Eastham is one of a number of services owned by Runwood Homes Limited. The service provides care and accommodation for up to 25 people who need assistance with personal care and may have care needs associated with living with dementia.

The inspection took place on 26 and 27 July 2017 and the inspection team consisted of one inspector.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manager 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.

At the last inspection on 3 and 4 June 2015, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’ and was meeting the fundamental standards. Although we found in one domain the service had reached the ‘Outstanding’ mark.

At the time of the inspection there were 24 people living at the service. The registered manager told us that this was now full capacity as a room that had previously been a ‘double’ occupancy room had been changed to a ‘single’ occupancy room.

The service was exceptionally responsive. People consistently experienced care that met their individual needs. People's lives had been enhanced as a result, often with outstanding outcomes which changed their lives.

The service was safe. Staff were deployed appropriately to meet people’s needs. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People’s needs were met by staff who had been recruited and employed after appropriate checks had been completed. Medication was dispensed by staff who had received training to do so.

The service was effective. People were cared for and supported by staff who had received training to support people to meet their needs. People were safeguarded from the potential of harm and their freedoms protected. Staff were provided with training in Safeguarding Adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported with their nutritional needs and had access to healthcare when required.

The service was caring. Staff were attentive to people's needs. Staff were able to demonstrate that they knew people well. Staff treated people with dignity and respect.

The service was well-led. The registered manager had been in post for a number of years and was knowledgeable about the people who lived at the service. The registered manager had quality monitoring processes in place to monitor and drive improvements at the service. The registered manager had a number of ways of gathering people’s views including talking with people, staff, and relatives.

Further information is in the detailed findings below.

During our inspection we spoke with 10 people who used the service and one person’s relative. All were positive about the standard of care at Eastham. One person told us told us, “I am happy here, I don’t want to go anywhere else.” Another said, “It (Eastham) is very good, I have got no complaints what so ever, I don’t think anyone will.”

People told us that the service was well led. One person remarked, “This place is excellently run.” Another person commented that under the registered manager’s watchful eye that, “Nothing goes a miss.”

People told us that they felt safe, and well looked after. They told us that staff supported them with their personal care, and when they become unwell, staff ensured that they were seen by a health professional within a timely manner. One person told us, “Staff are good to me…I don’t know all their names, but they are all good to me.”

We saw that people were given the opportunity to take part in group and one to one activities and build links with the local community. We saw that people were provided with a clean and homely environment.

People told us that they were given a choice of nutritious, home cooked meals and staff supported them to maintain a clean and homely environment. One person remarked, “Food is nice, I like my food.” Another person told us, “I have no complaints (about the food) what so ever.”

People who lived at Eastham had a range of complex needs including needs associated with dementia. People who were able to speak with us told us that they felt cared for, were given choices about every day activities and encouraged to be as independent as possible. One person said “There is plenty going on if you want to join in.”

A number of people were not able to tell us directly about their experiences. However, we observed that they were relaxed and they interacted positively in different ways with the staff. For example, people had one-to-one time with the staff who talked to them whilst painting their nails and people enjoyed the gentle way staff were assisting them to eat.

Eastham had all the necessary policy and procedures, records, quality assurance and monitoring systems in place for the protection of people who used the service. Staff were well trained and supported by the manager so that they could carry out their caring responsibilities effectively. People who used the service and their families were involved in their care arrangements and in helping to improve the service.

The inspection took place on the 3 and 4 June 2015.

Eastham is one of a number of services owned by Runwood Homes Limited. The service provides care and accommodation for up to 25 people who need assistance with personal care and may have care needs associated with living with dementia.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manager 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 showed a good knowledge of safeguarding procedures and were clear about the actions they would take to protect people. People were kept safe and risk assessments had been completed to help staff to support people with everyday risks. People’s medication was well managed and the service had systems in place to help ensure people received their medication as prescribed.

Recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. There were sufficient numbers of skilled, well trained and qualified staff on duty. Staff told us that they felt well supported to carry out their work and had received regular supervision and training.

People were provided and supported to eat and drink sufficient amounts to meet their nutritional needs. They were able to choose alternatives if they were not happy or did not like the choices offered on the menus.

People were supported to maintain good healthcare. They had access to a range of healthcare providers, such as their GP, dentists, chiropodists and opticians. The service kept clear records about all healthcare visits.

People had agreed to their care and that they had been asked how they would like this to be provided. They were treated with dignity and respect and staff provided care in a kind, caring and sensitive manner. Detailed assessments had been carried out and care plans were developed around the individual’s needs and preferences.

The Care Quality Commission monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and are required to report on what we find. The MCA sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The DoLS are a code of practice to supplement the main MCA code of practice. The registered manager had a good understanding of MCA and DoLS and appropriate documentation had been completed. Mental capacity assessments had been carried out where people were not able to make decisions for themselves. People had agreed to their care.

People knew who to raise complaints or concerns. The service had a clear complaints procedure in place which was clearly displayed. This provided information on the process and the timespan for response. We saw that complaints had been recorded and any lessons learned from them had been actioned.

The service had an effective quality assurance system. Meetings had been held for the people living at the service and for the staff. People felt listened to and that their views and opinions had been sought and the service had made appropriate improvements.