Eastlake provides accommodation for up to 53 people who require personal care. At the time of our inspection 53 people lived here. Eastlake is a purpose built property and all rooms are en-suite. The home is split into four units each with their own communal areas. People are able to move freely around the home and units.

There was a registered manager in post. 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.

People and their relatives gave positive feedback about the home, and its staff. A relative said, “I can't say enough about the staff here, they've been brilliant”.

People were safe at Eastlake. Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.

There were sufficient numbers of staff who were appropriately trained to meet the needs of the people who live here. Staff recruitment procedures were safe to ensure staff were suitable to support people in the home. The provider had carried out appropriate recruitment checks before staff commenced employment. They had also checked to ensure staff were eligible to work in the UK.

People would be protected in the event of an emergency. Each person had a plan which detailed the support they needed to get safely out of the building in an emergency. Appropriate safety checks were carried out on equipment and fire safety systems.

Staff induction and ongoing training was tailored to the needs of the people they supported. Staff received regular support in the form of annual appraisals and formal supervision to ensure they gave a good standard of safe care and support.

People received their medicines when they needed them. Staff managed medicines in a safe way and were trained in the safe administration of medicines.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had enough to eat and drink, and received support from staff where a need had been identified. People’s individual dietary requirements where met. Drinks were readily available to people via the use of ‘hydration stations’ in addition to regular drinks supplied by staff. Overall people were happy with the quality of the food. Recent work had been done to make improvements to the meals in response to people’s feedback.

People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them. People’s health was seen to improve due to the care and support staff gave.

The staff were kind and caring and treated people with dignity and respect. Staff took time to sit and talk with people, and encouraged them to take part in activities. Caring interactions were seen throughout the inspection, such as staff holding people’s hands and making people feel good about themselves. The staff knew the people they cared for as individuals.

People received the care and support as detailed in their care plans. People and relatives were involved in reviews of care to ensure it was of a good standard and meeting the person’s needs. .

People had access to a wide range of activities. People and relatives were positive about the choice of activitie

Eastlake provides care and accommodation for up to 53 people. On the day of our inspection, 41 people were living in the home. The home is divided into different living areas with people receiving care and support in each living area. Many people were living with dementia.

The inspection took place on the 15 February 2016 and was unannounced.

A registered manager was in post. 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.

The registered manager did not undertake quality assurance process, including regular audits on health and safety, infection control and medication. The registered manager met CQC registration requirements by sending in notifications when appropriate. We found both care and staff records were stored securely and confidentially.

People were kept safe. We spoke with the registered manager upon arrival regarding access to the service. The registered manager advised key pads were in place on the first floor for people with dementia, to reduce risks of falling. During the inspection we saw a key code on one of the three exits form the first floor. This demonstrated the risk of people falling down the stairs had not been correctly assessed or managed. However the manager immediately took action and later confirmed that access that the door had been secured for safety.

Incidents and accident were fully investigated by the registered manager, and actions put in place to reduce the risk to people of accidents happening again such as people falling.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When people lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. We did not consistently see the code of practice being applied in the service. We have made a recommendation to the provider regarding this.

People received their medicines as they were prescribed and when they needed them. Processes were in place in relation to the correct storage, disposal and auditing of people’s medicines. One person told us “Yes, I have never missed any of my medicines.”

People told us care staff treated them properly and they felt safe. One person said; “ I feel safe here. I would talk to the team leader if I had not felt safe with staff.” Staff had written information about risks to people and how to manage these in order to keep people safe. One person had been assessed as being at risk of falls, we saw an action plan detailing actions for staff to undertake to minimise the risk to the person which detailed the appropriate call system and mobility assessments in care plans.

Staff had received training in safeguarding adults and were able to tell us about the different types of abuse and signs a person may show if they were being harmed. Staff knew the procedures to follow to raise an alert should they have any concerns or suspect abuse may have occurred. One staff member said “ If I noticed or suspected any abuse I would report it to one of the team leaders. If they were not available I would report to one of the care managers.” and “They have to escalate all abuse to the Surrey safeguarding team, CQC and police. I would recognise abuse through different ways; if people become nervous, have bruising or are timid when you approach them.”

Care was provided to people by a sufficient number of staff who were appropriately trained and deployed. People did not have to wait to be assisted. One person said; “Staff come

One person using the service told us "I love my room and I feel very blessed. I could not ask for more. The staff respect my privacy and if I do not want to do something they give me choices and suggestions. I am exceptionally happy and settled here".

During the inspection we observed staff speaking respectfully and kindly to residents. There were lots of conversations and laughter during breakfast and lunch time. People using the service were offered choice and if they did not want to do something, staff offered them alternatives and asked them what they would like to do.

Throughout the inspection people were seen spending time in their rooms listening to music, spending time on the computer, having their hair done and taking part in various activities. Other people were seen spending time with the cats that lived at the service.

People who used the service were allowed to decorate their rooms to their taste and had pictures and photos on the walls. All the rooms that we saw had ornaments and personal belongings on show.

A family member told us "the staff are really nice - it is nice to see the same faces when we visit. I feel very happy that she is safe here. I have a lot of confidence in this place". Another family member said "the staff are well trained and supported. They have the skills and qualities to do their jobs. The staff get to know their residents and know what they like and when to prompt them to do something".

We spoke with four people who used the service. One person said “I’m very happy here. People are very good to me and very kind. The food is nice, I always get a choice”. A second person said “Food is alright, sometimes it can be excellent. The staff do their best”. A third person we spoke with said “The staff are fine and provide good care”. The fourth person we spoke with said “The food is nice here”.

We found the service had completed comprehensive assessments of people’s needs in order to be able to provide the most appropriate care. We found people’s care plans had contained detailed risk assessments which had been regularly reviewed.

We saw the service had systems in place to deal with poor nutrition and people were provided with adequate food and hydration.

We found all staff had been trained in safeguarding and the service had up to date safeguarding and whistle blowing policies. We found the service had systems in place to monitor the ordering, storage and disposal of medicines. We found there to be one gap in the Medication Administration Recording (MAR) sheets.

The service had a recruitment policy in place which had been followed when they had employed staff.