded promptly when they needed support, however, some staff told us they felt more staff were needed on each shift.

The provider had failed to ensure staff received appropriate training, supervision and support to enable them to carry out their role effectively. The provider had not taken adequate steps to ensure staff were up to date with their training and staff did not receive regular supervision. The provider’s recruitment procedures required improvement, to ensure staff employed were thoroughly assessed as suitable to work at the service.

People told us they felt safe at Eagle House and people’s relatives raised no concerns about their family member’s safety. However, the risks involved in receiving and delivering care were not consistently assessed and kept under review.

Staff understood what it meant to protect people from abuse. They knew how to report unsafe practice. Staff were required to complete safeguarding vulnerable adults training however, at the time of this inspection, not all staff were up to date with this training.

Medicines were stored safely and securely, and procedures were in place to ensure people received their medicines as prescribed.

People told us they enjoyed the food served at Eagle House. The cook was flexible and accommodating and considered people’s dietary needs and preferences.

People's care needs were not always accurately assessed and some people’s care records needed updating to help promote the delivery

We carried out this inspection on 13 November 2017. The inspection was unannounced. This meant no-one at the service knew we were planning to visit.

This was the service’s first inspection since their registration with the Care Quality Commission (CQC) in September 2016.

Eagle House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Eagle House is registered to provide accommodation for persons who require nursing or personal care and treatment of disease, disorder or injury. The service can accommodate a maximum of 46 people and offers accommodation for adults aged 55 onwards. The service works with people who have enduring mental health needs or learning disability. The service is divided into residential support with self-catering accommodation or nursing. The residential support is situated in four bungalows. Each bungalow can accommodate up to four people at any one time. At the time of our inspection there were 43 people living at the service.

There was a manager at the service who was registered with the CQC. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered provider to take at the back of the full version of the report.

People we spoke with were mostly positive about their experience of living at Eagle House. They told us they felt safe and were respected.

Staff were provided with relevant training which gave them the skills they needed to undertake their role. We found that some staff were not receiving supervision and appraisal at the frequency stated in the registered provider’s own policy and procedures.

During the inspection we saw staff responded appropriately and saw there we sufficient staff to meet people’s needs. However, people who used the service told us there were not sufficient numbers of staff deployed at the weekend.

We found systems were in place to make sure people received their medicines safely so their health needs were met. However, we saw the guidelines in place to help staff administer medicines prescribed ‘as required’ needed to be more detailed to support people consistently and safely.

Staff recruitment procedures were in place. The registered provider ensured pre-employment checks were carried out prior to new staff commencing employment to make sure they were safe to employ.

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

A programme of activities was in place. However, we observed people living at the service not joining in with activities and were not provided with social stimulation, which was based on their preferences. The registered provider told us they appointed a new activities coordinator who was due to start working at the service.

We saw policies in place to treat people with dignity and respect. We found improvements were needed to practices to promote people’s dignity who lived at the service.

People had access to a range of health care professionals to help maintain their health. A varied diet was provided, which took into account individual dietary needs and preferences. This meant people’s health was promoted and choices could be respected.

People said they could speak with staff if they had any worries or concerns and they would be listened to.

There were systems in place to monitor