Eastview Residential Home provides care for up to 14 older people. Some people using the service were living with dementia. At the time of this unannounced inspection of 18 December 2018, there were 13 people who used the service. This service was registered on 2 December 2010.

At our last inspection on 29 December 2017, we found five breaches of Regulation of the Health and Social Care Act 20018 (Regulated Activities) Regulations 2014. Improvements were needed with consent to care and treatment, how risks to people were monitored and managed, how people’s nutrition was managed and how the quality of the service was monitored by the provider. Improvements were also required to ensure safe recruitment procedures were followed and people’s care records were detailed and reflected how to meet their needs. We rated the service overall requires improvement. The key questions safe, effective, responsive and well-led were rated requires improvement. The key question caring was rated good.

At this inspection we found that improvements had been made and were ongoing. The provider was no longer in breach of any regulations. We were encouraged by the progress made by the management team to turn the service around and the overall rating has changed from requires improvement to good.

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.

Eastview Residential Home 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.

Eastview Residential Home provided a safe service to people. This included systems in place intended to minimise the risks to people, including from abuse, falls and with their medicines. Staff understood their roles and responsibilities in keeping people safe. They were trained and supported to meet people’s needs. Staff were available when people needed assistance and had been recruited safely. Where people required assistance to take their medicines there were arrangements in place to provide this support safely, following best practice guidelines.

People were cared for in a compassionate way by staff who understood their care needs. People were complimentary about the care they received and the approach of the management team and staff. Staff had developed good relationships with people. Staff consistently protected people’s privacy and dignity and promoted their independence.

People and their relatives where appropriate were involved in the planning of their care and people’s care records reflected their personal preferences. The care records were reviewed regularly and updated when people’s care needs changed.

People enjoyed a positive meal time experience and were supported to eat and drink enough to maintain a balanced diet. They were also supported to maintain good health and access healthcare services. Input from other professionals was sought where concerns were identified about a person’s health or wellbeing needs. Information about people’s healthcare needs was shared appropriately with other professionals to ensure continuity of care.

The registered manager and the staff understood their obligations under the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). 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 support this practice.

People were supported to pursue their hobbies and participate in activities that they chose. People knew how to complain and s

Eastview is a care home registered to provide care to 14 older people, some of whom may be living with dementia. At the time of our visit 13 people were living in the service.

At the last inspection on 30 June 2015 we rated the service ‘Good’ overall. At this inspection of 17 October 2017 we found that the service needed to make improvements in a number of areas. This included how risks to people were monitored and managed, how people’s nutrition was managed and how the quality of the service was monitored by the provider. Improvements were also required to ensure that care records reflected people’s needs in sufficient detail and that recruitment procedures were safe.

The service had 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 2008 and associated Regulations about how the service is run.

Risks to people were not consistently monitored and managed effectively. Where risks were identified the measures in place to reduce the risk were not always clear.

Care records did not contain enough information for staff to provide safe and effective care that met people’s individual needs. Staff we spoke with were not always aware of, or clear about the care people required and how this should be delivered. New staff had recently started at the service or were due to start after our inspection, and it was unclear how these staff would know how to care for people safely.

Where people had a low weight or were at risk of malnutrition, there were no clear plans stating how staff should support them to ensure they did not continue to lose weight. Staff practice we observed meant that we were not reassured that people were always actively encouraged to eat sufficient amounts.

The service did not practice safe recruitment procedures. This is because they did not always obtain appropriate identification, references and Disclosure and Barring Checks (DBS) before new staff were allowed on the premises.

The provider of the service did not assess and monitor the quality of the service and have systems in place to monitor the performance of the registered manager. This meant that areas for improvement we identified were not independently identified by the provider.

People told us there was enough competent staff to help them when they required it. However, improvements were required to ensure that the number of staff needed was calculated based on people’s social needs as well as their physical needs.

Staff told us they felt supported in their role. However, they did not consistently demonstrate a good knowledge of subjects they had received training in and this had not been identified by the service.

The service was not meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and complying with the principles of the Mental Capacity Act (MCA) 2005. Improvements were required to ensure that people’s capacity to make decisions was assessed and that plans were in place around people’s capacity to consent. Improvements were also required to ensure that a formal best interest’s process was followed where appropriate.

Improvements were required to the knowledge of staff and the registered manager around MCA and DoLS and how it applied to people in their care.

