Eckington Court Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Eckington Court Nursing Home provides nursing, personal care and accommodation for up to 50 older and younger people some of whom had dementia. On the day of our inspection there were 45 people living at the service, two of whom were in hospital.

We inspected on 5 June 2018 and the visit was unannounced. This meant the staff and the provider did not know we would be visiting.

At the last inspection in November 2016, the service was rated overall ‘Requires Improvement’, with a ‘Requires Improvement’ rating in both the Safe and Well Led domains. At this inspection, we found evidence to demonstrate and support the overall rating of ‘Good’.

The service had a registered manager. 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.

People told us they felt safe living at Eckington Court Nursing Home. Their relatives agreed with what they told us. Both the management team and the staff working at the service understood their responsibilities for keeping people safe from avoidable harm and abuse and knew to report any concerns to the relevant people, including the local authority and CQC.

People’s needs had been considered prior to them moving into the service and the risks associated with their care and support had been assessed and managed. There were arrangements in place to make sure action was taken and lessons learned when things went wrong, to improve safety across the service.

Plans of care had been developed for each of the people using the service and the staff team knew the needs of the people they were supporting well.

Appropriate pre-employment checks had been carried out when new members of staff had been employed, to check they were suitable to work at the service. An appropriate induction into the service had then been provided and relevant training completed to enable the staff to meet people’s individual needs.

People told us there were usually enough staff members to meet their current care and support needs. The exception to this would be if a staff member phoned in sick at the last minute. In these instances, the registered manager used existing staff members or regular agency workers to cover the shortfall whenever possible.

People told us the staff team were kind and caring and treated them with respect. Observations made during our visit confirmed this. People’s consent was always obtained before their care and support were provided and the staff team supported people in the way they preferred.

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 home supported this practice.

The staff team supported people to make decisions about their day to day care and support. They were aware of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) ensuring people's human rights were protected. Where people lacked the capacity to make their own decisions, these had been made for them in their best interest and in consultation with others.

People's food and drink requirements had been assessed and a balanced diet was being provided. Records kept for people assessed as being at risk of not getting the food and drinks they needed to keep them well were on the whole, up to date.

People received on-going healthcare support and had access to the relevant healthcare services.

People were supported with their medicines

This inspection took place on 22 November 2016 and was unannounced.

There is a requirement for Eckington Court Nursing Home to have a registered manager and a registered manager was in place at the time of this inspection. 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 service is registered to provide nursing and residential care for up to 50 people, including some people living with dementia. At the time of our inspection 41 people were using the service.

Medicines were not always well managed and administered. This was because not all people received their medicines as prescribed. In addition, records did not always accurately reflect what medicine people had received, or required.

Staff were not always available to provide care as required on the day of the inspection. The cover arrangements for when staff were unable to work due to illness, meant there was not always enough staff deployed to meet people’s needs.

Risks to people were identified and actions to reduce some risks were clearly recorded. However, other monitoring of risks to people’s health were not always clearly recorded.

Although checks on the quality and safety of services provided to people using the service were completed, they did not always result in consistent improvements.

The provider had taken steps to reduce the risks of abuse to people. Pre-employment checks were in place to help the provider make judgements as to whether staff applying to work at the service would be safe to do so.

Staff training was up to date and covered areas relevant to the care needs of people. However, staff were also being asked to complete checks on equipment that they had not been trained in, nor were competent to do so.

Most staff checked with people that they consented to their care and support. Policies and procedures were in place to ensure the principles of the Mental Capacity Act (MCA) 2005 were followed. Applications for assessments using the Deprivation of Liberty Safeguards (DoLS) had been made when required.

People were supported to enjoy mealtimes and received sufficient food and drink that met their nutritional needs. Staff were supported through supervision and training and demonstrated knowledge of people’s needs. People were supported to access other health care services as required.

Most of the time care and support respected people’s privacy and dignity. However we saw one occasion when this did not happen. People were supported by staff who were kind and caring. People’s choices and decisions were respected. People’s independence was supported.

People received personalised care from staff who understood them and their interests and hobbies. People were supported to engage in interests and activities that they enjoyed. People were asked for their views and people knew how to raise concerns or make suggestions.

The registered manager was viewed as being open and approachable and involved in the day to day management of the service. The registered manager was supported in their leadership by a supportive staff team.

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