Eastfield Farm Residential Home Limited

Updated 9 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This service has previously been in Special Measures. While improvements had been implemented resulting in the removal of Special Measures at our previous inspection in December 2017, we did not revise the overall rating for this provider to 'Good' as this required a longer-term track record of consistent good practice. We carried out this inspection to assure ourselves there had been sustained improvement.

This inspection took place on 18 July 2018 and was unannounced.

The inspection team consisted of one adult social care inspector and one expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. On this occasion the expert had experience of older people and dementia care.

Before this inspection we reviewed the information, we held about the service, such as notifications we had received from the provider and information we had received from the local authorities that commissioned services with them. Notifications are when providers send us information about certain changes, events or incidents that occur.

We contacted the local authority safeguarding adults and quality monitoring teams, and the local Healthwatch to enquire about any recent involvement they had with the service. Healthwatch is the consumer champion for health and social care.

We reviewed information from a Provider Information Return (PIR) submitted prior to the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with five care staff, the cook, the registered manager, and the provider's nominated individual. We spoke with four people who used the service and three relatives. We spent time observing the interaction between people, staff and visitors in and around the home.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not communicate directly with us.

We spent time looking at records involved with the management of the home and running of the service. This included the care records for four people, including associated medication records and handover sheets. We looked at recruitment, supervision and training records for three members of staff.

Updated 9 August 2018

This inspection took place on 18 July 2018 and was unannounced.

We completed our last inspection at this service in December 2017 to check improvements had been made to meet the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At that inspection we found the provider had acted and implemented sufficient improvements to their systems, processes and practice which meant they were no longer in breach of regulation.

During this inspection we checked and found evidence the provider had sustained the actions for improvement of the service from our last inspection.

Eastfield Farm Residential Home Limited 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.

The care home accommodates 26 people in one adapted building. At the time of this inspection 22 people were living at the home and receiving a service.

We were assisted during our inspection by a manager who was registered with the Care Quality Commission (CQC). 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.

Systems and processes were in place to ensure staff recognised signs of abuse and any concerns were appropriately investigated to help prevent similar events.

The provider had reviewed systems and processes in place to monitor and improve the quality and safety of the service provided.

Risk assessments were in place for activities of care and support and the environment, to ensure the service remained safe for everybody.

The provider was compliant with the Mental Capacity Act 2005. Where the provider had concerns about people's capacity to consent to particular decisions, assessments were completed and decisions were made in the person’s best interest. Where people were unable to agree to restrictive practices to keep them safe the provider had submitted Deprivation of Liberty Safeguards applications to the local authority for further assessment.

The provider was in the process of implementing new technology to record the daily activities staff assisted people with. Staff had access to information reflective of people's individual needs. We found one instance where information was not up to date but this was remedied during our inspection.

People’s needs were assessed to ensure they received appropriate support to take their medicines safely as prescribed. Medicines were managed and administered according to national guidelines and best practice by staff who had been assessed as competent in this role.

The home was clean but despite regular deep cleaning of people's rooms on a rotating basis we found three people’s rooms had an unpleasant odour. Records confirmed the rooms were checked daily and the provider informed us new carpets were fitted the weekend following our inspection to remove the odours.

The laundry room was organised with new storage boxes for people's clothes.

The provider continued to use a tool which helped evaluate people's individual needs to identify the amount of staff required. This had resulted in increased staffing.

People were supported with their health and wellbeing. Drinks were provided throughout the day and a menu was provided with a choice of food for people. People received additional support from dietary and nutritional specialists where this was required.

People received information in a format they could understand. People's personal preferences and wishes were recorded and staff were aware of any diverse needs.

People continued to enjoy activities of their choosing and live fulfilled lives. Staff were available to support people with their individual interests and hobbies.

Appropriate checks were completed to ensure suitable staff were employed. Staff received training and support to ensure they had the appropriate skills and knowledge to perform their role.

The provider had improved the support staff received with supervisions and these included focused discussions with staff to test their knowledge on their role and tasks they completed.

Relatives told us there were no restrictions on the times they could visit people living at the home and that they were always welcomed by staff on arrival.

There was a formal complaints system in place to manage any complaints received.

The provider completed audits and checks to maintain and improve the quality of the service received by people.