This inspection took place on 15 and 16 January 2019 and was unannounced on the first day.

Northern Counties Eventide Home is registered to provide accommodation and personal care for up to 29 people. At the time of the inspection there were 24 people living at the home.

Eventide is a Victorian property situated in a residential area of Southport. Accommodation is provided over three levels and a passenger lift provides access to all floors. Facilities at the home include three lounge areas, a spacious dining room and gardens to the front and rear. The home operates as a charitable trust with strong links to the Christian faith.

Eventide is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of our inspection a manager was in post who had made an application to CCQ to become registered. A registered manager is a person who has registered with 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.

At the last inspection in June 2016 we rated the home as 'Good.' At this inspection, we rated it as 'Requires improvement'. This is the first time the home has been given this rating. This is because we found the service to be in breach of ‘Safe, care and treatment’ and ‘Good governance’ which are breaches of Regulation 12 and Regulation 17 of the Health and Social Care Act (Regulated Activities Regulations) 2014.

Systems in place to manage topical medication, thickening agent, PRN medications (as and when required medication) were not always being properly managed and systems to manage the quality and safety of the service were not always effective.

We found that topical medicines were not managed safely. This meant that people were at risk of not receiving their topical medication as prescribed and in a safe and appropriate manner.

We also found that the use of thickening agent in fluids was not recorded on fluid input charts. This placed people at risk as it was unclear as to whether thickening agent had been added to their fluids.

We looked at the management of PRN medication. We found that for some people who were on PRN medication (such as pain relief), staff had not recorded the time of administration and some people did not have PRN protocols in place.

We also found systems to manage the quality and safety of the home were not always effective. Although we saw evidence some audits were carried out in relation to the safety and cleanliness of the environment and for the management of medication, there were no audits in place in relation to written documentation such as care plans, daily records and risk assessments.

You can see what action we asked the provider to take at the back of the full version of this report.

All of the people we spoke with and their relatives told us they felt safe living at Eventide. Staff understood their responsibilities in relation to safeguarding people from abuse and mistreatment and were able to explain how they would report any concerns.

Arrangements were in place with external contractors to ensure the premises were kept safe.

We looked at how accidents and incidents were reported in the service and found they were managed appropriately.

We looked at recruitment processes which were in place. We reviewed personnel records for four members of staff. We saw that each staff member’s suitability to work at the service had been checked prior to employment to ensure that staff were suitable to work with vulnerable people.

We looked at care records belonging to four people. We saw that people’s care requirements were identified and people were ap

This unannounced inspection was conducted on 13 June 2016.

Situated in a residential area of Southport, Northern Counties Eventide Home provides accommodation and personal care for up to 29 people. The home is a charitable trust with strong links to the Christian faith. Facilities at the home include three lounge areas, a dining room, a patio area, car parking and gardens. A passenger lift is available for access to the bedrooms located over three floors.

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 people that we spoke with and their relatives told us that care was delivered safely and we saw that the home had systems and checks in place to monitor safety. Staff knew how to recognise abuse and discrimination and understood what action to take if they had concerns.

A personal emergency evacuation plan (PEEP) had been produced for each person living at the home. The home had conducted regular fire drills and fire alarm testing. Fire safety equipment was tested by external contractors annually and by the home on a regular basis. Other essential safety checks, for example, gas safety and electrical safety were completed annually.

Staff were recruited safely following a robust process. Staffing numbers were more than sufficient to safely meet the needs of people living at the home and provide additional one-to-one time.

People’s medication was stored and administered in accordance with good practice.

Staff were suitably trained and skilled to meet the needs of people living at the home. The staff we spoke with confirmed that they felt equipped for their role. Training was provided by an external organisation and refreshed annually.

The records that we saw showed that the home was operating in accordance with the principles of the MCA.

Meals were prepared from fresh ingredients and served in a well presented dining room. Tables were laid out with table-cloths, napkins, matching crockery and cutlery. People were given choice about their preferred meals and offered drinks regularly.

People were supported to maintain good health and to access healthcare services by staff. We saw records of visits by a range of healthcare professionals in care files.

People told us and we observed that staff were very caring in their approach. People were treated with respect and their dignity was promoted throughout the inspection.

Friends and relatives were free to visit people at any time and spoke positively about their experience of the home.

Records relating to care used personalised language and offered a detailed, positive view of each person and their care needs. People and their relatives were actively involved in the planning and review of care. We saw evidence that care had changed following such reviews.

The home described itself as having strong links to the Christian faith and we saw that people were encouraged and supported to follow their faith by the home. People’s rooms were filled with personal items and family photographs.

The home had a programme of activities including quizzes, crafts, chair exercises and a history club. Activities were also organised away from the home. For example, a trip on a canal boat.

People’s views about the quality of the home and the care provided were sought during reviews of care and informally through conversation. People told us that staff and managers regularly asked if they were satisfied with their care and if they would like to change anything. They also told us that they would feel confident in making a complaint if they had to.

The registered manager was supported by a management team with responsibility for specific aspects of the service such as; care ma

This was a follow-up inspection to see if the provider (owner) had made improvements to the care records, in particular the risk assessments and care plans for people living at the home. We did not speak to people who lived at the home as part of this inspection.

The care records we looked at showed the home had made the improvements required. Risk assessments were up-to-date and care plans had been updated to reflect people's needs.

We spoke to six people who used the service and one relative. All said they were happy with the care and support provided. They said staff were attentive and that they were listened to. They said that staff were always available when needed. Some comments made were:-

“It’s a lovely place. They treat me well.”

“It’s good here. I get the support I need. The staff are generally nice.”

“It’s absolutely wonderful. I couldn’t fault it. Staff are always around when I need them.”

We found that people had their nutritional needs supported.

We found that there were sufficient staff available to meet the needs of the people who used the service.

We found there were systems in place to find out the views of the people who used the service and their relatives about how the home operated.

Care plans and risk assessments were in place with information about people’s needs and risks identified. We found that some improvements were needed to these records to ensure that staff had access to all the information required to support the people who used the service.

During our inspection we invited people to share with us their views and experience of living at Northern Counties Eventide Care Home. We also spoke with relatives and community health care professionals who were visiting the home at the time of our inspection.

People living at the home were positive and complimentary about the care and support they received. One person told us the staff were “kind and thoughtful.” Another person said, “The home has a good ethos and atmosphere”.

Care record files were clear and concise. Care plans were in place which reflected people’s needs and they were reviewed on a regular basis. Arrangements were in place for cleaning the building and minimising the risk of infections spreading.

Effective structures were established for the recruitment of new staff. Arrangements were in place for monitoring the quality of the service, including the opportunity for people living at the home and their relatives to provide feedback on the service.

We spoke with some of the people who live at the home and with friends and family members who visit them. One person said that she has lived at Eventide for two years and it’s lovely, she’s really happy there. When we explained the purpose of our visit to another of the people who live there he said “You won’t have a hard job here, we are very well cared for.” Another person told us that he goes out regularly with members of his family.

One visitor we spoke with said that the person they visit has no close family. It was her own choice to go and live at the home and she had past connections with it. She is quite happy and never has any complaints.

Another person told us that her relative has lived at the home for several years. She is very satisfied with his care and he seems happy living there. She has never had to make any complaints.

Another person said that her relative has lived at Eventide for eight years. She is now very frail but she has been happy at the home and they look after her very well. The family has had no complaints and they have nothing but praise for the home.

All of the people we spoke with expressed their satisfaction with the standard of hygiene at the home.