People told us and we observed that the staff were kind, caring and respectful towards them. People and their relatives were given the opportunity to feed back on the service and their views were acted on. Some improvements were required to ensure that people’s views about their care were reflected in care planning and care reviews.

Staff we spoke with knew people on an individual basis. Some care records contained information about people’s life history and some limited information about their likes and

Eastview Residential Home provides accommodation and personal care for up to 14 older people, some living with dementia.

There were 13 people living in the service when we inspected on 30 June 2015. This was an unannounced inspection. 

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.

There were procedures in place which safeguarded the people who used the service from the potential risk of abuse. Staff understood the various types of abuse and knew who to report any concerns to.

There were procedures and processes in place to ensure the safety of the people who used the service. These included checks on the environment and risk assessments which identified how the risks to people were minimised.

There were appropriate arrangements in place to ensure people’s medicines were obtained, stored and administered safely.

Staff were trained and supported to meet the needs of the people who used the service. Staff were available when people needed assistance, care and support. The registered manager was reviewing the staffing levels at the time of our inspection.  

People, or their representatives, were involved in making decisions about their care and support. People’s care plans had been tailored to the individual and contained information about how they communicated and their ability to make decisions. The service was up to date with changes to the law regarding the Deprivation of Liberty Safeguards (DoLS).

Staff had good relationships with people who used the service and were attentive to their needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.

People were supported to see, when needed, health and social care professionals to make sure they received appropriate care and treatment.

People’s nutritional needs were being assessed and met. Where concerns were identified about a person’s food intake, or ability to swallow, appropriate referrals had been made for specialist advice and support.

A complaints procedure was in place. People’s concerns and complaints were listened to, addressed in a timely manner and used to improve the service.

Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service. The service had a quality assurance system and shortfalls were addressed promptly. As a result the quality of the service continued to improve.

Prior to our inspection we had received a concern about the care provided. We checked what actions had been taken by the service as a result of these concerns. We found that the service had acted and implemented systems to reduce the risks of these concerns happening again.

We spoke with seven of the 12 people who used the service who told us that they were happy living in the service. One person said, "I am very happy." Another person said, "I'm well looked after, if I want something I just have to ask." Another said, "I am happy here."

People told us that the staff treated them with respect and kindness. One person said, "All the staff are very good." Another person said, “They (staff) are marvellous." Another said, "They (staff) are all very kind." This was confirmed in our observations during our inspection. We saw that staff interacted with people in a caring, respectful and professional manner.

We looked at the care records of four people who used the service and found that people experienced care, treatment and support that met their needs and protected their rights.

Staff personnel records that were seen showed that staff were trained and supported to meet the needs of the people who used the service.

We found that the service was clean and well maintained. Safety checks were regularly undertaken to ensure that people were provided with a safe environment to live in.

We spoke with six of the thirteen people who were using the service at the time of our visit. They told us that the staff treated them with respect and that their privacy was respected. One person said "They (staff) are smashing." Another person said "Staff are very good natured and helpful."

People told us that the staff listened and acted on what they said and that their needs were met. One person said "No fault with here, it is very good." Another person told us "They look after me very well, I have no complaints." Another person said "I like it here, I am happy."

People told us that they were provided with choices and sufficient amounts of food and drink. One person said "I enjoyed my lunch." Another person said that the food that they were provided with was "Lovely."

At our visit on 14 March 2011 we completed a Short Observational Framework for Inspection (SOFI). SOFI is a tool developed in conjunction with the University of Bradford. Using it we were able to observe the quality of care provided by the staff, including how they interact, engage and communicate with people living in the home and how they promote and respect people's individuality and dignity.

The SOFI followed five people who live in the home. Following this we spoke with six people and discussed their lives in the home. All were positive. A visiting professional told us a person who had recently been discharged from hospital was pleased to be back living in the home and was improving. We observed staff going to buy bacon because "that’s what people wanted".

One person living in the home said they were very happy and staff were very good to them. They commented staff were are all nice and they would highly recommend Eastview saying, “it is lovely living here and I would tell anyone to live here." Two other people told us staff treat them well, they are happy with the home and have no complaints.

Two people told us they like to sit outside when the weather is nice. Staff helped them to do this a few days ago but they decided to come in because it was too windy. Another person said they liked lunch but could not remember what it was. They said their favourite was fish and chips. Two people said they went out with relatives and said they were able to bring food and drink back for themselves.