Eachstep Blackburn

Updated 22 July 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors, a medicines inspector and two experts by experience undertook the inspection on day one. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. One inspector visited the service on day two.

Service and service type

Eachstep Blackburn is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Eachstep Blackburn is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced on the first day and announced on the second day.

What we did before the inspection

We reviewed information we had received about the service, such as notifications. These are events that happen in the service that the provider is required to tell us about. We also sought feedback from the local authority.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We observed how staff provided support for people to help us better understand their experiences of the care they received. We spoke with 12 people living in the home, nine relatives, six members of staff, the deputy manager, the manager and the director of operations. We also spoke with two visiting healthcare professionals.

We had a tour of the building and reviewed a range of records. This included five people’s care documentation, two staff files and a sample of people’s medication records. We also reviewed a range of records relating to the management of the service.

After the inspection

The provider sent us information about their planned actions in response to the findings of the inspection and the manager sent us additional information relating to the management of medicines.

Updated 22 July 2022

About the service

Eachstep Blackburn is a purpose built care home located near the centre of Blackburn. The home provides residential and nursing care up to a maximum of 64 people. There were 60 people living in the home at the time of the inspection. Accommodation is provided over three floors and all bedrooms are single with an ensuite toilet and shower room.

People’s experience of using this service and what we found

People told us they felt safe living in the home and were satisfied with the service provided. Staff understood how to protect people from harm or discrimination and had access to safeguarding adults’ procedures. There were sufficient staff deployed to meet people’s needs, however, we found some gaps in the recruitment records of new staff. There were shortfalls in some people’s care plans and records and risks to people’s health safety and well-being had not always been assessed and managed. The home had a satisfactory standard of cleanliness and staff had completed training on the prevention and control of infection. Medicines were not always managed safely.

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. People’s needs were usually assessed prior to them using the service. People were provided with a balanced diet; the dining experience on one floor was a pleasant social occasion. However, we made a recommendation to improve people’s dining experience on another floor. The provider had appropriate arrangements to ensure staff received training relevant to their role. The premises were light and spacious with themed areas. However, some walls and woodwork would benefit from redecoration. The operations director told us there was plans for redecoration and refurbishment.

Staff and relatives were concerned about a potential healthcare condition. This issue was discussed with the manager, who assured us they were seeking advice and support from medical professionals.

People were satisfied with their care and told us staff were kind and respectful. Whilst staff were caring, we noted there were limited interactions between the staff and people living in the home. The manager assured us this issue would be addressed. Staff respected people’s rights to privacy, dignity and independence.

People had individual care plans, however, whilst some plans had been completed other were incomplete and sections had been left blank. People spoken with could not recall discussing their needs and being involved in the development of their care plan. The manager explained a new electronic care planning system was due to be introduced.

Whilst the management team carried out a series of audits as part of the governance systems, we found shortfalls during the inspection in respect of the management of risks and medicines and the completion of records. We also found that people were given limited opportunities to express their views. We saw no evidence of group residents’ meetings and people had not been invited to complete a satisfaction survey.

The manager and director of operations were committed to making the necessary improvements to the service and sent us information on their intended actions following the inspection.

Rating at the last inspection

This service was registered with us on 13 October 2021 and this is the first inspection.

The last rating for the service under the previous provider was outstanding, published on 22 October 2020.

The rating at this inspection is requires improvement.

Why we inspected

The inspection was prompted in part due to concerns in relation to a lack of staff, medicine errors, management of healthcare condition, record keeping and the management of the home.

We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the management of risks, the management of medicines, the governance systems and record keeping. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.