What life is like for people using this service:

The quality of care provided, leadership and oversight of the home had deteriorated since our last inspection. The provider had recently identified this and taken actions to address it. This included the deployment of a temporary manager experienced in service recovery and improvement. These actions had already begun to improve aspects of the quality of care in the service, but were not yet embedded.

A wide range of checks were completed by staff, the manager and provider to check the quality and safety of the service. We found some areas for improvement which the provider had not recognised. The provider agreed to review their approach and make necessary changes to include these.

People, their relatives, staff and local authority officers were positive about the arrival of a new manager in the home and the actions they had already taken. A deterioration in communication with people and their relatives about recent events had caused anxiety and frustration. The provider and manager recognised this and were taking steps to improve communication with people and the staff team.

There was enough staff on duty to keep people safe but included high numbers of temporary staff supplied via an employment agency. Several staff including senior carers had recently left. The recruitment of new staff had not been successful and remained a challenge. The provider was reviewing how this could be improved, an ongoing project to recruit suitable permanent workers was in place.

People felt the use of agency staff at times effected the experience they had of the service. The manager worked hard to provide consistent agency workers to overcome this.

People were supported to take their medicines in a safe way, but staff did not always have robust details on when to give medicines that were prescribed 'as and when required'. Staff did not consistently complete records to show if people had been given their medicines.

The environment was safe and people had access to appropriate equipment where needed. Staff understood and implemented procedures to reduce the risk of the spread of infection, using personal protective equipment where required.

Staff understood the need to keep people safe and what was required to do this. Staff had received training in this area, and were clear they would report concerns to a manager or appropriate outside agency without delay.

More information is in Detailed Findings below:

Rating at last inspection: At the last inspection the service was rated Good (Report published 4 May 2017). At this inspection we changed the overall rating to Requires Improvement.

About the service: Eastlands Care Home is a residential care home that is registered to provide accommodation and personal or nursing care to a maximum of 35 people. At the time of our inspection, 23 people were living there.

Why we inspected: This focused inspection was carried out in response to incidents that had occurred in the service and concerns that had been raised about the safety and management of the service. We did not inspect the key questions of Effective, Caring and Responsive because ongoing monitoring did not raise any information about risks or concerns in these areas.

Follow up: We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve the rating of the service to at least Good. We will require them to provide an action plan detailing how this will be achieved. We will revisit the service in the future to check if improvements have been made.

Eastlands Care Home provides accommodation and care for up to 35 people, many of whom were living with dementia. At the time of our inspection there were 28 people living in the home.

There was a registered manager in the home. 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.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good

People were supported by staff who knew how to protect them from harm and risks to people’s health and wellbeing were managed and mitigated. There were enough staff to meet people’s care and support needs.

Medicines were stored and managed in a safe way and people received them as prescribed.

Staff received training relevant to their role and were supported further through regular supervisions. People had a choice of food and staff supported them with dietary requirements. Referrals to external healthcare professionals were made in a timely manner and people were able to request when they wanted to see a doctor or nurse.

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

Occupation was supported by an activities coordinator. The activities coordinator would have benefited from more time and resources being allocated. People’s visitors were welcomed and there were no restrictions on when they could visit.

There was clear and visible leadership in place and the staff team felt supported by the management team. There were effective systems in place to monitor and assess the quality of service being delivered.

Further information is in the detailed findings below.

This inspection took place on 18 February 2015 and was unannounced.

Eastlands Care Home is a residential care home that provides accommodation, care and support for up to 35 older people, some of who are living with dementia. At the time of the inspection, there were 29 people living at Eastlands Care Home.

There was a registered manager in place. 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 and associated Regulations about how the service is run.

People were complimentary about the way they were treated and cared for by staff. Their needs were met and they felt safe living at the home. The staff were respectful and used a friendly and attentive approach when talking with and assisting people. People felt they could speak to the provider and staff if they were worried about anything.

Staffing levels had been increased and staff had completed training that was appropriate to their role. They knew how to make sure that people were safe and protected from abuse and had opportunities to develop the skills and knowledge they needed to provide support to the people living at the service.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to all care services. Policies and procedures were in place and staff had completed this training. People had been assessed in respect of their capacity to make decisions for themselves about their care. The manager had liaised with the supervisory body about making applications when people were at risk of having their liberty restricted or deprived.

People were consulted and involved in regular discussions about the care and support they required and received. Staff knew the care and support needs of each person and they encouraged people to maintain their independence. People had access to healthcare professionals when they became unwell or required specialist medical attention.

Medicines were available for people to take when they needed them, had been accurately recorded when administered and were stored securely.

Concerns were listened to and were dealt with and resolved as quickly as possible. People had been given the opportunity to raise their concerns and influence how the service was run. Suggestions for improvements to the service were listened to, by the manager, and acted upon, when possible.

Regular checks were made of the way staff worked, the records held and the maintenance of the premises. This made sure that the home was well run and people received the care and support they needed.

We spoke with 2 people and one relative to find out what it was like to live in Eastlands. They were very complimentary about the service and the staff. One person told us, "The home is excellent, I would give them 100% for how they look after my relative." We found that the environment supported people's privacy and dignity. Everybody living in Eastlands Care Home had their own room.

We found that care was provided according to people's assessed needs, wishes and preferences and helped them to maintain their independence. People's nutritional needs were being met.

We saw that there was a complaints policy and procedure in place and that staff were aware of the complaints procedure. People who used the service told us that they were aware of how and who to complain to.

An inspection visit on the 6 December 2012 was completed following concerns identified regarding the care plan documentation at the inspection visit of 23 August 2012. People’s care was not evidenced as planned and delivered in line with an individual care plan. That inspection found records within care plans were conflicting, not current and relevant information that should have been recorded was not included. The home had been in the process of changing recording methods for care plans for a number of months and information was not found that would have assured the correct, individual support was being provided.

This visit on 6 December 2012 gave us the information not found at the last inspection. Records were completed comprehensively, the information was current, all actions to minimise or prevent risks had been written and the care plans had documented that a monthly review had taken place since the last inspection.

We spoke with six people who lived at Eastlands and one relative of a person using the service. We were told that staff always talked to them about their care and that choices were offered.

People told us that they felt their individual needs were met. One person told us, “I can choose what time I get up and go to bed,” and another person said, “The care staff make sure I am safe when using the hoist. I prefer this method.” “I chose this home out of a number I visited and I know I made the best choice. This is a great home. The staff are good and know what is required. I cannot fault it in any way.”

People told us that they felt safe living in this home. One person said “I have peace of mind and feel safe now I am living here.”

Those people spoken with told us they were happy with their home. They told us they liked their rooms and that the lounges and quieter areas were comfortable.

A relative said, “The team of staff are very able, capable and have the right personalities to do the job.”

Time spent in the communal areas and with people spoken to in their own rooms demonstrated to us that the quality of the care provided was suitable for those who were receiving this service. Comments such as, “I tried many homes before choosing this one” and “I am very happy here and would not want to live anywhere else” were just some of a number of good comments received.

During our observations we could see people interacting, relaxed and involved in the day to day activities carrying on throughout the day.

People with whom we spoke told us that they liked living at this home. They said they felt safe and happy. People told us that the staff were very kind and one person said “Some staff have a good sense of humour”. They said there were enough staff available to meet their needs most of the time.

People said they liked the food at the home and described it as “very good”. One person said there was “too much” food given to her. People told us they could spend their day where and with whom they liked. One person preferred to stay in their room and staff respected this choice.

People with whom we spoke told us that if they had any concerns they would speak with the manager. People said they were sure they would be listened to and the manager would put things right if she could. People said they were treated with respect by staff.