About the service:

This is the single care home within the provider’s current registration. The service is situated in a residential area of Datchet, with large green spaces surrounding the building. The building has three floors. The service provided accommodation and personal care to older adults, especially those with dementia. People lived in their own individual bedrooms. Rooms had ensuite bathroom facilities. There were also communal bathroom facilities, lounges and dining rooms. The service can accommodate up to 26 people. At the time of our inspection, 26 people used the service and there were 32 staff. For more details, please see the full report which is on our website at www.cqc.org.uk

People’s experience of using this service:

• Eton House Residential Home continued to provide exceptional care to people.

• People, relatives, staff and community professionals consistently described the service as outstanding.

• People were always protected against avoidable harm, abuse, neglect and discrimination. The care they received was safe.

• People’s risks were assessed and strategies put in place to protect them from avoidable harm.

• People experienced positive outcomes regarding their health and wellbeing.

• Staff support and training was excellent, particularly in the care of older adults with dementia.

• People and relatives provided consistently positive feedback about the care, staff and management. They provided examples of the outstanding care at the service and the positive changes that resulted in people’s lives.

• Care was person-centred and focused on ensuring people with dementia lived the best possible life.

• Care planning was based on people’s individual needs. People’s end of life wishes were recorded.

• The management team had embraced continuous learning, research and best practice, new ways of working and excellence in care techniques and practices.

• There was an extremely positive workplace culture and staff we spoke with provided excellent feedback about the management team. Staff were committed to and excited about their roles.

• 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.

• The service met the characteristics for a rating of “outstanding” in three of the five questions we inspected. Therefore, our overall rating for the service after this inspection was “outstanding”.

Rating at last inspection:

At our last inspection the service was rated “outstanding” (13 August 2016).

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

Eton House Residential Home is a care home without nursing that is registered to provide care for up to 26 people. During our inspection there were 24 people using the service.

The service had a registered manager. 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.

The majority of people who lived at Eton House Residential Home had a diagnosis of dementia. The registered manager ensured there was a joined up approach for staff to understand dementia; how it affected those who lived with it and how the environment and positive engagement with people were beneficial to people's well-being.

The service signed up to Care England’s ‘Dementia Pledge’ to demonstrate their commitment to provide great dementia care and this was taken further by the registered manager who took a pro-active approach to ensure staff received learning that would enhance best practice in the area of dementia care. The registered manager obtained a grant that helped the service to develop a physical environment that was ‘dementia friendly’.

People and their relatives were overwhelmingly positive. We heard various comments such as, “The care home goes beyond caring, it’s the best”, “The care offered here is pretty high”, “I think the home is very good”, “There’s lots of communication between staff and relatives”, “I think this is a lovely place and the staff do what they can to provide for a normal life” and “If this is where I have to live then this is where I want to do it.” We saw outstanding examples of how staff went "the extra mile" to ensure people's care needs were met.

Positive caring relationships were developed with people who used the service and staff demonstrated an excellent understanding of their care and support needs. The service continually strived to develop their staff team to ensure people were treated with compassion, kindness, respect and dignity. Observation records carried out by management ensured people were being treated with dignity and respect.

People were protected from the risk of harm at the service because staff were well-trained and fully understood their responsibilities in regards to safeguarding. People said they felt safe from harm. Fire safety evacuation plans and personal evacuation plans developed ensured people would receive the help required in the event of an emergency.

People were given their medicines safely by appropriately trained staff. There were sufficient numbers of staff to keep people safe and meet their care needs. People and their relatives showed appreciation that there was not a high turnover of staff.

Staff spoke positively about their supervision and professional development support received. For example, a staff member spoke about how they were supported in their current job role. They commented, “I am dyslexic but I am signed up on a leadership and management course. X (the registered manager) sees our potential, gives encouragement, sits down with you and lets you know how they will support you. This has really boosted my confidence.”

People had access to healthcare services. We saw good examples of the service working in partnership with a local commissioning group and other health professionals to ensure the best outcomes for people.

People participated in person-centred activities within the service and in the local community. We noted a wide variety of social activities were on offer. This included the involvement of students from local college and universities, who provided therapeutic activities (reminiscence) for people diagnosed with various forms of dementia.

Care plans and risk assessments were regularly reviewed and kept up to date. Reviews of care were undertaken to ensure the service was res

People told us the staff respected their dignity and privacy. One person said, “They make sure my door is shut when carrying out personal care.” One staff member told us, “When carrying out personal care, I would ensure the person is covered and speak to them at their level.” This meant people were treated with consideration and respect.

One person told us, “They always check on me. All I have to do is pull the cord and someone’s there.” We saw risk assessments were developed to prevent unsafe care.

People told us the home was fresh and kept clean. One person commented, “The toilets are clean, it’s a lot better than what it was.” Another person told us, “I would notice if it was dirty.” This showed the home provided and maintained a clean and appropriate environment that facilitated the prevention and control of infections.

One staff member told us, “…….I have a National Vocational Qualification (NVQ) level three certificate in health and social care. I could not start my job until all checks had been done.” This meant appropriate checks were undertaken before people staff began work.

People told us they knew what to do if they wanted to complain. One person commented, “I know who to approach if I am not happy. However I have never needed to complain.” This meant people were aware of the complaint process and understood what they should do if they needed to raise a complaint.

We spoke to three people at the home. All spoke positively about the care and support they received.

People told us about care and their care plans. One person commented, ‘It’s a book which tells them how to look after me.’ We asked people about the care and support they received. One person told us, ‘Staff treat me with respect and courtesy, some of the younger chaps can be a bit bossy.’ Whilst another commented, ‘Being here is like being at home’. “Staff do a really good job especially at night. I can pull the cord and somebody comes to you. I used to live by myself and was really scared that I would fall.” One relative told us, 'The service always involves in me in any decisions that have to be made.'

We observed staff interacting positively with people. We saw an individual who was upset, raising their voice at a member of staff and asking the same question repetitively. We observed the staff speaking calmly throughout, listening to them but speaking to them in a reassuring manner. We saw this approach had a positive effect on the individual, who eventually calmed down.

People told they would speak to staff if they had any concerns. One person told us, “I can tell them if I am not happy or being mistreated.” They told us the home had treated them well.

People told us whether they felt members of staff were trained to deliver care. One person commented, “The main staff are trained, not so much the new ones.”

Some people we spoke with told us they were happy at the service. They felt the activities provided were ok and that the staff did their best.

Some people said they did not know what a care plan was and that they had not seen one. However, they knew who their carer was and could recognise them by name and sight. They said they received good care from their carer.

People told us they enjoyed their meals and that they received enough food at each meal time.

People told us they felt safe at the service and that they were well looked after by their carers.

We spoke in detail with three residents and one relative during our visit to this home, and spoke with others more briefly throughout the day. In response to our interview questions, people told us that staff treated them well, and that they were able to express their views.

People told us they received the care they needed in a timely way, and would know who to speak to if they needed help. People told us their families were encouraged to be involved.Those we spoke with said they felt safe at Eton House, and as far as they could tell, staff were well trained for the work they were asked to do. We received a number of compliments about individual members of staff , and about the home as a whole. All those we spoke with said they were happy to be at Eton House.